Question 1

To assess a client who is experiencing symptoms of overflow incontinence,the nurse will focus on which area?

Accepted Answer

When the bladder becomes so full and distended that urine leaks out,it is called overflow incontinence.Clients with high risk for overflow incontinence are those with diabetes.

Question 2

Which of the following laboratory results would the nurse expect for the client who has chronic glomerulonephritis?

Accepted Answer

Chronic glomerulonephritis generally leads to permanent kidney damage.It is a progressive but slow,destructive process,causing loss of kidney function.The kidney will actually decrease in size as glomeruli are destroyed.End-stage renal disease (ESRD)may result.Nephrons lose their ability to concentrate urine,and the urine becomes pale and dilute.BUN,serum creatinine,and urine protein are monitored on a regular basis to monitor renal function.

Question 3

A client who has an allergy to sulfa drugs is given a prescription for Amoxil to treat a urinary tract infection.Which of these actions should the nurse take?

Accepted Answer

Antibiotic education for clients should include taking the medication as ordered,until the course is completed.

Question 4

A client who has multiple sclerosis develops total urinary incontinence.What initial treatment should the nurse tell the client to expect?

Accepted Answer

A blocked urethra or bladder weakness may prevent normal emptying.When no urine is retained in the bladder,it is termed total incontinence.Treatment includes an indwelling catheter attached to a collection bag.

Question 5

A client has developed a nosocomial cystitis.Which of these organisms MOST commonly causes cystitis?

Accepted Answer

Most urinary tract infections are caused by Escherichia coli,but some are caused by Candida albicans.

Question 6

Which of these statements should the nurse include for clients who have frequent urinary tract infections,to prevent recurrence?

Accepted Answer

Teaching for clients with frequent urinary tract infections to prevent recurrence should include cleaning the perineum front to back;wearing cotton undergarments;voiding more frequently,especially after sexual intercourse;and changing incontinence control products frequently to prevent infection.

Question 7

A client who had tonsillitis several weeks ago now complains of severe flank pain on the left side,headache,malaise,hematuria,and facial edema.The client describes urine appearing to be "smoky." The nurse should suspect the client has developed which of these conditions?

Accepted Answer

Clients may develop acute glomerulonephritis 1 to 3 weeks after an upper respiratory infection or skin infection caused by group A beta-hemolytic streptococcus.

Question 8

In addition to strict monitoring of intake and output,nursing interventions for the hospitalized client with acute glomerulonephritis would include which of the following?

Accepted Answer

Nursing interventions for the client with acute glomerulonephritis include strict monitoring of intake and output,vital signs,and daily weight;incorporating a turning schedule that includes range-of-motion exercises,and monitoring skin condition and integrity.

Question 9

A client with urinary retention may be treated by all of the following methods.Which method is preferred when the client is in acute distress?

Accepted Answer

A person who is unable to void when there is an urge to void has urinary retention.This condition creates urinary stasis and increases the possibility of infection.The urine may overflow the bladder's capacity,causing incontinence.The client may experience discomfort,anxiety,frequency of urination,and voiding of small amounts.The distended bladder can be palpated above the symphysis.The nurse should check for residual urine when the client does void.The way to check for residual urine is by catheterization.

Question 10

A client who has cystitis complains of extreme dysuria,and Pyridium has been prescribed.Which of these aspects should the nurse include in client teaching?

Accepted Answer

The client should be instructed that a reddish-orange discoloration of urine may occur.The client should also be instructed that this discoloration can stain fabric.The medication should be taken after meals to reduce the possibility of GI upset.A headache is an occasional side effect of the medication and does not warrant discontinuation of the medication.

Question 11

Which of these aspects should a nurse include when teaching a client who has nocturnal enuresis?

Accepted Answer

Incontinence during sleep is called nocturnal enuresis.Treatment includes limiting fluid intake after 6:00 P.M.

Question 12

The client with urge incontinence is BEST treated by which approach?

Accepted Answer

Urge incontinence occurs when a person is unable to suppress the sudden urge or need to urinate.An irritated bladder is often the cause.Treatment often includes encouraging a fluid intake of 3,000 mL/day.

Question 13

What is the goal of surgery to treat stress urinary incontinence?

Accepted Answer

Urinary incontinence is the involuntary loss of urine from the bladder.Although this is a physiologic problem,it also affects the client's emotional,psychological,and social well-being.All types of incontinence such as stress,urge,overflow,total,and nocturnal enuresis can be treated to restore and reconstruct the support of the pelvic floor muscles.

Question 14

What is the MOST common cause of urge incontinence?

Accepted Answer

Urge incontinence occurs when a person is unable to suppress the sudden urge or need to urinate.An irritated bladder is often the cause.

Question 15

Which of these normal changes occurring in the urinary system with aging may contribute to an older adult female client developing cystitis?

Accepted Answer

Cystitis,inflammation of the urinary bladder,is more common in females because of their short urethra,which allows bacteria to ascend from the vagina or rectum.Bacteria may descend from an infected kidney.Bacteria in the bladder multiply,causing redness and swelling of the wall of the bladder,which in turn causes increased urinary frequency,dysuria,pyuria,hematuria,and sometimes burning and urgency.The normal changes occurring in the urinary system with aging,such as weakening of bladder and perineal muscles that results in the inability to empty the bladder,may increase risk of developing cystitis in older females.

Question 16

A 60-year-old female client states that whenever she coughs,sneezes,or laughs there is leakage of urine.The nurse explains to the client that the incontinence this client experiencing is:

Accepted Answer

Stress incontinence,the most common type,is a leakage of urine when a person does anything that strains the abdomen such as coughing,laughing,jogging,dancing,sneezing,lifting,making a quick movement,or even walking.

Question 17

Discharge teaching for a client who has been treated for pyelonephritis would include which statement?

Accepted Answer

Pyelonephritis (pyelitis or nephropyelitis)is a bacterial infection of the renal pelvis,tubules,and interstitial tissue of one or both kidneys.The kidney becomes edematous,and the renal blood vessels become congested.The urine is usually cloudy,containing mucus,blood,and pus.The disease process causes fatigue,and bed rest should be followed during the acute phase.Sulfonamides,antimicrobials,and antipyretics are usually prescribed.Renal colic (severe pain in the kidney radiating to the groin)may impair urination.

Question 18

A client who has an enlarged prostate gland tells the nurse he feels like his bladder is not completely empty after voiding,and his health care provider requests a check for residual urine.Which of these nursing actions is correct?

Accepted Answer

The distended bladder can be palpated above the symphysis.The nurse should check for residual urine when the client does void.The way to check for residual urine is by cauterization.

Question 19

Nursing management of a client who has acute glomerulonephritis would include which aspect?

Accepted Answer

Nursing interventions for the client with acute glomerulonephritis include strict monitoring of intake and output,vital signs,and daily weight;incorporating a turning schedule that includes range-of-motion exercises;and monitoring skin condition and integrity.

Question 20

A client is to be treated for suspected cystitis.Which of these orders should the nurse implement first?

Accepted Answer

A urinary antimicrobial medication is given after a urinary specimen has been sent for C&S.Clients are usually asked to drink 3 to 4 liters of noncaffeinated fluid each day.Cranberry juice is especially beneficial,as it is believed to prevent bacteria from sticking to the wall of the bladder.Cystitis may lead to pyelonephritis.

Quiz 39: Urinary System