Deck 29: Disorders of the Lower Urinary Tract

Question 1

The patient reports persistent pelvic pain and urinary frequency and urgency.She says the pain improves when she empties her bladder.She does not have a fever and her repeated urinalyses over the past months have been normal,although she has a history of frequent bladder infections.She also has a history of fibromyalgia and hypothyroidism.Based on her history and complaints,her symptoms are characteristic of

A) neuroses.
B) ureteral stone.
C) neurogenic bladder.
D) interstitial cystitis.

Answer 1

interstitial cystitis.

Question 2

In addition to renal colic pain,signs or symptoms of ureteral stones may frequently include

A) hematuria.
B) postrenal renal failure.
C) urinary urgency.
D) proteinuria.

Answer 2

hematuria.

Question 3

Activation of parasympathetic nerves to the bladder will cause

A) bladder contraction.
B) bladder relaxation.
C) sphincter contraction.
D) urine reflux.

Answer 3

bladder contraction.

Question 4

The direct cause of stress incontinence is

A) the effect of aging.
B) pelvic muscle weakness.
C) neurologic conditions.
D) detrusor muscle overactivity.

Question 5

Detrusor muscle overactivity can be improved by administration of

A) alpha-receptor agonists.
B) botulinum toxin.
C) cholinergic agents.
D) nonsteroidal antiinflammatory agents.

Question 6

The difference between stress incontinence and urge incontinence is that stress incontinence

A) occurs in women, whereas urge incontinence occurs in both men and women.
B) occurs during sleep, whereas urge incontinence occurs during the waking hours.
C) is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.
D) is caused by a detrusor muscle problem, whereas urge incontinence is caused by a neurologic problem.

Question 7

Vesicoureteral reflux is associated with

A) increased serum creatinine.
B) recurrent cystitis.
C) polycystic renal disease.
D) proteinuria.

Question 8

Urinary retention with consistent or intermittent dribbling of urine is called

A) mixed incontinence.
B) enuresis.
C) stress incontinence.
D) overflow incontinence.

Question 9

A ureterocele is

A) an abnormally placed ureter.
B) an additional ureter.
C) a cystic dilation of a ureter.
D) fusion of both ureters at the bladder junction.

Question 10

Which group is at the highest risk for urinary tract infection?

A) Infants and children
B) Sexually active women
C) Adult males
D) Patients taking diuretics

Question 11

The microorganism that causes the vast majority of urinary tract infections is

A) Klebsiella.
B) Escherichia coli.
C) herpes simplex virus.
D) Candida albicans.

Question 12

A person is unaware that his bladder is full of urine,but complains that he is leaking urine almost constantly.The most accurate term for this type of incontinence is

A) overflow.
B) stress.
C) urge.
D) mixed.

Question 13

The most frequent initial symptom of bladder cancer is

A) bladder infection.
B) hematuria.
C) sudden incontinence.
D) dysuria.

Question 14

The normal post-void residual urine in the bladder is

A) less than 100 mL.
B) 150 to 200 mL.
C) 250 to 300 mL.
D) none of these; no normal residual volume is identified.

Question 15

The greatest risk factor for bladder cancer is

A) smoking.
B) recurrent bladder infections.
C) low fluid intake.
D) family history of bladder cancer.

Question 16

The disorder characterized by a neurologic lesion that affects bladder control is

A) neurogenic bladder.
B) detrusor inactivity.
C) bladder prolapse.
D) cystitis.

Question 17

Pelvic floor muscle training is appropriate for

A) overflow incontinence.
B) reflux prevention.
C) urge incontinence.
D) functional incontinence.

Question 18

A patient has ureteral colic.The manifestation that requires immediate notification of the physician is

A) severe flank pain.
B) vomiting.
C) pink-tinged urine.
D) chills and fever.

Question 19

The most commonly ordered diagnostic test for evaluation of the urinary system is

A) KUB.
B) cystogram.
C) ultrasonography.
D) cystography.

Question 20

The urinalysis finding most indicative of cystitis includes the presence of

A) WBCs and RBCs.
B) nitrites.
C) casts.
D) bacteria.

Question 21

Cystitis symptoms include (Select all that apply.)

A) CVA tenderness.
B) suprapubic pain.
C) dysuria.
D) fever.

Question 22

Characteristics of vesicoureteral reflux in children include (Select all that apply.)

A) possibly being genetic in nature.
B) often leading to recurrent urinary tract infections.
C) possibly resulting in hypertension.
D) usually requiring surgical intervention.

Question 23

A patient who has difficulty walking without assistance is incontinent of urine when help doesn't get to her quickly enough.The term for this type of incontinence is

A) extraurethral.
B) functional.
C) urge.
D) stress.

Question 24

Infection can lead to bladder stone formation.

Question 25

A patient,age 3,has vesicoureteral reflux."Why does that make him have so many bladder infections?" asks his mother.The nurse's best response is

A) "When he urinates, the urine makes a fluid trail to the bladder, and if he does not clean himself well, bacteria will enter and make a bladder infection."
B) "When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder."
C) "When he urinates, urine leaks into his bowel and bacteria from the bowel leak into the bladder, where they grow and make a bladder infection."
D) "When he urinates, urine stays in his bladder and the normal bacteria that live in the bladder have a chance to grow and cause a bladder infection."

Question 26

Characteristics of cystitis include (Select all that apply.)

A) more common in women.
B) less complicated in men.
C) associated with catheterization of the bladder.
D) fostered by stasis of urine.
E) usually resolve without treatment.

Question 27

Urge incontinence is often because of (Select all that apply.)

A) aging.
B) bladder infections.
C) obesity.
D) prostate enlargement.
E) diuretics.