Mastery quiz questions Ch.27

A patient is admitted with lower urinary tract obstruction and stasis. Which of the following is the primary intervention?

Urinary catheterization -

A patient has a postvoid residual (PVR) volume of 40 mL. Which of the following information would the nurse teach the patient?

"This is a normal value."

Which of the following types of pharmacological therapy does the nurse anticipate administering to a patient for treatment of a spastic bladder in order to decrease bladder hyperactivity?

Anticholinergic medications -Among the methods used to treat spastic bladder and detrusor-sphincter dyssynergia are the administration of anticholinergic medications to decrease bladder hyperactivity and urinary catheterization to produce bladder emptying. Antibiotics are used to treat urinary tract infections. Biofeedback is a behavioral method of treatment. Calcium channel blockers would not be effective in treating this disorder

What is the most common gram-negative bladder infection found in hospitalized clients?

Catheter-induced infection -Urinary catheters are a source of urethral irritation and provide a means for entry of microorganisms into the urinary tract. Catheter-associated bacteriuria remains the most frequent cause of gram-negative septicemia in hospitalized clients. Studies have shown that bacteria adhere to the surface of the catheter and initiate the growth of a biofilm that then covers the surface of the catheter.

Which of the following is the most common cause of lower uncomplicated urinary tract infections?

Escherichia coli -Most uncomplicated lower UTIs are caused by Escherichia coli. Other common uropathic pathogens include Enterococcus faecalis, Staphylococcus saprophyticus, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas species. Helicobacter, H. pylori, and Proteus amoeba do not cause UTIs.

The patient who has been admitted with a problem with his bladder has a postvoid residual (PVR) of 250 ml. The nurse understands that this indicates which of the following?

Inadequate bladder emptying -Postvoid residual (PVR) urine volume provides information about bladder emptying and NOT storage. A PVR value of less than 50ml is considered adequate bladder emptying and more than 200 ml indicates inadequate bladder emptying.

A client reports that she frequently suffers from UTIs after engaging in sexual intercourse. Which would be the best information for the nurse to provide?

Increase fluid intake before intercourse -A nonpharmacologic approach to the treatment of frequent UTIs associated with sexual intercourse is to increase fluid intake before intercourse and to void soon after intercourse. This procedure uses the washout phenomenon to remove bacteria from the bladder.

A patient with stress incontinence states, "every time I laugh or cough, I urinate on myself. Which of the following behavioral measures would be beneficial for the nurse to teach the patient?

Kegel exercises -Behavioral methods for incontinence include fluid management, timed/prompted voiding, pelvic floor exercises (Kegel exercises), bladder retraining, and toileting assistance. Bladder retraining and biofeedback techniques seek to reestablish cortical control over bladder function by having the person ignore urgency and respond only to cortical signals during waking hours. Indwelling catheters are not used routinely to control incontinence and is a medical intervention. Administering medications is considered to be a pharmacological intervention.

A nurse is caring for a patient in spinal shock. Which of the following interventions is appropriate in relation to the patient's urinary status?

Perform intermittent catheterization -After a spinal cord injury, the early effects on bladder function are quite different from those that follow recovery from the initial injury. During the period immediately after spinal cord injury, a state of spinal shock develops, during which all the reflexes, including the micturition reflex, are depressed. The bladder is atonic and cannot contract. Intermittent catheterization is necessary to prevent injury to urinary structures associated with overdistension of the bladder.

A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as which of the following?

Stress -Stress incontinence is the involuntary loss of urine associated with activities such as coughing and sneezing. Urge incontinence is the urgency and frequency associated with hyperactivity of the detrusor muscle. Overflow incontinence is the involuntary loss of urine when intravesicular pressure exceeds maximal urethral pressure. Functional incontinence is the lack of cognitive function to go to the bathroom

The client has just been diagnosed with bladder cancer and asks the nurse what causes it. Which of the following would be the nurse's best response to the client?

The cause is unknown

During male ejaculation, which of the following statements addresses why sperm is not normally seen inside the bladder?

The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time. -During male ejaculation, which is mediated by the SNS, the musculature of the trigone area and that of the bladder neck and prostatic urethra contract and prevent the backflow of seminal fluid into the bladder.

The nursing student, while studying anatomy and physiology, correctly identifies which of the following to be responsible for carrying urine to the bladder?

Ureters

A female teenager has experienced three uncomplicated urinary tract infections in the last 3 months. Knowing the anatomical location of the urethra, the nurse should educate this teenager about:

Wiping from front to back to preventEscherichia coli contamination of the urethra -Most commonly, urinary tract infections (UTIs) are caused by Escherichia coli that enter through the urethra. Escherichia coli are abundant in fecal matter. Other uropathic pathogens include Staphylococcus saprophyticus in uncomplicated UTIs and both non-E. coli gram-negative rods (Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas) and gram-positive cocci (Staphylococcus aureus, group B Streptococcus) in complicated UTIs.

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 -Urinary obstruction and urinary incontinence can be caused by several factors, including structural changes in the bladder, structural changes in the urethra, and impairment of neurologic control of bladder function. Changes in the gallbladder or pancreas do not cause urinary obstruction or incontinence.