A2 EX 3 CH.55 PREP U EXAM STUDY

neurogenic bladder

a urinary problem caused by interference with the normal nerve pathways associated with urination

cystectomy

excision of the bladder

pyelonephritis

inflammation of the renal pelvis and the kidney

A client has a suspected bladder tumor. What is the most common first symptom of a malignant tumor of the bladder? urgency dysuria fever painless hematuria

painless hematuria

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

"Make sure to eat enough fiber to prevent constipation."

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

"My urine will be eliminated through a stoma."

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client? "This medication will prevent re-infection." "This medication will relieve your pain." "This medication should be taken at bedtime." "This will kill the organism causing the infection."

"This medication will relieve your pain."

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? "When did you last urinate?" "Do you get up at night to urinate?" "How much fluid are you drinking?" "Have you had a fever and chills?"

"When did you last urinate

The nurse is caring for several older clients. For which client would the nurse be especially alert for signs and symptoms of pyelonephritis? A client with urinary obstruction A client with acute renal failure A client with a urinary tumor A female client with preexisting chronic glomerulonephritis

A client with urinary obstruction

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

Application of an ostomy pouch

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? Restricting fluid intake to reduce the need to void Encouraging the client to increase the time between voidings Establishing a predetermined fluid intake pattern for the client Assessing present voiding patterns

Assessing present voiding patterns

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what? Voiding at given intervals Bladder retraining Prompted voiding Interval voiding

Bladder retraining

Obstructive disorders

Bladder stones and urethral stricture

Which factor contributes to UTI in older adults? Low incidence of chronic illness Active lifestyle Sporadic use of antimicrobial agents Immunocompromise

Immunocompromise

A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following? The result of urethra abrasion (sexual intercourse) Through the bloodstream (hematogenous spread) Due to a fistula (direct extension) By ascending infection (transurethral)

By ascending infection (transurethral)

Which information is important when teaching a client how to perform self-catheterization? The catheter is rinsed with sterile normal saline after being soaked in a cleaning solution. Peroxide is recommended for cleaning the urinary catheter. Catheterization should occur every 4 to 6 hours and before bedtime. The nurse uses nonsterile technique in the hospital setting.

Catheterization should occur every 4 to 6 hours and before bedtime. rinsed with tap water after being soaked in a cleaning solution. Either antibacterial soap or povidone-iodine solution is recommended for cleaning urinary catheters at home. The nurse uses sterile technique in the hospital setting.

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective? Bactrim Macrodantin Septra Cipro

Cipro

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively? Menstrual history Client's manual dexterity and vision Dietary habits involving cholesterol-laden food History of allergy to iodine and seafood

Client's manual dexterity and vision

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? Urine with a specific gravity of 1.005-1.022 Rebound tenderness at McBurney's point An output of 200mL with each voiding Cloudy urine

Cloudy urine

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered?

Cloudy urine hematuria, fever, chills, anorexia, and malaise.

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence? Increased urine production due to metabolic conditions Bladder irritation related to urinary tract infections Obstruction due to fecal impaction or enlarged prostate Decreased pelvic muscle tone due to multiple pregnancies

Decreased pelvic muscle tone due to multiple pregnancies

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? If risk for chronic pyelonephritis is likely Reveals causative microorganisms Detects calculi, cysts, or tumors Shows damage to the kidneys

Detects calculi, cysts, or tumors Urinary obstruction is the most common cause of pyelonephritis in the older adult. A KUB may reveal obstructions such as calculi, cysts, or tumors. KUB is not indicated for detection of impaired renal function or reveal increased risk for chronic form of the disorde

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? Hyperparathyroidism Pancreatitis Diabetes mellitus Hyperuricemia

Diabetes mellitus

The nurse is caring for the client following surgery for a urinary diversion. The client refuses to look at the stoma or participate in its care. The nurse formulates a nursing diagnosis of: Anticipatory grieving Disturbed body image Deficient knowledge: stoma care Situational low self esteem

Disturbed body image

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? Void every 4 to 6 hours. Use tub baths as opposed to showers. Drink coffee or tea to increase diuresis. Drink liberal amount of fluids.

Drink liberal amount of fluids.

Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor? Eat plenty of cheese and eggs. Avoid foods such as buttermilk or yogurt. Add a few drops of diluted white vinegar to the pouch. Avoid pouches with carbon filters.

Eat plenty of cheese and eggs.

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 temporary pouch. In gathering information for the client, which urinary diversion would the nurse select? Ileal conduit Kock Pouch Ureterosigmoidostomy Indiana Pouch

Ileal conduit

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which item should the nurse include? Implement a 2- to 3-hour voiding schedule Perform straight catheterization every 4 hours Encourage voiding immediately after catheter removal Avoid drinking fluids for 6 hours

Implement a 2- to 3-hour voiding schedule voiding immediately is not encouraged

nonsocomial infection

Infection acquired while in a hospital or medical setting.

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? It's an abnormal finding that requires further assessment. It's a normal finding caused by blood loss during surgery. It's an abnormal finding that will correct itself when the client ambulates. It's a normal finding associated with the client's nothing-by-mouth status.

It's an abnormal finding that requires further assessment.

Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

Kidney

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?

Kidney

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: Compromised ligament and pelvic floor support of the urethra. Loss of motor control of the detrusor muscle. Uninhibited detrusor contractions. A stricture or tumor in the bladder.

Loss of motor control of the detrusor muscle. These patients also experience hyperreflexia in the absence of normal sensations associated with voiding.

A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient? Low-purine diet High-protein diet Low-calcium diet Low-phosphorus diet

Low-purine diet

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? Show photographs and drawings of the placement of the stoma. Maintain skin and stomal integrity. Suggest a visit to a local ostomy group. Determine the client's ability to manage stoma care.

Maintain skin and stomal integrity.

A client with a history of chronic cystitis comes to an outpatient clinic with signs and symptoms of this disorder. To prevent cystitis from recurring, the nurse recommends maintaining an acid-ash diet to acidify the urine, thereby decreasing the rate of bacterial multiplication. On an acid-ash diet, the client must restrict which beverage?

Milk

Which finding is an early indicator of bladder cancer? Painless hematuria Dysuria Occasional polyuria Nocturia

Painless hematuria

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? Deep flank and abdominal pain Muscle spasm and abdominal rigidity over the flank Decreasing kidney function associated with fever and hematuria Painless, gross hematuria

Painless, gross hematuria

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. For those patients who are incontinent, insert indwelling catheters. Encourage patients to wear briefs. Provide careful perineal care. Perform hand hygiene prior to patient care. Assist the patients with frequent toileting.

Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care

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

Perform meticulous perineal care daily with soap and water

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program? Smoking habits Occupational history History of allergies Physical and environmental conditions

Physical and environmental conditions

A client has developed urinary incontinence after having a urinary catheter in place for a few weeks. What is the initial nursing intervention the nurse should use to start the client with bladder training? Instruct the client to drink more fluids at night for a full bladder in the morning. Place client on a timed voiding schedule. Immediately after voiding, perform a bladder scan. Perform straight catheterizations at specific times each day.

Place client on a timed voiding schedule.

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? Pyridium Bactrim Levaquin Septra

Pyridium used specifically for relief of burning, pain, and other symptoms associated with UTI.

Sympathomimetics have which of the following effects on the body? Constriction of pupils Relaxation of bladder wall Decrease of heart rate Constriction of bronchioles

Relaxation of bladder wall

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis? Risk for altered urinary elimination Risk for infection Risk for deficient knowledge: self-catherization Risk for fluid volume excess

Risk for infection

A patient informs the nurse that every time she sneezes or coughs, she urinates in her pants. What type of incontinence does the nurse recognize the patient is experiencing? Stress incontinence Iatrogenic incontinence Functional incontinence Urge incontinence

Stress incontinence

Which nursing intervention should the nurse caring for the client with pyelonephritis implement? Administer acetaminophen (Tylenol). Straight catheterize the client every 4 to 6 hours. Restrict fluid intake to 1 liter per day. Teach client to increase fluid intake up to 3 liters per day.

Teach client to increase fluid intake up to 3 liters per day.

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? The nursing assistant places the drainage bag on the lower area of the wheelchair for transport. The nursing assistant places the drainage bag on the client's abdomen for transport. The nursing assistant keeps the catheter and drainage bag together when moving the client. The nursing assistant holds the drainage bag while the client moves to the wheelchair.

The nursing assistant places the drainage bag on the client's abdomen for transport. maintain the drainage bag lower than the genital region to avoid a backflow of urine into the bladder.

A client asks the nurse why cystitis is more common in women than in men. Which of the following body parts will the nurse include in the answer? The rectum The urethra The bladder The ureters

The urethra

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? Functional Stress Overflow Urge

Urge

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? Urinary calculi Acute glomerulonephritis Ureteral stricture Renal cell carcinoma

Urinary calculi

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction? Cystitis Bladder stones Urethral stricture Urinary retention

Urinary retention

voiding dysfunctions

Urinary retention and urinary incontinence

Which of the following is the most common site of a nosocomial infection? Skin Respiratory tract Gastrointestinal tract Urinary tract

Urinary tract

Which of the following is a strategy to promote urinary continence? Void regularly, 5 to 8 times a day Take diuretics after 4 PM Implement a low fiber diet Use caffeine in moderation

Void regularly, 5 to 8 times a day

The nurse recognizes that test results that most likely indicate a urinary tract infection include:

WBC 50

guidelines for initiating bladder retraining include

assessing the client's present intake patterns, voiding patterns, and reasons for each accidental voiding.

A client who has a history of neurogenic bladder uses a permanent, indwelling catheter to facilitate urine elimination. What can this client consume to decrease the likelihood of bladder infection? prune juice red meat cranberry juice increased protein

cranberry juice Cranberry juice or vitamin C may be recommended to keep the bacteria from adhering to the wall of the bladder and thus promoting their excretion and enhancing the effectiveness of drug therapy.

Strategies to promote urinary continence include

increasing awareness of the amount and timing of all fluid intake; avoid taking diuretics after 4 PM; avoiding bladder irritants, such as caffeine, alcohol, and aspartame (NutraSweet); taking steps to avoid constipation by drinking adequate fluids, eating a well-balanced diet high in fiber, exercising regularly, and taking stool softeners if recommended; and voiding regularly, 5 to 8 times a day (about every 2 to 3 hours).

stress incontinence

involuntary loss of urine through an intact urethra as a result of sneezing, coughing, or changing position

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:

notify the physician about cloudy or foul-smelling urine.

A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is: a procedure that increases support to the bladder by tightening the vaginal wall under the urethra. a procedure that increases storage capacity of the bladder. implantation of an artificial sphincter that can be inflated to prevent urine loss and deflated to allow urination. placement of small amounts of collagen in urethral walls to aid the closing pressure.

placement of small amounts of collagen in urethral walls to aid the closing pressure.

urinary diversion

surgical creation of an alternate route for excretion of urine

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? procedure for insertion of the catheter type and size of the catheter to be used administration of cleansing enemas placement of the catheter

type and size of the catheter to be used

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem? urethral strictures urinary retention urinary incontinence urinary tract infection

urinary tract infection