CH 35 Prep U
The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is:
bladder
Which assessment indicates to the nurse that a client may have a spastic bladder dysfunction?
incontinence
The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which statement?
"Alterations in bladder function can only occur when there is incontinence."
A young adult client is currently in a rehabilitation facility following a spinal cord injury at level T2. The nurse and client are discussing long-term options for continence management. Which statement demonstrates the client has a clear understanding of the issue?
"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."
In anatomy class, the instructor asks, "Explain how urine is expelled from the bladder during voiding." Which student has given the most accurate response?
"The detrusor muscle contracts down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder."
Following a health promotion class, which statement by a participant demonstrates an accurate understanding of the risk factors for bladder cancer?
"More than ever, I guess it would be worthwhile for me to quit smoking."
A client has a postvoid residual (PVR) volume of 40 mL. Which information would the nurse teach the client?
"This is a normal value."
A client has a postvoid residual (PVR) volume of 250 mL. Which information would the nurse tell the client?
"This value indicates you are having difficulty emptying your bladder."
One of the many tests done during urodynamic studies is the sphincter electromyelogram. What does this test study?
Activity of the voluntary muscles of the perineal area
A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?
Administration of alpha-adrenergic agonist drugs as ordered
Which type of pharmacologic therapy does the nurse anticipate administering to a client for treatment of a spastic bladder in order to decrease bladder hyperactivity?
Anticholinergic medications
A client asks the nurse what the most common sign/symptom of bladder cancer is. Which is the best response by the nurse?
Painless hematuria
A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and effective way to remember the transient and treatable causes of urinary incontinence is to use which acronym?
DIAPPERS
While studying about the process of urination, the nursing student learns that which muscle is known as the "muscle of micturition"?
Detrusor muscle
An older adult with urge incontinence and overactive bladder begins medication treatment with oxybutynin. Which side effects would the nurse include in the education?
Dry mouth and constipation are common.
A client reports urinary incontinence, specifically not feeling the urge to urinate until the bladder voids uncontrollably. Client history shows type 1 diabetes of 40+ years and compliance with medication and diet. What is the most likely diagnosis?
Incontinence related to neuropathy causing overactive bladder
A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 30.8 lb (14 kg) overweight. What conclusion can the nurse best draw about the etiology and pathophysiology of his bladder cancer?
It is caused by carcinogens that are excreted in the urine and stored in the bladder.
An older adult presents to the primary health care provider's office with a report of bladder leakage. Which assessment correlates with a diagnosis of stress incontinence?
Loss of small amounts of urine when laughing or sneezing
A nurse suspects a client may be experiencing flaccid bladder dysfunction based on 24-hour intake and output. Which diagnostic method is most likely to confirm or rule out whether the client is retaining urine?
Measurement of postvoid residual (PVR) by ultrasound
A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status?
Perform intermittent catheterization
A 71-year-old client reports to the nurse that he often notices a pink tinge to his urine. Upon further questioning, he states that he experiences no pain when voiding and has not noticed any change in the frequency of his voiding. Which response by the nurse is best?
Promptly report this finding to the client's health care provider.
Which events would suggest that an individual's physiologic response to an obstruction has progressed beyond the compensatory stage and is now in the decompensatory stage?
The detrusor muscle contraction becomes too short to expel urine completely.
A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?
Stress incontinence
A client is describing difficulty with urinating and informs the nurse that every time she coughs or laughs, she urinates and has begun to wear a thin pad. Which type of urinary incontinence is the client describing?
Stress incontinence
The nursing students have learned in class that causes of urinary obstruction and urinary incontinence include which of the following? Select all that apply.
Structural changes in the bladder Structural changes in the urethra Impairment of neurologic control of bladder function
The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer?
Surgical removal Radiation therapy Chemotherapy
An older adult client with an upper respiratory infection for several weeks has presented with urinary retention. The client reports taking nonprescription cold medications over and above the suggested dose. Which medication most likely is contributing to this urinary retention?
The anticholinergic effects of the medication are impairing normal bladder function.
Which client should have a feeling of bladder fullness?
The client with 200 mL of urine in the bladder
A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:
Urge incontinence
Which clinical manifestations would tell a nurse that a client is having progressive decompensation related to obstruction of urinary outflow?
When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized.
The nurse is providing care for a client newly diagnosed with a spinal cord injury. When the client asks why she can no longer control her bladder, which response by the nurse is the best explanation?
Your spinal cord injury has disrupted the control your brain has over your bladder. You will have to learn how to in-and-out catheterize yourself. You have a condition known as detrusor-sphincter dyssynergia.
The nurse is conducting preoperative teaching for a client with bladder cancer who is scheduled to undergo surgical creation of an alternative bladder reservoir. The nurse determines that the client is understanding the preoperative teaching when the client identifies the surgical treatment as:
cystectomy
A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer?
gross hematuria
A 56-year-old client reports urinary incontinence when laughing. The nurse documents this as which type of incontinence?
stress
A client is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which assessment data obtained by the nurse would indicate that the client should be screened for this disease?
Client reports that he occasionally has blood in his urine but has no pain with it.
