Chapter 27 Nursing Care of Patients with Urinary Tract Disorders

A female patient has a history of repeated urinary tract infections (UTIs). What should the nurse include in the assessment of this patient? A. Preferred method of birth control B Employment status C Height and weight D Activity status

Answer: A Explanation: A. Risk factors for UTIs include sexual intercourse and the use of diaphragm and spermicidal compounds for birth control. 2. Employment status does not have a direct relationship to repeat UTIs. 3. Height and weight do not have a direct relationship to repeat UTIs. 4. Activity status does not have a direct relationship to repeat UTIs.

A patient is being instructed on how to perform Kegel exercises. What should be included in these instructions? Select all that apply. A. Take a deep breath and hold while performing the exercise. B. Perform these exercises at least once per day. C. While voiding, stop the flow of urine and hold for a few minutes. D. Tighten the muscles around the anus to resist defecation. E. Perform these exercises for at least several months.

. Answer: C, D Explanation: C. The patient begins Kegel exercises by identifying the pelvic muscles by stopping the flow of urine during voiding and holding for a few seconds. D. The patient begins Kegel exercises by identifying the pelvic muscles by tightening the muscles around the anus as though resisting defecation. 3. The patient should keep abdominal muscles and breathing relaxed while performing Kegel exercises. 4. The exercises should be performed twice a day, 25 repetitions each time. 5. It is important to establish a routine because these exercises should be continued for life.

The nurse is caring for a patient with a urinary stoma. In which order should the nurse provide care? Place in order the steps of the process. Choice 1. Cleanse the skin around stoma with soap and water, rinse, and pat or air-dry. Choice 2. Assess the stoma, noting color and moisture. Choice 3. Remove the old pouch; use warm water to loosen the seal. Choice 4. Use the stoma guide to determine the size of the bag opening and/or protective ring. Trim as needed. Choice 5. Apply the bag with an opening no more than 1-2 mm wider than the outside of the stoma. Choice 6. Apply a skin barrier; allow the skin to dry, then connect the bag to the urine-collection device.

Answer: 3, 2, 1, 4, 6, 5 Explanation: Choice 1. This is the third step. Choice 2. This is the second step. Choice 3. This is the first step. Choice 4. This is the fourth step. Choice 5. This is the last step. Choice 6. This is the fifth step.

The nurse is preparing to collect a urine culture specimen from a catheterized patient. What should the nurse do to safely obtain this specimen? A. With a sterile syringe, aspirate several milliliters of urine from the sampling port using sterile technique. B. Disconnect the catheter from the drainage tubing and allow 1-3 mL of urine to drain into a sterile specimen container. C. With a sterile syringe and needle, aspirate 50 mL of urine from the catheter above where it is connected to the drainage tubing. D. Empty a small volume of urine from the urine collection bag into a sterile specimen cup.

Answer: A Explanation: A Several milliliters of urine can be aspirated with a sterile syringe from the sampling port using sterile technique. 2. The urinary catheter and drainage system should remain a closed system to prevent infection. 3. The urinary catheter and drainage system should remain a closed system to prevent infection. 4. Urine in the drainage bag has collected over several hours and is not fresh, as needed for a culture specimen.

An 80-year-old female patient says to the nurse, "I can't hold my water very well so I don't leave the house much." What is an appropriate nursing response? A. "This is not something you have to live with. Talk with your doctor about this problem." B. "I understand." C. "I guess it's hard getting older." D. "Do you get enjoyment out of watching television?"

Answer: A Explanation: A. Although urinary incontinence rarely causes serious physical effects, it frequently has significant psychosocial effects and can lead to lowered self-esteem, social isolation, and even institutionalization. Patients should be informed that urinary incontinence is not a normal consequence of aging and that treatments are available. 2. The nurse must give a response that addresses the problem while showing empathy. 3. The nurse must give a response that addresses the problem while showing empathy. 4. Asking the patient about television viewing has no relevance.

A patient is diagnosed with struvite kidney stones. What interventions should the nurse anticipate being prescribed for this patient? A. Surgical intervention and antibiotic therapy B. Limiting foods high in calcium and taking thiazide diuretics C. Sodium-restricted diet and taking penicillamine

Answer: A Explanation: A. Management of the patient with struvite kidney stones includes surgical intervention or lithotripsy to remove the stone and antibiotic therapy for urinary tract infections (UTIs). 2. Limiting foods high in calcium and prescribing thiazide diuretics is common management for the patient with calcium phosphate and/or oxalate kidney stones. 3. Sodium restriction and penicillamine therapy are part of the treatment for cystine stones. 4. A low-purine diet and potassium citrate are prescribed commonly for uric acid stones.

An older female patient asks why she is having more urinary tract infections (UTIs) now that she is older. What should the nurse explain is a contributing factor to the incidence of UTIs among older adult females? A. Loss of tissue elasticity B. Enhanced immune response C. Reduced risk of urinary stasis D. Reduced and less protective prostatic secretions

Answer: A Explanation: A. The loss of tissue elasticity results in changes in bladder position, which contributes to the development of UTIs. 2. An impaired immune response contributes to the increased incidence of UTIs in older females. 3. An increased risk of urinary stasis contributes to the higher incidence of UTIs in older females. 4. Prostatic secretions are found in males.

The nurse observes a distended bladder and no change in urine output in a patient with an indwelling urinary catheter and drainage system. What should the nurse do first? A. Assess the catheter tubing for kinks and position it so drainage is maintained by gravity. B. Notify the physician. C. Flush the catheter with sterile saline using a large syringe. D. Change the catheter.

Answer: A Explanation: A. The nurse should assess and maintain the patency and integrity of all catheter systems. A kinked catheter may damage the urinary system. 2. Notifying the physician is not an immediate intervention. 3. Flushing a catheter increases the risk of infection. 4. Changing a catheter increases the risk of infection.

A female patient asks the nurse for ways to prevent recurrent urinary tract infections. How should the nurse respond? A. "Avoid douching." B. "Clean the perineal area from back to front." C. "Use feminine hygiene sprays." D. "Wear clean nylon underpants."

Answer: A Explanation: A. The nurse should suggest measures to maintain the integrity of perineal tissues, including avoiding douching. 2. Women should be instructed to cleanse the perineal area from front to back after voiding and defecating. 3. Feminine hygiene sprays should be avoided. 4. Cotton briefs should be worn.

The nurse is instructing a patient with uric acid stones on methods to prevent lithiasis. Which patient statement indicates that teaching has been effective? A. "I should avoid organ meats and sardines in my diet." B. "I will increase purine-rich foods in my diet." C. "I know to avoid eating vitamin D-enriched foods." D. "I will have to make my urine more acidic by eating cheese, cranberries, grapes, and tomatoes."

Answer: A Explanation: A. The patient with uric acid stones requires a diet low in purines, which are found in organ meats and sardines. 2. The patient with uric acid stones requires a diet low in purines. 3. Patients with calcium stones should limit vitamin D. 4. A patient with uric acid stones should not try to make the urine more acidic.

A patient with an indwelling urinary catheter is exhibiting signs of asymptomatic bacteriuria. What would be the best course of action for this patient? A. Removing the catheter and beginning antibiotic therapy B. Beginning intravenous antibiotic therapy C. Beginning 3-day course of oral antibiotic therapy D. Removing the catheter and monitoring for continued signs of bacteriuria

Answer: A Explanation: A. The preferred treatment for catheter-associated urinary tract infections (UTIs) is to remove the indwelling catheter, then administer a 7- to 14-day course of oral antibiotic therapy to eliminate the infection. 2. The catheter needs to be removed before antibiotic therapy is begun. 3. Antibiotics for this health problem should be prescribed for 7 to 14 days. 4. Removing the catheter without initiating antibiotic therapy would not solve the problem. The infection could worsen.

A patient has had a renal stent removed. What should be included in the care of this patient? A Monitoring urine output B. Encouraging ambulation C. Ensuring adequate protein intake D. Monitoring blood pressure

Answer: A Explanation: A. Urine output should be monitored closely for the first 24 hours after stent removal. Edema or stricture of ureters may impede output and lead to hydronephrosis and kidney damage. 2. Ambulation is not a priority for this patient. 3. Adequate protein intake is not a priority for this patient. 4. Blood pressure monitoring is not a priority for this patient.

A patient with bladder cancer is scheduled for surgery to create a continent urinary reservoir. What should the nurse include when teaching the patient about this procedure? Select all that apply. A. Electrolytes may need to be monitored. B. Part of the bowel is used for the pouch. C. The patient will learn how to perform self-catheterization. D. A urinary collection device is not necessary. E. The ureters are brought to the surface.

Answer: A B C D Explanation: A. The continent urinary reservoir may absorb urea and electrolytes, resulting in imbalances. Electrolytes may need to be monitored. B. A significant portion of the bowel is required to form the pouch and stoma of a continent urinary reservoir. C. With a continent urinary reservoir, the patient must be able and motivated to manage self-catheterization. D. With a continent urinary reservoir, a drainage collection device is not necessary. 2. In a cutaneous ureterostomy, the ureters are brought to the skin surface.

The nurse is planning care for a patient recovering from bladder neck surgery. What should the nurse include in this patient's plan of care? Select all that apply. A. Securing urinary catheters in position B. Reporting any onset of bright red urine C. Measuring urine output and reporting changes D. Gently tugging on urinary catheter every shift E. Expecting urine to be pink and gradually clear

Answer: A B C E Explanation: A. To maintain stability and patency, the catheter should be secured in position. B. Bright red urine can indicate hemorrhage and should be reported. C. Urine output should be measured and changes in output reported. E. Urine color after surgery will be pink and then gradually clear. 4. Pulling on catheters increases the risk for pressure on the surgical incision and should not be done.

A patient is diagnosed with chronic pyelonephritis. Which health problem is this patient at risk for developing? A. Cystitis B. Chronic kidney disease C. Acute renal failure D. Renal calculi

Answer: B Explanation: B. Chronic pyelonephritis involves chronic inflammation and scarring of the tubules and interstitial tissues of the kidney. It is a common cause of chronic kidney disease. 2. Cystitis may cause acute pyelonephritis. 3. Cystitis may cause acute renal failure. 4. Renal calculi are generally caused by dietary intake, not by chronic pyelonephritis.

A patient is discharged after photocoagulation for a bladder papilloma. When should this patient be instructed to return for a follow-up evaluation with the healthcare provider? A 1 year B. 3 months C 3 years D. If symptoms return in the year following surgery

Answer: B Explanation: B. Following cystoscopic tumor resection, patients are followed at 3-month intervals for tumor recurrence. 2. Follow-up needs to be timely; 1 year would be too long. 3. Follow-up needs to be timely; 3 years would be too long. 4. The patient would be encouraged to make a follow-up appointment at any time if symptoms recur.

A patient who is recovering from spinal surgery had "an accident" while attempting to reach the bathroom to void. Which type of incontinence did this patient probably experience? A. Urge B Functional C. Stress D. Total

Answer: B Explanation: B. Functional incontinence results from physical, environmental, or psychosocial causes. Impaired mobility is one such cause. 2. Urge incontinence occurs when the patient must void immediately when the urge is perceived. 3. Stress incontinence is the result of coughing or laughing. 4. Total incontinence is the loss of all voluntary control over urination and urine loss occurring without stimulus and in all positions.

A male patient comes to the emergency department with symptoms of renal colic. Which body structure should the nurse realize is obstructed by a calculus? A. Bladder B. Ureter C. Renal pelvis D. Urethra

Answer: B Explanation: B. Renal colic is acute, severe flank pain on the affected side. It develops when a stone obstructs the ureter and causes ureteral spasm. 2. Calculi in the bladder would not cause flank pain or colic. 3. Calculi in the renal pelvis would not cause flank pain or colic. 4. Calculi in the urethra would not cause flank pain or colic.

While being catheterized for urinary retention, a patient becomes diaphoretic and pale. What should the nurse do to help this patient? A. No action is needed, as this situation is transient. B The nurse should clamp the catheter after draining 500 mL of urine. C. The nurse should remove the urinary catheter. D. The nurse should provide the patient with fluids.

Answer: B Explanation: B. Some patients may experience a vasovagal response and become pale, sweaty, and hypotensive if the bladder is rapidly drained. The nurse should be aware that it is a possible response in some patients and be able to recognize and respond to it. Draining 500 mL increments and clamping the catheter for 5 to 10 minutes between increments may prevent this response. 2. The vasovagal response is a possible response in some patients during catheterization. The nurse should be able to recognize the vasovagal response and take the appropriate action. 3. Removing the urinary catheter will not address the symptoms. 4. Replacing fluids will not address the symptoms.

A patient with a history of recurrent urinary tract infections (UTIs) asks if there are any complementary approaches to reducing the risk of developing future infections. What should the nurse instruct this patient? Select all that apply. A. Drink blueberry juice. B. Take saw palmetto. C. Drink cranberry juice. D. Limit the intake of vitamin C. E. Apply lavender over the abdomen.

Answer: B C Explanation: B. Herbal supplements, such as saw palmetto, have a urinary antiseptic effect and may be beneficial in treating or preventing UTIs. C. Research supports the use of cranberry products to prevent UTIs in women with recurrent symptomatic infections. 2. Blueberry juice is not identified to be used to prevent and treat UTIs. 4. Limiting vitamin C will not reduce the risk of developing UTIs. 5. Adding lavender to bathwater, not applying it to the abdomen, may relieve the discomfort of a UTI.

The nurse provides a patient with a subcutaneous dose of bethanechol chloride (Urecholine). For which manifestation should the nurse prepare to give the patient atropine? Select all that apply. A. Voided 250 mL B. Audible wheezes C. Increase in heart rate D. Drop in blood pressure E. New onset shortness of breath

Answer: B C D E Explanation: B. Atropine is the antidote for an adverse reaction from bethanechol chloride (Urecholine). Audible wheezes would necessitate the use of atropine. C. Atropine is the antidote for an adverse reaction from bethanechol chloride (Urecholine). An increase in heart rate would necessitate the use of atropine. D. Atropine is the antidote for an adverse reaction from bethanechol chloride (Urecholine). A drop in blood pressure would necessitate the use of atropine. E. Atropine is the antidote for an adverse reaction from bethanechol chloride (Urecholine). Shortness of breath would necessitate the use of atropine. 1. Voiding is an expected effect from bethanechol chloride (Urecholine).

The nurse instructs a patient with spastic bladder about the prescribed medication tolterodine (Detrol). What patient statements indicate that teaching has been effective? Select all that apply. A. "I can drink wine with dinner while taking this medication." B. "I can take this with or without food." C. "This medication might make me drowsy." D. "I should call my doctor if I have problems breathing." E. "I should be careful driving while taking this medication."

Answer: B C D E Explanation: B. This medication can be taken irrespective of food intake. C. This medication may cause drowsiness. D. The patient should report any difficulty breathing. E. The patient should use caution when driving while taking this medication. 5. The patient should not use any alcohol while taking this medication.

A patient is discharged after transurethral resection of a superficial bladder tumor. What should the nurse include in this patient's discharge instructions? Select all that apply. A. Maintain bed rest B. Avoid constipation and continue to use stool softener. C. Increase fluid intake. D Make a follow-up appointment in 1 year. E. Call the physician if painless hematuria develops.

Answer: B,C,E Explanation: B. The patient should be instructed to avoid straining with stool and take a stool softener. C The patient should be instructed to increase fluids to 2500-3000 mL/day. E. The patient should be instructed to monitor for excessive bleeding. 5. Follow-up appointments will be scheduled more frequently than every year. 3. Bed

A male patient has a history of calcium calculi. Which medication should the nurse expect to be prescribed for this patient? A. Penicillin (Pentids) B. Allopurinol (Alloprim) C Metolazone (Zaroxolyn) D. NSAIDs

Answer: C Explanation: C. A thiazide diuretic, which is frequently prescribed for calcium calculi, acts to reduce urinary calcium excretion and is very effective in preventing further stones. Metolazone (Zaroxolyn) is a thiazide diuretic. 2. Penicillin (Pentids) is an antimicrobial and does not affect the development of calcium stones. 3. Allopurinol (Alloprim) is used to reduce serum levels of uric acid and has no effect on the development of calcium stones. 4. NSAIDs (nonsteroidal anti-inflammatory drugs) are used to reduce pain and fever and have no effect on the development of calcium stones.

The nurse instructs a female patient on ways to prevent urinary tract infections (UTIs). Which patient statement indicates that teaching has been effective? A. "I should limit my intake of water so I won't need to urinate so often." B. "I should wear only nylon underpants." C. "I should drink 2 to 2-1/2 quarts of fluid per day." D. "I should void every 6 hours while I am awake."

Answer: C Explanation: C. An intake of 2 to 2-1/2 quarts of fluid per day will help to prevent UTIs. 2. Fluid intake should be increased. 3. Cotton underpants are best, and nylon should be avoided because synthetic fibers dry and irritate the perineal area and promote bacteria growth. 4. The patient should not delay emptying the bladder when the urge is felt. Emptying the bladder every 2-4 hours is recommended to prevent urinary stasis.

A middle-aged male patient comes to the clinic complaining of "frequency" and voiding "small amounts of urine at a time." Which health problem should the nurse suspect is occurring with this patient? A. Cystitis B. Renal calculi C. Benign prostatic hypertrophy (BPH) D. Bladder cancer

Answer: C Explanation: C. Benign prostatic hypertrophy (BPH) is a common cause of urinary retention; difficulty initiating and maintaining urine flow is often the presenting complaint in men with BPH. 2. Cystitis symptoms may include frequency but would be coupled with burning, pain during urination, and hematuria. 3. Renal calculi would likely cause flank pain. 4. Bladder cancer symptoms would include hematuria.

A male patient is admitted for removal of a bladder papilloma. What should the nurse assess in this patient? A. Daily fluid intake B. Pedal pulses C. History of cigarette smoking D. Appetite level

Answer: C Explanation: C. Carcinogenic breakdown products of certain chemicals and from cigarette smoke are excreted in the urine and stored in the bladder, which possibly causes a local influence on abnormal cell development. Cigarette smoking is the primary risk factor for bladder cancer. The risk in smokers is twice that of nonsmokers. 2. Daily fluid intake is an important assessment but is not related to an increased risk for bladder papilloma. 3. Pedal pulses are an important assessment but are not related to an increased risk for bladder papilloma. 4. Appetite is an important assessment but is not related to an increased risk for bladder papilloma.

The nurse is caring for an older patient who is prone to developing urinary tract infections (UTIs). Which method of bladder emptying should be recommended for this patient? A. Indwelling urinary catheterizations B. Credé method C. Intermittent catheterization D. Timed intervals for taking patient to bathroom to void

Answer: C Explanation: C. Intermittent catheterization carries a lower risk of infection and is preferred for patients who are unable to empty the bladder by voiding. 2. An indwelling urinary catheter has a higher risk of infection. 3. The Credé method is a technique used to assist patients with spinal cord injury to empty the bladder. 4. Timed intervals for voiding would not be effective if the patient is unable to empty the bladder by voluntary voiding. The urine would remain in the bladder and be a site for infection to develop.

A patient diagnosed with a symptomatic urinary tract infection (UTI) is prescribed phenazopyridine (Pyridium). What should the nurse instruct the patient about the color of the urine? A. It will have a green tint. B. It will turn brown. C. It will become orange or red. D. It will become clearer and pale yellow.

Answer: C Explanation: C. Phenazopyridine (Pyridium) turns urine orange or red. 2. This medication does not turn the color of urine to green. 3. This medication does not turn the color of urine to brown. 4. This medication does not turn the color of urine to a clear pale yellow.

A patient with pyelonephritis asks the nurse to explain the condition. How should the nurse respond? A. "It is an inflammation of the bladder." B. "It is an infection of the lower urinary tract." C. "It is an infection of the kidney." D. "It is a blockage in the tube from your kidney to your bladder."

Answer: C Explanation: C. Pyelonephritis is an infection of the renal pelvis and parenchyma, the functional unit of the kidney. 2. Pyelonephritis is not an inflammation of the bladder. 3. Pyelonephritis does not occur in the lower urinary tract. 4. Pyelonephritis does not occur in the ureter.

A female patient is admitted with an overdistended bladder. Which diagnostic test can be done to confirm the diagnosis of urine retention? A. Renal scan B. Intravenous pyelography (IVP) C. Bladder scan D. MRI

Answer: C Explanation: C. Urinary retention is confirmed using a bladder scan. 2. A renal scan provides information about the structure of the kidney and vascular flow in the renal system, but it is not the test of choice in determining urine retention. 3. Intravenous pyelography (IVP) provides information about the structure of the kidney and vascular flow in the renal system, but it is not the test of choice in determining urine retention. 4. An MRI would provide information about the structure of the kidney and vascular flow in the renal system, but it is not the test of choice in determining urine retention.

A patient is participating in bladder retraining activities. Which toileting activity will reduce the patient's episodes of incontinence? Select all that apply. A. Intermittent straight catheterization B. External catheter placement at bedtime C. Scheduled toileting D. Use of adult incontinence protection devices E. Habit training

Answer: C, E Explanation: C. Behavioral techniques such as scheduled toileting reduce the frequency of incontinence. Scheduled toileting is toileting at regular intervals (e.g., every 2 to 4 hours). E. Habit retraining is toileting the patient on a schedule that corresponds with the normal pattern. 3. Intermittent straight catheterization is not a toileting activity. 4. External catheter placement is not a toileting activity. 5. Adult incontinence devices do not reduce periods of incontinence.

A patient is experiencing postoperative urinary retention. Which medication should the nurse expect to be prescribed for this patient? A. Tolterodine (Detrol) B. Propantheline bromide (Pro-Banthine) C. Nitrofurantoin (Macrobid) D. Bethanechol chloride (Urecholine)

Answer: D Explanation: 1. Bethanechol chloride (Urecholine) increases detrusor muscle tone, producing a contraction strong enough to initiate micturition. It is primarily used to treat postoperative and postpartum urinary retention. 2. Tolterodine (Detrol) is used to treat spastic bladder. 3. Propantheline bromide (Pro-Banthine) is used to treat spastic bladder. 4. Nitrofurantoin (Macrobid) is a urinary anti-infective medication.

A male patient with a urinary stoma says, "I looked at it while you were out of the room. It's not so bad." Which behavior should the nurse consider this patient is demonstrating? A. Denial B. Grief C. Anger D. Coping

Answer: D Explanation: D. Adaptive mechanisms include learning as much as possible about the surgery and its effects, practicing procedures, setting realistic goals, and rehearsing various alternative outcomes. Accepting the stoma as part of the self is vital to adapting to the changed body image and is indicated by a willingness to perform self-care. 2. The patient may initially use defensive coping mechanisms such as denial, minimization, and dissociation from the immediate situation to reduce anxiety and maintain psychological integrity. 3. Grief may be expressed by the patient with a new stoma, but this patient's statement does not indicate grief. 4. Anger may be expressed by the patient with a new stoma, but this patient's statement does not indicate anger.

A patient is scheduled for a lithotripsy for renal calculi. What should the nurse explain to the patient as the purpose of a bowel preparation prior to this procedure? A. Ensuring that there is no evidence of constipation prior to the procedure B. Increasing comfort C. Reducing postoperative pain D Ensuring maximum visualization of the kidney and the stones

Answer: D Explanation: D. Fecal material in the bowel may impede fluoroscopic visualization of the kidney and stone. 2. Constipation prior to the procedure has no bearing on the procedure if bowel preparation is completed. 3. Bowel preparation would not contribute to patient comfort. 4. Bowel preparation would not reduce postoperative pain.

A patient with a urinary diversion device is at risk for impaired skin integrity. Which intervention should the nurse perform for this patient? A. Changing urine collection device every other day B. Teaching self-catheterization technique C. Monitoring for foul-smelling urine D Emptying the bag reservoir every 2 hours

Answer: D Explanation: D. Overfilling the collection bag can damage the seal, allowing leakage and contact of urine with the skin. 2. The urine collection device is changed as needed. 3. Teaching self-catheterization technique is not an appropriate intervention for this problem. 4. Monitoring for foul-smelling urine does not help with the risk for impaired skin integrity.

An older patient with diabetes is diagnosed with a flaccid bladder. What should be included in the care of this patient? A. The importance of maintaining alkaline urine B. Instruction on the use of anticholinergic medications C. Reminder to restrict fluids D Instruction on the Credé method of bladder emptying

Answer: D Explanation: D. The Credé method (applying pressure to the suprapubic region with the fingers of one or both hands), manual pressure on the abdomen, and the Valsalva maneuver (bearing down while holding one's breath) promote bladder emptying for the patient with a spastic or flaccid bladder. 2. Altering the pH of the urine would not help the patient adapt to the neurogenic issue that is causing flaccid bladder. 3. Taking anticholinergics would not help the patient adapt to the neurogenic issue that is causing flaccid bladder. 4. Restricting fluids would not help the patient adapt to the neurogenic issue that is causing flaccid bladder.

A female patient with multiple medical problems experiences incontinence, regardless of the position or situation. For which type of incontinence should the nurse plan care? A. Urge B. Stress C. Overflow D. Total

Answer: D Explanation: D. Total incontinence is the loss of all voluntary control over urination, and urine loss occurs without stimulus and in all positions. 2. Urge incontinence is associated with a strong urge to void. 3. Stress incontinence is the result of coughing or laughing. 4. Overflow incontinence results from an inability to empty the bladder and is characterized by overdistention and the loss of small amounts of urine.