Patho Exam 4 Ch 27

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The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which of the following statements?

"Alterations in bladder function can only occur when there is incontinence."

A 24 year-old man is currently in rehabilitation facility following a spinal cord injury at level T2. He is discussing his long term options for continence management. Which of the following statements by the client demonstrates he has a clear understanding of the issue?

"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."

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

Catheter-induced infection.

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."

A patient has a postvoid residual (PVR) volume of 250 mL. Which of the following information would the nurse tell the patient?

"This value indicates you are having difficulty emptying your bladder."

A mother asks, "why can't my 1 year old go to the bathroom by himself?" Which of the following is the nurse's best response?

"Your child is too young to begin toilet training."

A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?

Administration of a-adrenergic agonistic drugs as ordered.

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.

The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is which of the following?

Bladder.

A client reports that she 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 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?

Kegel exercises.

When teaching a community education class about the 7 warning signs of cancer, the nurse will note that the most common sign of bladder cancer is:

Painless bloody urine.

A patient is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which of the following assessment data obtained by the nurse would indicate that the patient should be screened for this disease?

Patient reports that he occasionally has blood in his urine but has no pain with it.

Because they strengthen the pelvic floor muscles, Kegel exercises are most likely to help:

Stress incontinence.

When determining the treatment and management for incontinence, the physician considers which of the following? Select all that apply.

Type of incontinence, Accompanying health problems, and Person's age.

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 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.

An 87 year-old male resident of an assisted living facility has been consistently continent of urine until the last several weeks. Which of the following actions by the care providers at the facility is the most likely priority?

Performing a physical examination and history to determine the exact cause and character of the incontinence.

A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises, because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?

Stress incontinence.

A patient is describing difficulty with urinating and informs the nurse that every time she coughs or laughs, she urinates and has begun to wear a thin pad. Which of the following types of urinary incontinence is the patient describing?

Stress incontinence.

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.

The nursing students have learned in class that causes of urinary incontinence include which of the following? Select all that apply.

Structural changes in the bladder, Structural changes in the urethra, and Impairment of neurologic control of bladder function.

The nurse working on a GU floor for clients who have bladder cancer identifies which of the following to be acceptable treatments for this cancer? Select all that apply.

Surgical removal, Radiation therapy, and Chemotherapy.

A 61 year-old woman who has had an upper respiratory infection for several weeks has presented to her family physician with complaints of a recent onset of urinary retention. She reveals to her physician that she has been taking non-prescription cold medications over and above the suggested dose for the past two weeks. Which of the following phenomena will her physician most likely suspect is contributing to her urinary retention?

The anticholinergic effects of the medication are impairing normal bladder function.

Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?

The stretch receptors in the bladder wall become hypersensitive.

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.

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.

Diuretics, Hypnotics, and Sedatives.

A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse tell the client is the most common sign of bladder cancer?

Gross hematuria.

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.

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

Urinary catheterization.

A 65-year-old Caucasian female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include:

cytoscopy.


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