Topic 10: Urinary Elimination and Reproduction
b, c, d, e
An older adult client decides not to pursue testing for possible prostate cancer and refuses to have blood work and a biopsy performed. Which risk(s) may the client wish to avoid? Select all that apply. a. premature death b. bleeding c, pain d. urinary difficulties e. infection
stress
An older adult client experiences urinary incontinence when laughing or sneezing. For which type of incontinence will the nurse plan care for this client? a. stress b. mixed c. overflow d. urgency
640
An older adult client has an 8-inch diameter area of urine on the bed linen. How many milliliters of urine should the nurse estimate that the client voided? Record your answer using a whole number.
a, b, c, d
A client asks what can be done to reduce the incidence of vaginitis. What should the nurse instruct this client? Select all that apply. a. Wear cotton underwear. b. Use lubricants with intercourse. c. Keep the genital area clean and dry. d. Avoid sprays to the genital area. e. Douche weekly.
b
A client has been encouraged to reduce intake of high-caffeine beverages but admits to drinking several cups of black tea each day. The nurse should identify what problem-based care concern? a. urinary elimination b. altered health maintenance c. infection risk d. toileting activity of daily living deficit
a
A client with benign prostatic hypertrophy is being treated with medication. The expresses concern that the medication is causing weight loss. What should the nurse suspect is occurring with this client? a. metastatic prostate cancer b. prostatic hypertrophy is advancing c. medication dose is too high d. medication dose is too low
c
A home care registered nurse evaluated the plan of care for an older adult client with urge incontinence. Which statement by the client indicates the need for further teaching? a. "I purchased a fancy commode for my bedroom." b. "I drink enough water, but do it early in the day." c. "I am concerned. I still have to get up once or twice per night to urinate." d. "I make certain I do not get constipated."
d
A middle-aged female client has severe scoliosis and reports not having sexual relations with her spouse. For which concern will the nurse plan care for this client? a. anxiety b. coping impairment c. discomfort risk d. altered body image perception
a
A nurse assesses an older adult client who has high blood pressure and chronic obstructive pulmonary disease. The client has been prescribed nicardipine and an ipratropium inhaler. This medication regimen combines a calcium-channel blocker and an anticholinergic. For which urinary effect will the nurse teach the client to monitor? a. nocturia b. urinary tract infection c. uric acid calculi d. hematuria
a
A nurse assesses the urinary elimination of an older adult client while the client's caregiver is present. Which action by the nurse is appropriate? a. Work to identify terms that the older adult comprehends. b. Give the interview questions to the client in writing. c. Wait until the person initiates a discussion of this embarrassing topic. d. Ask the older adult's caregiver the questions privately.
d
A nurse educates an older adult male client to perform pelvic floor muscle exercises. Which teaching will be included in a nurse's instructions? a. Interrupt the flow of urine several times each time you urinate. b. Contract your legs and buttocks while contracting the pubococcygeal muscle. c. Perform the exercise while standing over the toilet. d. Identify the correct muscle by making the base of your penis move up and down.
neurogenic incontinence
A patient that has muscular sclerosis is associated with what type of incontinence:
a
A registered nurse assesses an older adult client 24 hours after a retropubic suspension surgical procedure. The client is confused, exhibits muscle twitching, and reports being nauseated. Which laboratory data should the nurse assess? a. sodium b. blood urea nitrogen c. white blood cell count d. hemoglobin
d
An older adult client admitted to the hospital for knee arthroplasty (replacement) developed postoperative pneumonia. While recovering, the client was placed on bed rest and became disoriented and incontinent. For which concern is the client at highest risk? a. anxiety b. social isolation c. altered body image d. altered skin integrity
b
An older adult client has developed urinary incontinence. The client states, "When I have to go, I go. I cannot make it to the bathroom before it leaks out." For which type of incontinence should the nurse develop a plan of care? a. functional incontinence b. urge incontinence c. mixed incontinence d. stress incontinence
a
An older adult client is embarrassed because of an episode of urinary incontinence associated with a fecal impaction. What should the nurse explain to the client about this type of incontinence? a. "It was probably because of your bowel problem." b. "You have too much urine in your bladder." c. "You have undiagnosed bladder spasms." d. "It is caused by weak pelvic floor muscles."
stress
An older adult client receives a recommendation for weight reduction as an approach to help with urinary incontinence. For which type of incontinence is this intervention appropriate to recommend? a. overflow b. stress c. urgency d. neurogenic
b
An older adult client, residing in a long-term care facility, has been newly prescribed an antimuscarinic agent for urge urinary incontinence. Which action will the nurse take? a. administer with a full glass of water b. monitor the client closely for worsening cognitive impairment c. toilet the client before administering the medication d. assess the client for drooling and diarrhea
b
An older male client asks if something is wrong because it is taking longer to achieve an erection. How should the nurse respond to this client's concern? a. "This problem is associated with heart problems." b. "You are experiencing a normal age-related change." c. "This means that you have lost a great amount of testosterone." d. "You need to see a urologist to have your prostate gland checked."
b
The nurse identifies interventions to prevent the development of a urinary tract infection (UTI) in an older adult client. What assessment finding caused the nurse to add these interventions to the plan of care? a. follows a low-fat diet b. treatment for diabetes mellitus c. with lactose intolerance d. discomfort because of hip arthritis
a, c, d, e
The nurse assesses an older woman regarding urinary health. Which interview question(s) is appropriate? Select all that apply. a. "Do you ever leak urine?" b. "How much alcohol do you drink each day?" c. "Do you have any discomfort or burning when you pass urine?" d. "Do you ever wear pads or protective garments to protect your clothing from wetness?" e. "When you urinate do you have any difficulty starting the stream or keeping the stream going?" f. Consume the largest amounts of liquid during the early part of the day, and limit fluid intake at about 2 to 4 hours before bedtime.
b
The nurse cares for an older adult client experiencing urinary retention. Which intervention should the nurse add to this client's plan of care? a. Apply cold compresses to the hands. b. Instruct to massage bladder area. c. Suggest voiding in a seated position. d. Assist to ambulate before voiding.
c
The nurse develops a plan of care for a family with a experiencing caregiver fatigue related to the client's overnight urinary incontinence. Which intervention will the nurse include? a. Administer diphenhydramine at bedtime. b. Monitor bowels for diarrhea and constipation. c. Assist the client to the bathroom prior to bedtime. d. Limit the fluid intake of the client to 1,000 ml each day.
a
The nurse educates an older adult client with stress incontinence. Which statement will the nurse include in the education? a. "Your condition is a result of increased intra-abdominal pressure." b. "Your condition occurs shortly after you feel the urge to void." c. "Your condition involves overdistension of the bladder." d. "Your condition does not involve the urinary system, but is instead due to an outside cause."
c
The nurse instructs an older adult client on performance of Kegel exercises. Which direction should the nurse provide to help the client identify the appropriate muscles to exercise? a. Clench the buttocks muscles. b. Take a deep breath. c. Void and stop the stream. d. Bear down with abdominal muscles.
a
The nurse is assisting an older adult client with changing the client's sanitary briefs, which revealed that the client was incontinent of urine. Which statement by the client requires further follow up by the nurse? a. "I have found this is something that happens from time to time at my age." b. "I have to use a chair that I can get out of easily now." c. "I am starting to recognize the urge to void sooner than I have in the past." d. "I make sure that I can easily find my way to the restroom."
b, c, d
The nurse is caring for an older adult client with urinary incontinence. Which intervention(s) will the nurse implement to improve this client's quality of life? Select all that apply. a. Suggest that the client use absorbent products as a precautionary measure. b. Provide teaching about normal urinary function. c. Assess the knowledge and beliefs of the client regarding urinary incontinence. d. Identify environmental barriers to continence in the client's home. e. Instruct the client to stop taking diuretic medication.
a
The nurse is caring for an older adult female client who has been diagnosed with vaginitis. On which problem-based care concern will the nurse focus? a. altered skin integrity b. anxiety c. altered urinary elimination d. altered body image
a, b, c
The nurse is collecting health history information from an older adult client. Which statement(s) by the client indicates the presence of a risk factor for impaired urinary function? Select all that apply. a. "I am not a big water drinker." b. "When you get to be my age, it is hard to make it to the bathroom." c. "I have been on a calcium channel blocker for years." d. "I always remember to exercise my core muscles." e. "It is important for me to find furniture I can get out of easily."
b, c, d, e
The nurse is completing a physical assessment of an older adult female client focused on the reproductive system. Which action(s) will the nurse include in the assessment? Select all that apply. a. Inspect the rectum. b. Inspect the genitalia for lesions. c. Assess for genital bleeding. d. Assess for genital discharge. e. Palpate the breasts.
a, b, c, d, e, f
The nurse is creating a urinary continence training program for an older adult client. Place the steps of the continence training program in the appropriate order. a. Identify the usual voiding pattern, noting the times of incontinence and information about fluid intake. b. Keep a diary to record information at hourly intervals: dry or wet, amount voided, place of voiding, fluid intake, and sensation and awareness of the need to void. c. Establish a schedule that allows for emptying of the bladder before incontinence is likely to occur. d. Request the equipment and assistance necessary for optimal voiding at scheduled times. e. Consume the largest amounts of liquid during the early part of the day, and limit fluid intake at about 2 to 4 hours before bedtime. f. Gradually increase the length of time between voidings until the interval is 2 to 4 hours long.
c
The nurse is providing education about urinary incontinence to an older adult client. Which statement by the client requires further follow up by the nurse? " a. Urination is both a voluntary and involuntary process, overall." b. "Control of urination depends on other body systems working as they should." c. "Urinary incontinence is a condition for which there is no treatment." d. "Several changes happen in the body with age that increase the risk for urinary incontinence."
d
The nurse is reviewing lifestyle changes with an older adult client to support urinary continence. Which statement by the client requires further follow up by the nurse? a. "I will reduce the amount of caffeinated beverages I drink." b. "I will keep a urinal close at hand in case I feel the sudden urge to urinate." c. "I will pay close attention to my voiding patterns after eating and drinking." d. "I will stay at home to ensure that I can remain close to the toilet."
b
The nurse manager notes a reduction in the number of urinary tract infections being diagnosed in older adult clients. Which unit-based protocol likely contributed to this outcome? a. no oral fluids after 1800 hours b. cranberry juice with breakfast c. bed rest for all clients after lunch d. urinary catheters for incontinent clients
b
The nurse notes that an older adult client's biopsy of vaginal tissue is positive for cancer. What care will the nurse expect to be prescribed for this client next? a. surgery b. identification of a primary site c. radiation d. chemotherapy
b
The nurse notes that an older client has experienced signs of benign prostatic hypertrophy "for years." What additional diagnostic testing may be prescribed for this client? a. liver function tests b. kidney function evaluation c. colonoscopy d. bone scan
c
The nurse plans care for an older adult client recovering from prostate cancer surgery. Which action should the nurse emphasize to prevent an injury and postoperative infection? a. limit the intake of fiber and fluids b. expect bright red blood in the urine c. avoid strenuous activities for 3 to 4 weeks d. use the Valsalva maneuver to evacuate the bowels
c
The nurse reviews an older adult client's urinary symptoms. Which statement by the client requires follow up by the nurse? a. "I try to avoid caffeinated beverages because they make my symptoms worse." b. "I usually urinate once or twice during the night." c. "I have trouble making it to the restroom on time." d. "I am not restricting my fluid intake any longer."
c
The older adult client is at risk for altered skin integrity related to urinary incontinence. Which goal is the most important to facilitate balance among the client's physiologic needs? a. The client accepts his or her change in health status. b. The client is able to ambulate to the toilet safely. c. The client stays dry and odor free. d. The client reduces fluid intake appropriately.
a
The older adult client is at risk for injury related to urinary incontinence. Which goal is the priority? a. The client is free from falls related to escaped urine. b. The client participates actively in physical therapy. c. The client restores desired roles. d. The client remains free from infection.
A
The staff nurse at a long-term care facility is training a newly hired nurse on how to promote the urinary function of older adult clients. Which behavior by the newly hired nurse requires further follow up by the staff nurse? A. proactively using absorbent products for clients in case they experience incontinence B. ensuring that newly admitted clients are aware of where the nearest restrooms are located C. assisting a client with an unsteady gait to the toilet as soon as the client expresses the need to void D. encouraging a client with a urinary tract infection to drink plenty of fluids
d
What action should the nurse prioritize when trying to prevent an older adult client's risk for urosepsis? a. Push fluids unless contraindicated. b. Encourage the use of a toileting schedule. c. Administer prophylactic antibiotics as prescribed. d. Avoid the use of urinary catheters whenever possible.
a, d, e
When advising the older adult female client about the use of vaginal lubricants, which substance(s) will the nurse included? Select all that apply. a. K-Y jelly b. perfumed soap c. petroleum jelly d. aloe vera gel e. vitamin E oil
b, c, d
Which action(s) will the nurse teach an older adult client to do to enhance voiding and prevent urinary retention? Select all that apply. a. Soak hands in cold water. b. Rock back and forth. c. Void in an upright position. d. Massage the bladder area. e. Decrease fluid intake.
c
Which older female reproductive system problem is associated with the nursing diagnosis anxiety? a. Infection b. Cancer c. Sexual dysfunction d. Vaginitis
c
Which teaching will the nurse include in a urinary health promotion webinar for aging clients? a. foods high in vitamin D b. voiding in an seated position c. adequate fluid intake d. adequate rest
a
While the nurse is performing an assessment on an older adult client, the client discloses a recent problem with urinary incontinence. The client reports discussing this problem with friends, but not with a health care provider. How will the nurse respond? a. "What are some ways that you have taken care of this issue?" b. "Tell me about what your friends have shared with you." c. "Why have you not yet shared this with your health care provider?" d. "I will be required to share this information with your health care provider."
