ch. 61 practice questions

D

A patient reports experiencing involuntary loss and constant dribbling of urine because of an enlarged prostate. Which condition would the nurse document in the medical record? a. Urge incontinence b. Stress incontinence c. Reflex incontinence d. Overflow incontinence

a, c, e

A female patient has acquired a urinary tract infection (UTI) for the second time. Which information would the nurse include when teaching the patient measures to prevent future infections? Select all that apply. One, some, or all responses may be correct. a. Increase water intake. b. Take a vitamin A supplement daily. c. Wear loose-fitting cotton underwear. d. Clean the perineal area from back to front. e. Take prescribed antibiotics as directed, and schedule a follow-up appointment.

B

A male patient being treated for bladder cancer has a live virus compound instilled into the bladder as a treatment. Which instruction would the nurse provide for postprocedure home care? a. "Please be sure to stand when you are urinating." b. "Do not share your toilet with family members for the next 24 hours." c. "After 12 hours, your toilet should be cleaned with a 10% solution of bleach." d. "Your underwear worn during the procedure and for the first 12 hours afterward should be bagged and discarded."

a (Pregnant women with UTIs require prompt and aggressive treatment because simple cystitis can lead to acute pyelonephritis. This in turn can cause preterm labor with adverse effects for the fetus.)

A patient who is 6 months pregnant comes to the prenatal clinic with a suspected urinary tract infection (UTI). Which action would the nurse take? a. Refers the patient to the clinic health care provider for immediate follow-up b. Discharges the patient to her home for strict bedrest for the duration of the pregnancy c. Instructs the patient to drink a minimum of 3 L of fluids, especially water, every day to "flush out" bacteria d. Recommends that the patient refrain from having sexual intercourse until after she has delivered her baby

B

To which principle would the nurse adhere to minimize catheter-associated urinary tract infections (CAUTIs)? a. Use of indwelling catheter for routine measurement of urine b. Use of intermittent catheterization for postoperative urinary retention c. Use of antimicrobial catheters for patients who require a urinary catheter d. Use of antiseptic solutions to cleanse the periurethral area for routine hygiene

C

Which assessment would assist with the confirmation of the presence of stress incontinence? a. Abdominal assessment b. External genitalia assessment c. Asking the patient to cough while wearing a perineal pad d. Asking the patient to voluntarily start and stop urine flow during a void

B

Which care principles regarding discharge activities would the certified Wound, Ostomy, and Continence Nurse (CWOCN) teach a patient who has had a cystectomy? a. Respiratory care b. Stoma and pouch care c. Nutritional and dietary care d. Wiping from front to back (asepsis)

A, B, D

Which change associated with age contributes to the development of urinary tract infections (UTIs)? Select all that apply. One, some, or all responses may be correct. a. Immunity b. Fecal incontinence c. Decreased urine pH d. Decreased estrogen e. Use of medications with cholinergic properties

C

Which clinical finding in a postmenopausal patient with urethritis would the nurse attribute to low estrogen levels? a. Urinalysis indicates pyuria. b. Urethral culture is positive for bacteria. c. A pelvic examination shows tissue changes. d. Urinalysis indicates the presence of bacteria.

a, d, e

Which clinical finding would the nurse attribute to the presence of kidney stones? Select all that apply. One, some, or all response may be correct. a. Smoky urine b. Urine pH of 6 c. Odorless urine d. Increased serum calcium e. Increased serum phosphate

D

Which condition is likely to occur in a patient who is on immunosuppressant medication? a. Cystitis b. Acute infection c. Renal insufficiency d. Fungal urinary tract infection

a, d, e

Which factor in the medical history would the nurse ask about in a patient with urethritis? Select all that apply. One, some, or all responses may be correct. a. Pyuria b. Flank pain c. Antibiotic use d. Painful urination e. Sexually transmitted infection (STI)

a, c, d (Age contributes to the incidence of urinary tract infections (UTI) such as cystitis for a variety of reasons, including prostate enlargement in men and low estrogen levels in women. Diabetes mellitus causes excess glucose production that provides a medium for bacterial growth and development of UTI. Infectious cystitis is most commonly caused by pathogens from the bowel, which gain entry into the sterile environment of the bladder.)

Which factor may contribute to the development of infectious cystitis? Select all that apply. One, some, or all responses may be correct. a. Age b. Peritonitis c. Diabetes mellitus d. Bowel pathogens e. Elevated erythropoietin levels

a, b, c, d, e

Which factor would the nurse assess in a patient who is at risk for infectious cystitis? Select all that apply. One, some, or all responses may be correct. a. Diabetes mellitus b. Corticosteroid use c. Antibiotic therapy d. Indwelling catheter e. Compromised immunity

B

Which finding would the nurse anticipate when assessing the perineal area of a female patient who suspected of having a urinary tract infection? a. Vaginal discharge b. Pink urethral meatus c. Inflamed labial tissue d. Ulcerations around the urethral meatus

a, b, d

Which food would the nurse instruct the patient with urinary calcium oxalate stones to avoid to prevent future stone formation? Select all that apply. One, some, or all response may be correct. a. Spinach b. Black tea c. Sardines d. Rhubarb e. Organ meats

D (Although instructions to avoid douches, drink cranberry juice, and urinate before and after sex may be helpful, they are geared toward prevention of urinary tract infections)

Which information would be beneficial for the nurse to include when teaching a patient with urinary incontinence? a. Avoid using douches. b. Drink cranberry juice. c. Empty your bladder before and after sex. d. Avoid exercises such as running and jogging.

a, b, e

Which information would the nurse include when providing preoperative education to a patient scheduled for extracorporeal shock wave lithotripsy? Select all that apply. One, some, or all responses may be correct. a. "Be sure to finish all of your antibiotics." b. "Your urine will be strained after the procedure." c. "You will need to change the incisional dressing once a day." d. "Immediately call the health care provider if you notice bruising." e. "Remember to drink at least 3 L of fluid a day to promote urine flow."

B

Which information would the nurse include when teaching a patient about preventing further flare-ups of cystitis? a. Take tub baths often. b. Consume at least 2 to 3 L of fluids daily. c. Empty the bladder at least every 6 hours. d. Wash the perineal area with antiseptic solution.

B, D, E

Which information would the nurse include when teaching a patient about the administration of trimethoprim/sulfamethoxazole for treatment of urinary tract infection? Select all that apply. One, some, or all responses may be correct. a. Monitor the pulse twice daily while taking this drug. b. Drink a full glass of water with each dose of the drug. c. Avoid taking the drug within 2 hours of taking an antacid. d. Wear sunscreen and protective clothing when out in the sun. e. Disclose any allergies to sulfa drugs before beginning therapy.

a, b, d, e (Emptying the bladder is important, but not keeping it empty)

Which information would the nurse include when teaching a patient about the administration of trimethoprim/sulfamethoxazole to treat a urinary tract infection? Select all that apply. One, some, or all responses may be correct. a. Take this drug with 8 oz of water. b. Drink at least 2 to 3 L of fluids every day. c. Try to urinate frequently to keep the bladder empty. d. Be certain to wear sunscreen and protective clothing. e. You will need to take all of the drug to get the benefits.

a (Douching is an unhealthy behavior because it removes beneficial organisms, as well as the harmful ones)

Which instruction would the nurse include when educating a female patient about hygiene measures to reduce her risk for a urinary tract infection (UTI)? a. Wipe from front to back. b. Use only white toilet paper. c. Douche, but only once a month. d. Wipe with the softest toilet paper available.

a, b, c

Which instruction would the nurse include when teaching a female patient about cystitis? Select all that apply. One, some, or all responses may be correct. a. If urine remains cloudy, call the clinic. b. Try to take in 64 oz of fluid each day. c. Be sure to complete the full course of antibiotics. d. Expect some flank discomfort until the antibiotic has worked. e. Cleanse the perineum from back to front after using the bathroom.

D

Which instruction would the nurse include when teaching a patient measures to decrease the risk for urinary tract infection (UTI)? a. Limit fluid intake. b. Limit sugar intake. c. Increase caffeine consumption. d. Drink 2 to 3 L of fluid daily.

a, d, f

Which intervention would be helpful in preventing bladder cancer? Select all that apply. One, some, or all response may be correct. a. Stopping the use of tobacco b. Drinking 2½ L of fluid a day c. Using pelvic floor muscle exercises d. Showering after working with or around chemicals e. Wearing a lead apron when working with chemicals f. Wearing gloves and a mask when working around chemicals and fumes

a, b, c

Which nonsurgical method would the nurse teach a patient to manage stress incontinence? Select all that apply. One, some, or all responses may be correct. a. Perform Kegel exercises. b. Reduce excess body weight. c. Practice vaginal cone therapy. d. Walk to strengthen pelvic muscles. e. Use artificial sweeteners instead of sugar.

C (Elevating the collection bag above the bladder causes reflux of pathogens from the bag into the urinary tract.)

Which nursing activity illustrates proper aseptic technique during catheter care? a. Irrigating the catheter daily b. Sending a urine specimen to the laboratory for testing c. Positioning the collection bag below the height of the bladder d. Applying povidone-iodine ointment to the perineal area after catheterization

D (Encouraging fluids, though a valuable practice for patients with catheters, will not necessarily prevent the occurrence of UTIs in the hospital setting. In some patients, their conditions do not permit an increase in fluids, such as those with congestive heart failure and kidney failure. Irrigating catheters daily is contraindicated; any time a closed system is opened, bacteria may be introduced)

Which nursing intervention or practice is most effective in helping to prevent urinary tract infections (UTI) in hospitalized patients? a. Encouraging patients to drink fluids b. Irrigating all catheters daily with sterile saline c. Recommending catheters be placed in all patients d. Periodically re-evaluating the need for indwelling catheters

a, b, c (most postoperative patients should have the indwelling catheter removed by the third day after surgery because the risk for a urinary tract infection (UTI) increases due to bacterial colonization as early as 48 hours after catheter insertion. Urinary catheterization in incontinent older adults is unnecessary because it can be better managed with less risk for UTI using adult incontinence pads. The comatose patient with hourly intake and output monitoring must have a urinary catheter in place to keep an accurate record of fluid balance. The patient who is incontinent and has perineal skin breakdown may need to keep the indwelling catheter to maintain clean and dry skin to promote wound healing.)

Which patient with an indwelling urinary catheter would the nurse reassess to determine if continued catheterization is necessary? Select all that apply. One, some, or all responses may be correct. a. Patient in post-anesthesia care b. 3-day postoperative patient c. Incontinent older adult in long-term care d. Incontinent patient with perineal skin breakdown e. Comatose patient with hourly intake and output monitoring

B, D, E (The older-adult patient with dementia would not benefit from community resources and support groups because of the patient's cognitive difficulties. Urinary calculi typically are not a long-term problem that require community resources and support groups.)

Which patient with long-term urinary problems would the nurse refer to community resources and support groups? Select all that apply. One, some, or all responses may be correct. a. 80-year-old with dementia b. 32-year-old with a cystectomy c. 48-year-old with urinary calculi d. 44-year-old with a Kock pouch e. 78-year-old with urinary incontinence

a, d, e

Which risk factor is associated with bladder cancer? Select all that apply. One, some, or all responses may be correct. a. History of cigarette smoking b. Infection by Klebsiella pneumoniae c. Repeated use of indwelling catheters d. Infection by Schistosoma haematobium e. Exposure to textile industry chemicals

a, b, d

Which statement by the nurse to a patient with diabetes regarding the risk for stone formation is correct? Select all that apply. One, some, or all responses may be correct. a. "What you eat may contribute to the formation of stones." b. "Obesity is known to play a part in the formation of stones." c. "The chance of you developing stones is low because you are young." d. "Metabolic issues have a strong association with stone formation." e. "Family history of stones does not increase the chances of you having them."