Question 1

A nurse teaches clients about the difference between urge incontinence and stress incontinence.Which statements should the nurse include in this education? (Select all that apply.)

Accepted Answer

Clients who suffer from stress incontinence have weak pelvic floor muscles or urethral sphincter and cannot tighten their urethra sufficiently to overcome the increased detrusor pressure.Stress incontinence is common after childbirth,when the pelvic muscles are stretched and weakened from pregnancy and delivery.Urge incontinence occurs in people who cannot suppress the contraction signal from the detrusor muscle.Abnormal detrusor contractions may be a result of neurologic abnormalities including dementia,or may occur with no known abnormality.Post-void residual is associated with reflex incontinence,not with urge incontinence or stress incontinence.Management of urge incontinence includes decreasing fluid intake,especially in the evening hours.

Question 2

A nurse teaches a client about self-catheterization in the home setting.Which statements should the nurse include in this client's teaching? (Select all that apply.)

Accepted Answer

The key points in self-catheterization include washing hands,using lubricants,and maintaining a regular schedule to avoid distention and retention of urine that leads to bacterial growth.A smaller rather than a larger lumen catheter is preferred.The client needs to catheterize more often than every 12 hours.Self-catheterization in the home is a clean procedure.

Question 3

A nurse assesses a client with a fungal urinary tract infection (UTI).Which assessments should the nurse complete? (Select all that apply.)

Accepted Answer

Clients who are severely immunocompromised or who have diabetes mellitus are more prone to fungal UTIs.The nurse should assess for these factors by asking about medical history,current medical problems,and the current medication list.A physical examination and a post-void residual may be needed,but not until further information is obtained indicating that these examinations are necessary.Travel to foreign countries probably would not be important because,even if exposed,the client needs some degree of compromised immunity to develop a fungal UTI.

Question 4

A nurse teaches a client with a history of calcium phosphate urinary stones.Which statements should the nurse include in this client's dietary teaching? (Select all that apply.)

Accepted Answer

Clients with calcium phosphate urinary stones should be taught to limit the intake of foods high in animal protein,sodium,and calcium.Clients with calcium oxalate stones should avoid spinach,black tea,and rhubarb.Clients with uric acid stones should avoid red wine.

Question 5

A nurse provides phone triage to a pregnant client.The client states,"I am experiencing a burning pain when I urinate." How should the nurse respond?

Accepted Answer

Pregnant clients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy.The nurse should encourage the client to make an appointment and have the infection treated.Burning pain when urinating does not indicate the start of labor or weakening of pelvic muscles.

Question 6

A nurse teaches a female client who has stress incontinence.Which statements should the nurse include about pelvic muscle exercises? (Select all that apply.)

Accepted Answer

The client should be taught that the muscles used to start and stop urination are pelvic muscles,and that pelvic muscles can be strengthened by contracting and relaxing them.The client should tighten pelvic muscles for a slow count of 10 and then relax the muscles for a slow count of 10,and perform this exercise 15 times while in lying-down,sitting-up,and standing positions.The client should begin to notice improvement in control of urine after several weeks of exercising the pelvic muscles.

Question 7

A nurse cares for clients with urinary incontinence.Which types of incontinence are correctly paired with their clinical manifestation? (Select all that apply.)

Accepted Answer

Stress incontinence is a loss of urine with physical exertion,coughing,sneezing,or exercising.Urge incontinence presents with an abrupt and strong urge to void and usually has a large amount of urine released with each occurrence.Overflow incontinence occurs with bladder distention and results in a constant dribbling of urine.Functional incontinence is the leakage of urine caused by factors other than a disorder of the lower urinary tract.Reflex incontinence results from abnormal detrusor contractions from a neurologic abnormality.

Question 8

A nurse teaches a client about self-care after experiencing a urinary calculus treated by lithotripsy.Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)

Accepted Answer

The client should be taught to finish the prescribed antibiotic to ensure that he or she does not get a urinary tract infection.The client should drink at least 3 liters of fluid daily to dilute potential stone-forming crystals,prevent dehydration,and promote urine flow.After lithotripsy,the client should expect bruising that may take several weeks to resolve.The client should also experience blood in the urine for several days.The client should report any pain,fever,chills,or difficulty with urination to the provider as these may signal the beginning of an infection or the formation of another stone.

Question 9

A nurse assesses a client who has had two episodes of bacterial cystitis in the last 6 months.Which questions should the nurse ask? (Select all that apply.)

Accepted Answer

Fluid intake,estrogen levels,and immune suppression all can increase the chance of recurrent cystitis.Family history is usually insignificant,and cranberry juice,not grapefruit or orange juice,has been found to increase the acidic pH and reduce the risk for bacterial cystitis.

Question 10

A nurse cares for a client with urinary incontinence.The client states,"I am so embarrassed.My bladder leaks like a young child's bladder." How should the nurse respond?

Accepted Answer

The nurse should accept and acknowledge the client's concerns,and assist the client to learn techniques that will allow control of urinary incontinence.The nurse should not diminish the client's concerns with the use of pads or stating statistics about the occurrence of incontinence.

Question 11

A nurse assesses a male client who is recovering from a urologic procedure.Which assessment finding indicates an obstruction of urine flow?

Accepted Answer

The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow.This rarely causes pain and has no impact on blood pressure.The client may experience overflow incontinence with the involuntary loss of urine when the bladder is distended.Blood in the urine is not a manifestation of the obstruction of urine flow.

Question 12

A nurse teaches a client who is starting urinary bladder training.Which statement should the nurse include in this client's teaching?

Accepted Answer

The client should try to hold the urine consciously until the next scheduled toileting time.Toileting should occur at specific intervals during the training.The toileting interval should be no less than every hour.The interval can be increased once the client becomes comfortable with the interval.

Question 13

A nurse assesses a client who presents with renal calculi.Which question should the nurse ask?

Accepted Answer

There is a strong association between family history and stone formation and recurrence.Nephrolithiasis is associated with many genetic variations; therefore,the nurse should ask whether other family members have also had renal stones.The other questions do not refer to renal calculi but instead are questions that should be asked of a client with a urinary tract infection.

Question 14

A nurse plans care for clients with urinary incontinence.Which client is correctly paired with the appropriate intervention?

Accepted Answer

Exercise therapy and electrical stimulation are used for clients with stress incontinence related to childbirth or low levels of estrogen after menopause.Exercise therapy increases pelvic wall strength; it does not improve ambulation.Physical therapy and a bedside commode would be appropriate interventions for the client who has difficulty ambulating.Habit training is the type of bladder training that will be most effective with cognitively impaired clients.Bladder training can be used only with a client who is alert,aware,and able to resist the urge to urinate.

Quiz 66: Care of Patients with Urinary Problems