MLQ Ch. 55

The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms? A. Antispasmodic agents B. Anticholinergic agents C. Urinary analgesics D. Antibiotics

B

The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located? A. At the belt line B. Away from skin folds C. Over a bony prominence D. At the umbilicus

B

Which of the following is the most common symptom of bladder cancer? A. Pelvic pain B. Back pain C. Altered voiding D. Painless gross hematuria

D

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? A. Intermittent catheterizations B. Application of an ostomy pouch C. Irrigating the urinary diversion D. Exercises to promote sphincter control

B

Patients with urolithiasis need to be encouraged to: A. Limit their voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system. B. Increase their fluid intake so that they can excrete 2.5 to 4 liters every day. C. Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. D. Supplement their diet with calcium needed to replace losses to renal calculi.

B

The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with a temporary pouch. In gathering information for the client, which urinary diversion would the nurse select? A. Indiana Pouch B. Ileal conduit C. Kock Pouch D. Ureterosigmoidostomy

B

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply. A. Encourage patients to wear briefs. B. Perform hand hygiene prior to patient care. C. Provide careful perineal care. D. Assist the patients with frequent toileting. E. For those patients who are incontinent, insert indwelling catheters.

B, C, D

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply. A. Urinary retention B. Risk for impaired skin integrity C. Chronic pain D. Disturbed body image E. Deficient knowledge: management of urinary diversion

B, D, E

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer? A. Muscle spasm and abdominal rigidity over the flank B. Decreasing kidney function associated with fever and hematuria C. Deep flank and abdominal pain D. Painless, gross hematuria

D

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? A. Urge B. Functional C. Overflow D. Stress

A

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence? A. Consulting with a dietitian B. Giving the client a glass of soda before bedtime C. Encouraging intake of at least 2 L of fluid daily D. Taking the client to the bathroom twice per day

C

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to: A. A stricture or tumor in the bladder. B. Uninhibited detrusor contractions. C. Loss of motor control of the detrusor muscle. D. Compromised ligament and pelvic floor support of the urethra.

C

A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude? A. The pouch faceplate doesn't fit the stoma. B. A skin barrier was applied properly. C. The skin wasn't lubricated before the pouch was applied. D. Stoma dilation wasn't performed.

A

A female client who suffers from urethral strictures undergoes a dilation procedure and experiences a burning sensation while voiding. Which nursing instruction would be most helpful? A. Instruct the use of warm sitz baths. B. Urge the application of moisture sealants. C. Encourage a visit to a local ostomy support group. D. Advise cleansing of the perineum frequently.

A

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? A. Perform meticulous perineal care daily with soap and water B. Place the catheter bag on the client's abdomen when moving the client C. Use a clean technique during insertion D. Use a sterile technique to disconnect the catheter from the tubing to obtain urine specimens

A

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? A. Perform meticulous perineal care daily with soap and water B. Use clean technique during insertion C. Use sterile technique to disconnect the catheter from the tubing to obtain urine specimens D. Place the catheter bag on the client's abdomen when moving the client

A

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction? A. The nursing assistant places the drainage bag on the client's abdomen for transport. B. The nursing assistant places the drainage bag on the lower area of the wheelchair for transport. C. The nursing assistant keeps the catheter and drainage bag together when moving the client. D. The nursing assistant holds the drainage bag while the client moves to the wheelchair.

A

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? A. "My urine will be eliminated through a stoma." B. "My urine will be eliminated with my feces." C. "I will not need to worry about being incontinent of urine." D. "A catheter will drain urine directly from my kidney."

A

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do? A. Take the antibiotic for 3 days as prescribed. B. Be sure to take the medication with grapefruit juice. C. Understand that if the infection reoccurs, the dose will be higher next time. D. Take the antibiotic as well as an antifungal for the yeast infection she will probably have.

A

Which statement by the client who is performing self-catheterization indicates a need for further teaching? A. "I should perform self-catheterization every 4 to 6 hours." B. "I should lubricate the catheter before insertion." C. "I will need a sterile catheter kit each time I self-catheterize." D. "I will wash my catheter will hot soapy water."

A

Which instruction would be included in a teaching plan for a client diagnosed with a UTI? A. Drink coffee or tea to increase diuresis. B. Drink liberal amount of fluids. C. Take tub baths as opposed to showers. D. Void every 4 to 6 hours.

B

Which nursing diagnosis is appropriate for a client with renal calculi? A. Functional urinary incontinence B. Risk for infection C. Ineffective tissue perfusion (renal) D. Decreased cardiac output

B

Which term refers to inflammation of the renal pelvis? A. Urethritis B. Pyelonephritis C. Interstitial nephritis D. Cystitis

B

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? A. Renal cell carcinoma B. Acute glomerulonephritis C. Urinary calculi D. Ureteral stricture

C

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report? A. "Have you had a fever and chills?" B. "Do you get up at night to urinate?" C. "When did you last urinate?" D. "How much fluid are you drinking?"

C

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate? A. "Use scented powders to disguise any odor." B. "Try drinking coffee throughout the day." C. "Make sure to eat enough fiber to prevent constipation." D. "Limit the number of times you urinate during the day."

C

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization? A. administration of cleansing enemas B. procedure for insertion of the catheter C. type and size of the catheter to be used D. placement of the catheter

C

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following? A. Hyperuricemia B. Hyperparathyroidism C. Diabetes mellitus D. Pancreatitis

C

A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care? A. Administer pain medication every 2 hours. B. Clean the stoma with soap and water after the patient voids. C. Monitor urine output hourly and report output less than 30 mL/hr. D. Turn the patient every 2 hours around the clock.

C

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? A. High sodium B. High protein C. Low purine D. Low oxalate

C

The nurse advises the patient with chronic pyelonephritis that he should: A. Decrease his intake of calcium rich foods to prevent kidney stones. B. Limit his fluid intake to 1.5 L/day to minimize bladder fullness, which could cause backward pressure on the kidneys. C. Increase fluids to 3 to 4 L/24 hours to dilute the urine. D. Decrease his sodium intake to prevent fluid retention.

C

The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which factor as contributing to UTIs in older adults? A. Active lifestyle B. Low incidence of chronic illness C. Immunocompromise D. Sporadic use of antimicrobial agents

C

Which statement describing urinary incontinence in an older adult client is true? A. Urinary incontinence in the elderly population can't be treated. B. Urinary incontinence is a normal part of aging. C. Urinary incontinence isn't a disease. D. Urinary incontinence is a disease.

C

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site? A. Ureter B. Bladder C. Urethra D. Kidney

D

A client undergoes surgery to remove a malignant tumor followed by a urinary diversion procedure. Which postoperative procedure is the most important for the nurse to perform? A. Show photographs and drawings of the placement of the stoma. B. Determine the client's ability to manage stoma care. C. Suggest a visit to a local ostomy group. D. Maintain skin and stomal integrity.

D

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to: A. report bright pink urine within 24 hours after the procedure. B. report the presence of fine, sandlike particles through the nephrostomy tube. C. limit oral fluid intake for 1 to 2 weeks. D. notify the physician about cloudy or foul-smelling urine.

D

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal? A. Relieve any obstruction. B. Determine the stone type. C. Prevent nephron destruction. D. Relieve the pain.

D

Sympathomimetics have which of the following effects on the body? A. Constriction of pupils B. Decrease of heart rate C. Constriction of bronchioles D. Relaxation of bladder wall

D

The nurse is educating a patient with urolithiasis about preventive measures to avoid another occurrence. What should the patient be encouraged to do? A. Limit voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system. B. Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. C. Add calcium supplements to the diet to replace losses to renal calculi. D. Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation.

D

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client? A. Ginger ale at dinner time B. Milk at lunch C. Fruit juice midmorning D. Coffee in the morning

D

The nurse knows that which of the following body parts explains why cystitis is more common in woThe nurse knows that which of the following body parts explains why cystitis is more common in women? A. The ureters B. The rectum C. The bladder D. The urethra

D

When describing the types of bladder tumors that may occur, which type would the nurse identify as most common? A. Adenocarcinoma B. Squamous cell carcinoma C. Papillary carcinoma D. Transitional cell carcinoma

D

Which medication may be ordered to relieve discomfort associated with a urinary tract infection? A. Levofloxacin B. Ciprofloxacin C. Nitrofurantoin D. Phenazopyridine

D

Which of the following is the most common site of a nosocomial infection? A. Respiratory tract B. Gastrointestinal tract C. Skin D. Urinary tract

D