Deck 59: Caring Forclients With Disorders of the Bladder and Urethra

Question 1

A client who is hospitalized is wearing a condom catheter for urinary incontinence. Which of the following would be most appropriate to include in this client's plan of care?

A) Checking the catheter for kinks.
B) Changing the condom catheter every 3 days.
C) Keeping the penis positioned in an upward manner.
D) Emptying the drainage bag when it is completely full.

Answer 1

Checking the catheter for kinks.

Question 2

A female client who suffers from urethral strictures undergoes a dilation procedure. Following the procedure, she experiences a burning sensation while voiding. Which of the following instructions would be most helpful?

A) Encourage her to visit a local ostomy support group.
B) Advise her to cleanse her perineum frequently.
C) Urge her to apply moisture sealants.
D) Instruct her to take warm sitz baths.

Answer 2

Instruct her to take warm sitz baths.

Question 3

A client is learning how to perform Kegel exercises. Which statement by the client indicates a need for additional teaching?

A) "I need to sit or stand with my legs slightly apart."
B) "I should draw in my muscles like when I'm moving my bowels."
C) "I need to hold the position for at least 10 second."
D) "I should repeat the sequence of exercises 3 to 4 times a day."

Answer 3

"I need to hold the position for at least 10 second."

Question 4

An older adult male client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises him to wear barrier garments such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity?

A) Avoiding the application of moisture sealant.
B) Exposing the affected area to air.
C) Using scented sprays or perfumes.
D) Avoiding using an electric room deodorizer.

Question 5

A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands that this drug is an effective treatment because it:

A) Increases contraction of the detrusor muscle.
B) Increases bladder neck resistance.
C) Reduces bladder spasticity.
D) Decreases involuntary bladder contractions.

Question 6

A female client is undergoing a bladder training program as treatment for urinary incontinence. Which of the following techniques would be the most appropriate suggestion?

A) Performing Kegel exercises.
B) Instilling dimethyl sulfoxide (DMSO) in the bladder.
C) Using the services of a chronic pain center.
D) Taking warm sitz baths.

Question 7

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?

A) Need to wear underwear made from synthetic material
B) Importance of urinating every 4 to 6 hours while awake
C) Suggestion to take tub baths instead of showers
D) Need to urinate after engaging in sexual intercourse

Question 8

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively?

A) Client's manual dexterity and vision
B) History of allergy to iodine and seafood
C) Dietary habits involving cholesterol-laden food
D) Menstrual history

Question 9

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

A) Urinary retention
B) Fever
C) Frequency
D) Painless hematuria

Question 10

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

A) "Use scented powders to disguise any odor."
B) "Make sure to eat enough fiber to prevent constipation."
C) "Try drinking coffee throughout the day."
D) "Limit the number of times you urinate during the day."

Question 11

A client is suspected of having interstitial cystitis. Which diagnostic test would the nurse anticipate as being used to confirm the diagnosis?

A) Cystoscopy
B) Voiding cystourethrogram
C) Urine culture
D) Bladder biopsy

Question 12

The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important?

A) Set up a routine schedule of every 4 hours to check for residual urine.
B) Check for residual after the client reports the urge to void.
C) Record the volume of urine obtained.
D) Catheterize the client immediately after the client voids.

Question 13

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?

A) Suprapubic cystostomy tube
B) Permanent drainage with a urethral catheter
C) Clean intermittent catheterization
D) Credé voiding procedure

Question 14

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?

A) Cystitis
B) Bladder stones
C) Urinary retention
D) Urethral stricture

Question 15

When describing the types of bladder tumors that may occur, which type would the nurse identify as most common?

A) Transitional cell carcinoma
B) Squamous cell carcinoma
C) Adenocarcinoma
D) Papillary carcinoma

Question 16

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor?

A) History of untreated gonorrhea
B) History of bladder inflammation
C) History of cigarette smoking
D) History of a sexually transmitted disease

Question 17

A client is suspected of having an outflow obstruction. Which of the following would the nurse expect the client to report?

A) Forceful stream
B) Straining to empty bladder
C) Urgency
D) Dysuria

Question 18

A male client is very anxious about the ineffective sexuality pattern that he faces after a urinary diversion procedure. Which of the following would be most appropriate to help reduce the client's anxiety?

A) Tactfully ask the client questions about sexual patterns.
B) Discourage him from sharing his feelings with his partner.
C) Suggest Kegel exercises to ease painful intercourse.
D) Discuss alternatives to sexual intercourse.

Question 19

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

A) Low oxalate
B) Low purine
C) High protein
D) High sodium

Question 20

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?

A) Stress
B) Urge
C) Overflow
D) Functional

Question 21

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

A) Application of an ostomy pouch
B) Intermittent catheterizations
C) Exercises to promote sphincter control
D) Irrigating the urinary diversion

Question 22

A client is being discharged home after a radical cystectomy and creation of ureterosigmoidoscopy. Which of the following must be avoided?

A) Intermittent self-catheterization
B) Stoma irritation
C) Enemas
D) Sodium intake

Question 23

A client with a malignant bladder tumor removed by fulguration is being instructed to have follow cystoscopic examinations at which frequency?

A) Every month
B) Every 3 months
C) Every 6 months
D) Every 12 months

Question 24

Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor?

A) Avoid foods such as buttermilk or yogurt.
B) Eat plenty of cheese and eggs.
C) Avoid pouches with carbon filters.
D) Add a few drops of diluted white vinegar to the pouch.

Question 25

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the student have understood the material when they identify which of the following as a cause of stress incontinence?

A) Increased urine production due to metabolic conditions
B) Decreased pelvic muscle tone due to multiple pregnancies
C) Bladder irritation related to urinary tract infections
D) Obstruction due to fecal impaction or enlarged prostate