Chapter 35 Pathophysiology NCLEX-Style Review Questions

A client who has just been diagnosed with a spastic bladder asks the nurse what that means. What would be the nurse's best response? -"It is a problem with the amount of urine." -"It is a problem with storing urine." -"It is a problem with producing urine." -"It is a problem with getting rid of urine."

"It is a problem with storing urine."

The client who has just been diagnosed with bladder cancer asks the nurse what treatment he will have to undergo. What would be the nurse's best response to this question? -"You will need to ask your physician." -"It's whatever you prefer. You can have either chemo or radiation therapy." -"The methods used depend on the grade of the tumor and the lesion's invasiveness." -"I really do not have anything to do with the treatments."

"The methods used depend on the grade of the tumor and the lesion's invasiveness."

A client with bladder cancer asks the nurse, "What did the doctor mean by intravesicular chemotherapy? Am I going to lose all my hair and have to go for treatments over months and months?" The best response would be: -"This is when they put the chemotherapy directly into the bladder to kill any cancer cells." -"The doctor will place a scope up your urethra, into the bladder, and burn the lining of the bladder with a laser and then inject some tuberculosis bacillus into the lining." -"They will take you to radiology and inject some chemotherapy through your abdomen into your bladder." -"This is when they use a CyberKnife to cut off any lesions and then inject chemotherapy into the remaining portion of the bladder."

"This is when they put the chemotherapy directly into the bladder to kill any cancer cells."

For a normal adult, the client will sense fullness of the bladder when the bladder contains what amount of urine? -200 to 250 mL -100 to 150 mL -400 to 500 mL -300 to 350 mL

400 to 500 mL

Which client is at greatest risk of developing bladder cancer? -A 40-year-old black male with a history of prostate enlargement -A 65-year-old white male with a history of bladder stones -A 50-year-old white woman with a history of two bladder infections -A 30-year-old black female with a 2-year history of diabetes

A 65-year-old white male with a history of bladder stones

The nurse is evaluating client risk for the development of overactive bladder/urge incontinence and determines that which client is at highest risk for this condition? -A client embarrassed to use a bedpan -A client with a recent stroke -A client whose arthritis makes walking difficult -A client with diabetes mellitus

A client with diabetes mellitus

Which statement accurately describes the etiology of stress incontinence? -The involuntary release of urine related to a strong sense of urgency -The decrease in smooth muscle of the bladder causing increased urination -Overactivity of the voiding reflexes related to the nervous system damage -An increase in intra-abdominal pressure that results in involuntary urination

An increase in intra-abdominal pressure that results in involuntary urination

A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which medication should the nurse plan on the physician ordering to also treat this problem? -Anticholinergic medication -Calcium channel blocker -Cholinergic -Skeletal muscle relaxant

Anticholinergic medication

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: -Diathermy -Segmental surgical resection -Endoscopic resection -Cystectomy

Cystectomy

Which physiologic change in the elderly population contributes to urinary incontinence? -Increased bladder capacity -Decline in detrusor muscle function -Increased bladder contractility -Side effects of medication

Decline in detrusor muscle function

A client with a neurogenic bladder has a lesion at the level of sacral reflexes/peripheral nerves that innervate the bladder. The nurse anticipates the client will experience which type of bladder dysfunction? -Detrusor-sphincter dyssynergia -Spastic bladder dysfunction -Flaccid bladder dysfunction -Bladder paralysis dysfunction

Flaccid bladder dysfunction

A client diagnosed with urinary obstruction exhibits a weak, small urinary stream and hesitancy. The client most likely is experiencing: -Early obstruction -Compensation -Spasmodic response -Decompensation

Decompensation

Which reserve urinary structure helps to stop micturition when it is occurring and maintains continence under high bladder pressure? -Internal urethra -External sphincter -Urinary vesicle -Detrusor muscle

External sphincter

When conducting an admission interview with a client with a history of urinary incontinence, the nurse will specifically ask whether the client is prescribed which classification of medications in order to determine a possible cause? Select all that apply. -Hypnotics -Sedatives -Diuretics -Tricyclic antidepressants -Acetylcholines

Hypnotics, Sedatives, Diuretics

A female client asks the nurse if there is any noninvasive treatment to help with the involuntary loss of urine that occurs when she coughs or sneezes. Which is the best response by the nurse? -Implanted artificial sphincter -Kegel exercises -Periurethral injection of a bulking agent -Self-catheterization

Kegel exercises

A client is scheduled for urodynamic studies and asks the nurse, "What exactly is this study going to show related to my voiding problems?" Which nursing response(s) is accurate related to bladder function assessment via urodynamic studies? Select all that apply. -Pressure changes in the intra-abdominal area -Characteristics of urine flow during voiding -Intraluminal pressure changes along the entire urethra with the bladder at rest -Muscle activity of the external urinary sphincter -How fast (milliters/minute) the bladder can empty

Pressure changes in the intra-abdominal area, Characteristics of urine flow during voiding, Muscle activity of the external urinary sphincter

The nurse is conducting a community health education program on urinary retention and urinary incontinence. The nurse determines that the participants are understanding the education when they state that the most common cause of urinary retention is: -Chronic stress response -Pelvic inflammatory disease -Psychosocial disorders -Prostate enlargement

Prostate enlargement

A middle-aged man reports new-onset urinary changes. Which reported change(s) would lead the health care provider to suspect an early stage of obstruction is occurring? Select all that apply. -Constant pain in the back on the right side -Reports of bladder spasm -Bright red blood in the urine, especially in the early morning -Increase in number of times client urinates throughout the day and night -Diminished ability to suppress urination

Reports of bladder spasm, Increase in number of times client urinates throughout the day and night, Diminished ability to suppress urination

An older adult states that he awakens at least three times each night to void. When assessing the client, what potential causative factor should the nurse prioritize? -The client states that the majority of his fluid intake during the day is tea or coffee. -The client takes over-the-counter glucosamine supplements for the treatment of arthritis. -The client takes his prescribed beta-blocker and diuretic each evening at bedtime. -The client's father was diagnosed with bladder cancer when he was in his 60s.

The client takes his prescribed beta-blocker and diuretic each evening at bedtime.

Which nursing intervention would be most appropriate for the nurse to include on the plan of care of a client experiencing functional urinary incontinence? -Using adult diapers -Toileting the client every 2 to 4 hours -Placing the urinal within reach -Restricting client's use of diuretics

Toileting the client every 2 to 4 hours