Question 1

The nurse understands that stress incontinence occurs:&#10;A) With a urinary tract infection (UTI)&#10;B) Because of emotional strain&#10;C) As a result of increased intraabdominal pressure&#10;D) With a specific amount of urine in the bladder

Accepted Answer

If intraabdominal pressure increases,then the patient can have dribbling.A UTI causes frequency as a result of irritation in the bladder.Emotional strain can cause frequency.Specific volume of urine in the bladder triggers reflex incontinence.

Question 2

An older adult who is on bed rest after surgery is prescribed morphine for pain.Which of the following is the nurse's priority for preventive care?&#10;A) Constipation&#10;B) Diarrhea&#10;C) Poor solid food intake&#10;D) Poor liquid intake

Accepted Answer

This older adult is at high risk for developing constipation as a result of being on bed rest and being prescribed an opiate for pain.A decrease in activity,combined with the use of an opiate,often leads to constipation,not diarrhea.Appetite can be poor for the first few days after surgery,but it often returns without incidence.Decreased fluid intake is often supplemented with intravenous fluids for the first few days after surgery.

Question 3

The nurse assesses a male resident in a nursing home for urinary incontinence and determines that he is unaware of the problem.Which recommendation should the nurse implement?&#10;A) Limit oral fluid intake.&#10;B) Provide regular toileting.&#10;C) Apply absorbent undergarment.&#10;D) Encourage frequent rest periods.

Accepted Answer

The nurse provides regular toileting to promote voiding and to prevent incontinence for a resident with a potential cognitive impairment.The nurse avoids limiting oral fluid intake; older adults,especially those living in residential facilities,are at higher risk for dehydration than younger people.Using absorbent undergarments may be unnecessary if the incontinence can be controlled with regular toileting.Nursing research supports the claim that ambulatory residents are less likely to be incontinent.This resident may have dementia,but maintaining mobility will have a greater impact in preventing incontinence.

Question 4

Which action should be included in all bladder-retraining programs?&#10;A) Toileting at bedtime&#10;B) Using adult incontinence pads&#10;C) Toileting every hour&#10;D) Providing 1000 ml of fluids daily

Accepted Answer

Toileting at bedtime should be incorporated for all patients.This intervention decreases the amount of urine in the bladder during the night.Incontinence pads are not encouraged during the retraining process.Toileting is not automatically scheduled every hour but is based on the individual's needs.The volume of scheduled fluid intake is also based on the individual's needs.

Question 5

The nurse evaluates the urinalysis (UA)of a female patient with an indwelling urinary catheter.The UA report shows gross contamination of the urine.Rank the nursing interventions in order,beginning with the first intervention the nurse should implement.

A)Provide perineal hygiene.
B)Provide urinary catheter care.
C)Check the duration of catheterization.
D)Obtain a urine specimen from a sterile port.
E) None of the above

Accepted Answer

Gross contamination of a urine specimen is a costly error because contaminated urine is unsuitable for evaluation.The nurse responds to the report of contamination by determining how long the catheter has been in place; increased duration increases the risk of a UTI from fecal contamination and can affect subsequent nursing interventions.The second intervention is providing catheter care.Regardless of the cause of the specimen contamination,catheter care is a suitable nursing intervention because it decreases the colony count on the catheter.Third,the nurse progresses to perineal care.This intervention follows catheter care because of the principle of asepsis regarding working from the least contaminated to the most contaminated area.Finally,the nurse obtains another urine specimen from a sterile port.Although the catheter has been washed,the nurse rubs the port with alcohol and withdraws urine with a sterile needle and syringe to prevent the introduction of contaminants into the specimen.

Question 6

A large residual urine volume characterizes what type of incontinence?&#10;A) Urge&#10;B) Stress&#10;C) Overflow&#10;D) Functional

Accepted Answer

Dribbling,hesitancy,and a large residual urine volume characterize overflow incontinence.Both urge incontinence and stress incontinence are associated with a small residual urine volume.Functional incontinence is not associated with residual urine volume.

Question 7

Which of the following is a true statement about elimination in older adults?&#10;A) Defecation less than once each day is not necessarily constipation.&#10;B) Mineral oil is recommended as a laxative for the older adult.&#10;C) Excessive sleep can be a symptom of constipation.&#10;D) Leaking liquid feces should be treated as diarrhea.

Accepted Answer

Constipation is present when fewer than three bowel movements occur per week or when the frequency decreases.Mineral oil and saline laxatives can be harmful.Fiber,fruit,and fluids are the first recommendations; stimulant laxatives such as senna and cascara can be used on a short-term basis.Altered cognitive status,increased agitation,and unexplained falls can be symptoms of constipation; these behaviors may be the only clinical symptom of constipation in cognitively impaired older persons.Excessive sleep has not been identified as a symptom.Liquid feces may be leaking around a fecal impaction,and antidiarrheal treatment can aggravate the impaction.

Question 8

An older adult is in the hospital because of heart failure and has become incontinent of urine.Which evidence-based resource should the nurse use to guide continence care for this patient?&#10;A) Nursing Standard Practice Protocol&#10;B) The Borun Center training modules&#10;C) Toolkit from the American Geriatrics Society&#10;D) The Centers for Medicare and Medicaid Services

Accepted Answer

The Nursing Standard Practice Protocol is a resource for urinary incontinence in older adults admitted to acute care.The Borun Center provides training modules suitable for nurses managing incontinence in residents in long-term care facilities.The American Geriatrics Society helps with managing urinary incontinence in primary care settings.The Centers for Medicare and Medicaid Services supply guidelines for managing urinary incontinence in long-term care facilities.

Question 9

An older woman tells the nurse practitioner that she fears her family will place her in a nursing home because she developed stress incontinence.Which recommendation should the nurse implement?&#10;A) Tell her to eliminate the use of caffeinated beverages.&#10;B) Coordinate a family conference with the older adult.&#10;C) Recommend exercises to strengthen the pelvic floor.&#10;D) Schedule voiding for every 2 hours around the clock.

Accepted Answer

The nurse practitioner recommends pelvic floor exercises to strengthen the pelvic floor and the muscles that surround the urethra,vagina,and rectum to decrease the incidence of stress incontinence.Stress incontinence is usually due to weakened pelvic floor muscles; therefore eliminating caffeinated beverages can be an ineffective treatment.Arranging a family conference is premature and potentially embarrassing for the older adult.Many therapies are available to decrease this older adult's incontinence.Scheduled voiding is recommended at 2- to 4-hour intervals during the day and at 4-hour intervals at night.

Question 10

The nurse is caring for a patient who has recently had an indwelling catheter placed.The nurse should assess the patient for:&#10;A) An increase in oral fluid intake&#10;B) A change in mental status&#10;C) Upper back pain&#10;D) A decrease in activity

Accepted Answer

The nurse assesses the older adult's mental status.Changes in mental status,character of urine,decreased appetite,abdominal pain,chills,low back pain,urethral discharge in men,new onset of incontinence,or even respiratory distress may signal a possible UTI in older people.An indwelling catheter does not often cause a decrease in activity.

Question 11

Continuous indwelling catheter use is indicated for which condition(s)?&#10;A) Urethral obstruction&#10;B) Urinary retention&#10;C) Stress incontinence&#10;D) Severely impaired skin integrity

Accepted Answer

The answer of Continuous indwelling catheter use is indicated for...

Question 12

Which option is part of a program that addresses bowel incontinence in an older adult patient?&#10;A) Ensuring that a toilet or commode is readily accessible to the patient&#10;B) Encouraging the intake of 1 liter of water each day&#10;C) Expecting a rapid and full recovery&#10;D) Toileting the patient 10 to 15 minutes after meals

Accepted Answer

The answer of Which option is part of a program...

Question 13

What is the most important aspect of care for the nurse to maintain when assisting an older patient with urinary incontinence?&#10;A) Availability of protective rubber garments&#10;B) Using indwelling urinary catheters&#10;C) Using smooth muscle relaxants&#10;D) Maintaining an attitude that is respectful and positive about resolving the problem

Accepted Answer

The answer of What is the most important aspect of...

Question 14

Which signs and symptoms are characteristic of a urinary tract infection (UTI)in an older adult?&#10;A) Fever&#10;B) Uremia&#10;C) Dysuria&#10;D) Anorexia&#10;E) Flank pain&#10;F)Turbid urine

Accepted Answer

The answer of Which signs and symptoms are characteristic of...

Question 15

Long-term use of external catheters can lead to which complication(s)?&#10;A) Fungal skin infections&#10;B) Penile skin maceration&#10;C) Atrophy&#10;D) Edema&#10;E) Phimosis

Accepted Answer

The answer of Long-term use of external catheters can lead...

Question 16

The nurse wants to begin helping a resident who is overweight and has urinary incontinence with healthy bladder behavior skills.Which intervention should the nurse implement?&#10;A) Begin a low-calorie diet for weight management.&#10;B) Schedule voiding at 2- to 4-hour intervals.&#10;C) Instruct the resident to practice abdominal exercises.&#10;D) Reduce the time between an urge to void and voiding.

Accepted Answer

The answer of The nurse wants to begin helping a...

Deck 10: Elimination