Question 1

The nurse is providing care to a client at a local clinic. The nurse suspects that the client is experiencing a urinary tract infection. Which urinalysis result supports the nurse's suspicions?

Accepted Answer

A)A urinalysis typically consists of the pH, glucose, specific gravity, protein, and WBC count. The pH, glucose, and specific gravity are all within normal limits. A normal WBC is 3-4. The WBC count for this client is high and indicates infection.
B)A urinalysis typically consists of the pH, glucose, specific gravity, protein, and WBC count. The pH, glucose, and specific gravity are all within normal limits. A normal WBC is 3-4. The WBC count for this client is high and indicates infection.
C)A urinalysis typically consists of the pH, glucose, specific gravity, protein, and WBC count. The pH, glucose, and specific gravity are all within normal limits. A normal WBC is 3-4. The WBC count for this client is high and indicates infection.
D)A urinalysis typically consists of the pH, glucose, specific gravity, protein, and WBC count. The pH, glucose, and specific gravity are all within normal limits. A normal WBC is 3-4. The WBC count for this client is high and indicates infection.

Question 2

The charge nurse is observing a newly licensed nurse conduct an abdominal assessment on a client admitted with an abdominal mass that is affecting bowel elimination. Which actions by the newly licensed nurse would require the charge nurse to intervene? Select all that apply.

Accepted Answer

A)Physical examination of the abdomen in relation to bowel elimination problems includes inspection, auscultation, percussion, and palpation. Auscultation should precede palpation, because palpation can alter peristalsis. Never use deep palpation on a client who has an abdominal mass, renal transplant, or polycystic kidneys, or who is at risk for hemorrhage.
B)Physical examination of the abdomen in relation to bowel elimination problems includes inspection, auscultation, percussion, and palpation. Auscultation should precede palpation, because palpation can alter peristalsis. Never use deep palpation on a client who has an abdominal mass, renal transplant, or polycystic kidneys, or who is at risk for hemorrhage.
C)Physical examination of the abdomen in relation to bowel elimination problems includes inspection, auscultation, percussion, and palpation. Auscultation should precede palpation, because palpation can alter peristalsis. Never use deep palpation on a client who has an abdominal mass, renal transplant, or polycystic kidneys, or who is at risk for hemorrhage.
D)Physical examination of the abdomen in relation to bowel elimination problems includes inspection, auscultation, percussion, and palpation. Auscultation should precede palpation, because palpation can alter peristalsis. Never use deep palpation on a client who has an abdominal mass, renal transplant, or polycystic kidneys, or who is at risk for hemorrhage.
E)Physical examination of the abdomen in relation to bowel elimination problems includes inspection, auscultation, percussion, and palpation. Auscultation should precede palpation, because palpation can alter peristalsis. Never use deep palpation on a client who has an abdominal mass, renal transplant, or polycystic kidneys, or who is at risk for hemorrhage.

Question 3

The nurse is providing care to a client who is experiencing urinary retention. Which diagnostic tool does the nurse anticipate will be ordered for this client?

Accepted Answer

A)An ultrasonic bladder scan is the diagnostic test that is used to examine for residual urine. A urinalysis is often used to monitor the urine for infection. An IVP is used to diagnosis a kidney stone. A cystoscopy allows direct visualization of the bladder wall and urethra. It is often used to remove stones.
B)An ultrasonic bladder scan is the diagnostic test that is used to examine for residual urine. A urinalysis is often used to monitor the urine for infection. An IVP is used to diagnosis a kidney stone. A cystoscopy allows direct visualization of the bladder wall and urethra. It is often used to remove stones.
C)An ultrasonic bladder scan is the diagnostic test that is used to examine for residual urine. A urinalysis is often used to monitor the urine for infection. An IVP is used to diagnosis a kidney stone. A cystoscopy allows direct visualization of the bladder wall and urethra. It is often used to remove stones.
D)An ultrasonic bladder scan is the diagnostic test that is used to examine for residual urine. A urinalysis is often used to monitor the urine for infection. An IVP is used to diagnosis a kidney stone. A cystoscopy allows direct visualization of the bladder wall and urethra. It is often used to remove stones.

Question 4

The nurse is providing care to a client who is experiencing urinary incontinence. Which independent nursing intervention is the most appropriate for this client?

Accepted Answer

A)Clients with urinary incontinence must be taught hygiene care-sometimes called incontinence care-to protect against tissue breakdown. Encouraging increased fluid intake is appropriate for a client who is dehydrated. Instructing on self-catheterization and providing catheter care is appropriate for a client who is diagnosed with urinary retention.
B)Clients with urinary incontinence must be taught hygiene care-sometimes called incontinence care-to protect against tissue breakdown. Encouraging increased fluid intake is appropriate for a client who is dehydrated. Instructing on self-catheterization and providing catheter care is appropriate for a client who is diagnosed with urinary retention.
C)Clients with urinary incontinence must be taught hygiene care-sometimes called incontinence care-to protect against tissue breakdown. Encouraging increased fluid intake is appropriate for a client who is dehydrated. Instructing on self-catheterization and providing catheter care is appropriate for a client who is diagnosed with urinary retention.
D)Clients with urinary incontinence must be taught hygiene care-sometimes called incontinence care-to protect against tissue breakdown. Encouraging increased fluid intake is appropriate for a client who is dehydrated. Instructing on self-catheterization and providing catheter care is appropriate for a client who is diagnosed with urinary retention.

Question 5

The nurse is caring for a client with a history of urinary tract infections (UTIs). Which action by the nurse would decrease the risk of the client experiencing future UTIs?

Accepted Answer

A)Suppressing urination increases the risk of urinary tract infections. The pelvic floor muscles should not be used to force urine flow, and doing so is considered a poor toileting habit. The client should wipe from front to back because wiping from back to front would contaminate the urinary meatus. The client should decrease the use of caffeine in the diet because caffeine is a bladder irritant.
B)Suppressing urination increases the risk of urinary tract infections. The pelvic floor muscles should not be used to force urine flow, and doing so is considered a poor toileting habit. The client should wipe from front to back because wiping from back to front would contaminate the urinary meatus. The client should decrease the use of caffeine in the diet because caffeine is a bladder irritant.
C)Suppressing urination increases the risk of urinary tract infections. The pelvic floor muscles should not be used to force urine flow, and doing so is considered a poor toileting habit. The client should wipe from front to back because wiping from back to front would contaminate the urinary meatus. The client should decrease the use of caffeine in the diet because caffeine is a bladder irritant.
D)Suppressing urination increases the risk of urinary tract infections. The pelvic floor muscles should not be used to force urine flow, and doing so is considered a poor toileting habit. The client should wipe from front to back because wiping from back to front would contaminate the urinary meatus. The client should decrease the use of caffeine in the diet because caffeine is a bladder irritant.

Question 6

The nurse is conducting education regarding urinary health at an assisted living facility. When planning topics to include in the session, which are appropriate for the nurse to consider? Select all that apply.

Accepted Answer

A)When planning an education session regarding urinary health at an assisted living facility, the nurse would include information that affects the urinary health of the older adult client. Information that is appropriate for the nurse to consider is the decrease in renal blood flow due to vascular changes and that urinary incontinence may occur because of issues with mobility and neurological impairment. While all of the other statements are true regarding urinary health, they are not appropriate for this presentation to older adult clients.
B)When planning an education session regarding urinary health at an assisted living facility, the nurse would include information that affects the urinary health of the older adult client. Information that is appropriate for the nurse to consider is the decrease in renal blood flow due to vascular changes and that urinary incontinence may occur because of issues with mobility and neurological impairment. While all of the other statements are true regarding urinary health, they are not appropriate for this presentation to older adult clients.
C)When planning an education session regarding urinary health at an assisted living facility, the nurse would include information that affects the urinary health of the older adult client. Information that is appropriate for the nurse to consider is the decrease in renal blood flow due to vascular changes and that urinary incontinence may occur because of issues with mobility and neurological impairment. While all of the other statements are true regarding urinary health, they are not appropriate for this presentation to older adult clients.
D)When planning an education session regarding urinary health at an assisted living facility, the nurse would include information that affects the urinary health of the older adult client. Information that is appropriate for the nurse to consider is the decrease in renal blood flow due to vascular changes and that urinary incontinence may occur because of issues with mobility and neurological impairment. While all of the other statements are true regarding urinary health, they are not appropriate for this presentation to older adult clients.
E)When planning an education session regarding urinary health at an assisted living facility, the nurse would include information that affects the urinary health of the older adult client. Information that is appropriate for the nurse to consider is the decrease in renal blood flow due to vascular changes and that urinary incontinence may occur because of issues with mobility and neurological impairment. While all of the other statements are true regarding urinary health, they are not appropriate for this presentation to older adult clients.

Question 7

The nurse is providing care to newborns in the nursery. When assessing the newborns' urinary output, which does the nurse anticipate as normal daily urinary output?

Accepted Answer

A)Normal urinary output for the newborn at 1-2 days of age is 15-60 mL per day. Normal urinary output for a newborn 3 to 10 days of age is 100-300 mL per day. The normal output for the newborn at 10 days of age to the infant at 2 months of age is 250-400 mL per day. Normal output for an infant at 2 months of age through 1 year is 400-500 mL per day.
B)Normal urinary output for the newborn at 1-2 days of age is 15-60 mL per day. Normal urinary output for a newborn 3 to 10 days of age is 100-300 mL per day. The normal output for the newborn at 10 days of age to the infant at 2 months of age is 250-400 mL per day. Normal output for an infant at 2 months of age through 1 year is 400-500 mL per day.
C)Normal urinary output for the newborn at 1-2 days of age is 15-60 mL per day. Normal urinary output for a newborn 3 to 10 days of age is 100-300 mL per day. The normal output for the newborn at 10 days of age to the infant at 2 months of age is 250-400 mL per day. Normal output for an infant at 2 months of age through 1 year is 400-500 mL per day.
D)Normal urinary output for the newborn at 1-2 days of age is 15-60 mL per day. Normal urinary output for a newborn 3 to 10 days of age is 100-300 mL per day. The normal output for the newborn at 10 days of age to the infant at 2 months of age is 250-400 mL per day. Normal output for an infant at 2 months of age through 1 year is 400-500 mL per day.

Question 8

A client is diagnosed with high blood pressure that is not responding to medications. The nurse suspects renal stenosis. When assessing for this condition, which location will the nurse use for auscultation?

Accepted Answer

A)The nurse should auscultate the renal arteries by placing the bell of the stethoscope lightly in the areas of the renal arteries, located in the left and right upper abdominal quadrants. Systolic bruits ("whooshing" sounds)may indicate renal artery stenosis.
B)The nurse should auscultate the renal arteries by placing the bell of the stethoscope lightly in the areas of the renal arteries, located in the left and right upper abdominal quadrants. Systolic bruits ("whooshing" sounds)may indicate renal artery stenosis.
C)The nurse should auscultate the renal arteries by placing the bell of the stethoscope lightly in the areas of the renal arteries, located in the left and right upper abdominal quadrants. Systolic bruits ("whooshing" sounds)may indicate renal artery stenosis.
D)The nurse should auscultate the renal arteries by placing the bell of the stethoscope lightly in the areas of the renal arteries, located in the left and right upper abdominal quadrants. Systolic bruits ("whooshing" sounds)may indicate renal artery stenosis.

Question 9

The client is experiencing urinary urgency and frequency. Which medication should the nurse anticipate may be prescribed by the healthcare provider?

Accepted Answer

A)Oxybutynin is an anticholinergic that reduces urgency and frequency by blocking muscarinic receptors in the detrusor muscle of the bladder, thereby inhibiting contractions and increasing storage capacity. The nurse would anticipate an order for oxybutynin. Furosemide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bumetanide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bethanechol chloride is a cholinergic agent that stimulates bladder contraction and facilitates voiding.
B)Oxybutynin is an anticholinergic that reduces urgency and frequency by blocking muscarinic receptors in the detrusor muscle of the bladder, thereby inhibiting contractions and increasing storage capacity. The nurse would anticipate an order for oxybutynin. Furosemide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bumetanide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bethanechol chloride is a cholinergic agent that stimulates bladder contraction and facilitates voiding.
C)Oxybutynin is an anticholinergic that reduces urgency and frequency by blocking muscarinic receptors in the detrusor muscle of the bladder, thereby inhibiting contractions and increasing storage capacity. The nurse would anticipate an order for oxybutynin. Furosemide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bumetanide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bethanechol chloride is a cholinergic agent that stimulates bladder contraction and facilitates voiding.
D)Oxybutynin is an anticholinergic that reduces urgency and frequency by blocking muscarinic receptors in the detrusor muscle of the bladder, thereby inhibiting contractions and increasing storage capacity. The nurse would anticipate an order for oxybutynin. Furosemide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bumetanide is a diuretic and works in a specific place within the nephron to increase fluid excretion and prevent fluid reabsorption. Bethanechol chloride is a cholinergic agent that stimulates bladder contraction and facilitates voiding.

Question 10

The nurse is assigned to a postpartum client who had an anesthetic block during labor and delivery. When providing care for this client, which does the nurse anticipate?

Accepted Answer

A)The postpartum woman is at risk for overdistention, incomplete bladder emptying, and buildup of residual urine (urine that remains in the bladder after voiding). Glycosuria is expected for a client during pregnancy, not during the postpartum period. Nocturnal enuresis and risk for hyperkalemia are anticipated for older adult clients.
B)The postpartum woman is at risk for overdistention, incomplete bladder emptying, and buildup of residual urine (urine that remains in the bladder after voiding). Glycosuria is expected for a client during pregnancy, not during the postpartum period. Nocturnal enuresis and risk for hyperkalemia are anticipated for older adult clients.
C)The postpartum woman is at risk for overdistention, incomplete bladder emptying, and buildup of residual urine (urine that remains in the bladder after voiding). Glycosuria is expected for a client during pregnancy, not during the postpartum period. Nocturnal enuresis and risk for hyperkalemia are anticipated for older adult clients.
D)The postpartum woman is at risk for overdistention, incomplete bladder emptying, and buildup of residual urine (urine that remains in the bladder after voiding). Glycosuria is expected for a client during pregnancy, not during the postpartum period. Nocturnal enuresis and risk for hyperkalemia are anticipated for older adult clients.

Question 11

A client presents in the emergency department exhibiting signs indicative of the onset of a bowel obstruction. Which bowel sounds should the nurse anticipate when auscultating the client's abdomen?

Accepted Answer

A)High-pitched tinkling, rushing, or growling bowel sounds-known as borborygmus-are indicative of the onset of bowel obstruction. Gurgling or clicking sounds are considered normal. Absence of bowel sounds is indicative of late bowel obstruction, not onset of bowel obstruction. A continuous medium pitched hum-called a venous hum-is indicative of a cirrhotic liver.
B)High-pitched tinkling, rushing, or growling bowel sounds-known as borborygmus-are indicative of the onset of bowel obstruction. Gurgling or clicking sounds are considered normal. Absence of bowel sounds is indicative of late bowel obstruction, not onset of bowel obstruction. A continuous medium pitched hum-called a venous hum-is indicative of a cirrhotic liver.
C)High-pitched tinkling, rushing, or growling bowel sounds-known as borborygmus-are indicative of the onset of bowel obstruction. Gurgling or clicking sounds are considered normal. Absence of bowel sounds is indicative of late bowel obstruction, not onset of bowel obstruction. A continuous medium pitched hum-called a venous hum-is indicative of a cirrhotic liver.
D)High-pitched tinkling, rushing, or growling bowel sounds-known as borborygmus-are indicative of the onset of bowel obstruction. Gurgling or clicking sounds are considered normal. Absence of bowel sounds is indicative of late bowel obstruction, not onset of bowel obstruction. A continuous medium pitched hum-called a venous hum-is indicative of a cirrhotic liver.

Question 12

Inadequate fluid intake slows the passage of chyme along the intestines. This slowed passage increases the absorption of fluid from the chyme. How does this decreased intake and increased passage time affect the feces expelled from the body?

Accepted Answer

A)When fluid intake is inadequate or output is excessive, the passage of chyme slows and the absorption of fluid increases. The end result is feces that is harder and drier than normal. Watery, soft feces is the result of rapid intestinal transit that leads to inadequate fluid absorption.
B)When fluid intake is inadequate or output is excessive, the passage of chyme slows and the absorption of fluid increases. The end result is feces that is harder and drier than normal. Watery, soft feces is the result of rapid intestinal transit that leads to inadequate fluid absorption.
C)When fluid intake is inadequate or output is excessive, the passage of chyme slows and the absorption of fluid increases. The end result is feces that is harder and drier than normal. Watery, soft feces is the result of rapid intestinal transit that leads to inadequate fluid absorption.
D)When fluid intake is inadequate or output is excessive, the passage of chyme slows and the absorption of fluid increases. The end result is feces that is harder and drier than normal. Watery, soft feces is the result of rapid intestinal transit that leads to inadequate fluid absorption.

Question 13

The nurse is caring for a group of clients on a medical-surgical unit. Which client does the nurse anticipate to be at the greatest risk for alterations in urinary elimination?

Accepted Answer

A)The client who is 80 years old with frequent urination at night may be having problems with his prostate. Older male adults experience urinary retention due to prostate enlargement, causing an alteration in urinary elimination. The 25-year-old experiencing low self-esteem has a psychological problem and will need therapy to find the root of the problem. The client who had bladder cancer and now has an ileal conduit doesn't have kidney damage, only the bladder removed. Continued urine production through the ileal conduit will need to be observed and assessed frequently by the staff. The client with high blood pressure takes medication to remove excess fluid from the body, and as long as urine elimination increases, there should be no problems.
B)The client who is 80 years old with frequent urination at night may be having problems with his prostate. Older male adults experience urinary retention due to prostate enlargement, causing an alteration in urinary elimination. The 25-year-old experiencing low self-esteem has a psychological problem and will need therapy to find the root of the problem. The client who had bladder cancer and now has an ileal conduit doesn't have kidney damage, only the bladder removed. Continued urine production through the ileal conduit will need to be observed and assessed frequently by the staff. The client with high blood pressure takes medication to remove excess fluid from the body, and as long as urine elimination increases, there should be no problems.
C)The client who is 80 years old with frequent urination at night may be having problems with his prostate. Older male adults experience urinary retention due to prostate enlargement, causing an alteration in urinary elimination. The 25-year-old experiencing low self-esteem has a psychological problem and will need therapy to find the root of the problem. The client who had bladder cancer and now has an ileal conduit doesn't have kidney damage, only the bladder removed. Continued urine production through the ileal conduit will need to be observed and assessed frequently by the staff. The client with high blood pressure takes medication to remove excess fluid from the body, and as long as urine elimination increases, there should be no problems.
D)The client who is 80 years old with frequent urination at night may be having problems with his prostate. Older male adults experience urinary retention due to prostate enlargement, causing an alteration in urinary elimination. The 25-year-old experiencing low self-esteem has a psychological problem and will need therapy to find the root of the problem. The client who had bladder cancer and now has an ileal conduit doesn't have kidney damage, only the bladder removed. Continued urine production through the ileal conduit will need to be observed and assessed frequently by the staff. The client with high blood pressure takes medication to remove excess fluid from the body, and as long as urine elimination increases, there should be no problems.

Question 14

A nurse is caring for a client with congestive heart failure. The healthcare provider prescribes propranolol (Inderal)for the client. Which instruction should the nurse include when administering a beta-adrenergic like propranolol (Inderal)to the client?

Accepted Answer

A)A beta-adrenergic blocker such as propranolol can cause urinary retention; therefore, it would be important for the client to notify the healthcare provider if this occurs. Clients should always check with their healthcare provider before stopping any medication, because there could be some major complications. Constipation has been reported from clients taking propranolol, but a laxative should not be taken every day, as one can become dependent. This medicine should be taken with food, not on an empty stomach, in order to enhance absorption.
B)A beta-adrenergic blocker such as propranolol can cause urinary retention; therefore, it would be important for the client to notify the healthcare provider if this occurs. Clients should always check with their healthcare provider before stopping any medication, because there could be some major complications. Constipation has been reported from clients taking propranolol, but a laxative should not be taken every day, as one can become dependent. This medicine should be taken with food, not on an empty stomach, in order to enhance absorption.
C)A beta-adrenergic blocker such as propranolol can cause urinary retention; therefore, it would be important for the client to notify the healthcare provider if this occurs. Clients should always check with their healthcare provider before stopping any medication, because there could be some major complications. Constipation has been reported from clients taking propranolol, but a laxative should not be taken every day, as one can become dependent. This medicine should be taken with food, not on an empty stomach, in order to enhance absorption.
D)A beta-adrenergic blocker such as propranolol can cause urinary retention; therefore, it would be important for the client to notify the healthcare provider if this occurs. Clients should always check with their healthcare provider before stopping any medication, because there could be some major complications. Constipation has been reported from clients taking propranolol, but a laxative should not be taken every day, as one can become dependent. This medicine should be taken with food, not on an empty stomach, in order to enhance absorption.

Question 15

Clients experiencing diarrhea often lose electrolytes. Which of the following best describes the reason for this loss?

Accepted Answer

A)Diarrhea causes rapid passage of chyme through the large intestine. This reduces the time available for the large intestine to absorb electrolytes and results in the electrolytes being lost with feces. Diarrhea typically increases secretion of intestinal mucus rather than decreasing it. Pathogenic microorganisms result in inflammation of the mucosa. Bacteria in the intestine cannot break down electrolytes.
B)Diarrhea causes rapid passage of chyme through the large intestine. This reduces the time available for the large intestine to absorb electrolytes and results in the electrolytes being lost with feces. Diarrhea typically increases secretion of intestinal mucus rather than decreasing it. Pathogenic microorganisms result in inflammation of the mucosa. Bacteria in the intestine cannot break down electrolytes.
C)Diarrhea causes rapid passage of chyme through the large intestine. This reduces the time available for the large intestine to absorb electrolytes and results in the electrolytes being lost with feces. Diarrhea typically increases secretion of intestinal mucus rather than decreasing it. Pathogenic microorganisms result in inflammation of the mucosa. Bacteria in the intestine cannot break down electrolytes.
D)Diarrhea causes rapid passage of chyme through the large intestine. This reduces the time available for the large intestine to absorb electrolytes and results in the electrolytes being lost with feces. Diarrhea typically increases secretion of intestinal mucus rather than decreasing it. Pathogenic microorganisms result in inflammation of the mucosa. Bacteria in the intestine cannot break down electrolytes.

Question 16

The nurse is caring for a client diagnosed with benign prostatic hyperplasia (BPH)who is experiencing an increase in symptoms. Which statement by the client would best explain the source of the increased symptoms?

Accepted Answer

A)Use of cold medications can increase symptoms because of their anticholinergic properties. Avoiding caffeine and decreasing oral intake at night may resolve symptoms. A vasectomy does not affect the symptoms of BPH.
B)Use of cold medications can increase symptoms because of their anticholinergic properties. Avoiding caffeine and decreasing oral intake at night may resolve symptoms. A vasectomy does not affect the symptoms of BPH.
C)Use of cold medications can increase symptoms because of their anticholinergic properties. Avoiding caffeine and decreasing oral intake at night may resolve symptoms. A vasectomy does not affect the symptoms of BPH.
D)Use of cold medications can increase symptoms because of their anticholinergic properties. Avoiding caffeine and decreasing oral intake at night may resolve symptoms. A vasectomy does not affect the symptoms of BPH.

Question 17

The nurse is caring for an older adult client on a medical-surgical unit. The client tells the nurse, "I don't get any sleep at night because I have to get up and use the bathroom every couple of hours!" When providing an explanation for the nocturia, which statement by the nurse is the most appropriate?

Accepted Answer

A)Approximately 70% of older women and 50% of older men have to get up two or more times during the night to empty their bladders due to decreased bladder capacity. A decrease in blood supply causes an increase in urine concentration. A decrease in the number of nephrons decreases the filtration rate. A decrease in cardiac output decreases peripheral circulation, which would decrease urinary output day or night.
B)Approximately 70% of older women and 50% of older men have to get up two or more times during the night to empty their bladders due to decreased bladder capacity. A decrease in blood supply causes an increase in urine concentration. A decrease in the number of nephrons decreases the filtration rate. A decrease in cardiac output decreases peripheral circulation, which would decrease urinary output day or night.
C)Approximately 70% of older women and 50% of older men have to get up two or more times during the night to empty their bladders due to decreased bladder capacity. A decrease in blood supply causes an increase in urine concentration. A decrease in the number of nephrons decreases the filtration rate. A decrease in cardiac output decreases peripheral circulation, which would decrease urinary output day or night.
D)Approximately 70% of older women and 50% of older men have to get up two or more times during the night to empty their bladders due to decreased bladder capacity. A decrease in blood supply causes an increase in urine concentration. A decrease in the number of nephrons decreases the filtration rate. A decrease in cardiac output decreases peripheral circulation, which would decrease urinary output day or night.

Question 18

The nurse admits a client to the medical unit for a urinary disorder. Which questions are appropriate for the nurse to include when assessing the client's voiding pattern? Select all that apply.

Accepted Answer

A)When assessing the client's voiding pattern it is appropriate for the nurse to ask how many times the client voids in a 24-hour period; if the pattern of urination has change frequently; and how often the client gets out of bed at night to urinate. Questions regarding the color and odor associated with urine are appropriate when assessing urine characteristics.
B)When assessing the client's voiding pattern it is appropriate for the nurse to ask how many times the client voids in a 24-hour period; if the pattern of urination has change frequently; and how often the client gets out of bed at night to urinate. Questions regarding the color and odor associated with urine are appropriate when assessing urine characteristics.
C)When assessing the client's voiding pattern it is appropriate for the nurse to ask how many times the client voids in a 24-hour period; if the pattern of urination has change frequently; and how often the client gets out of bed at night to urinate. Questions regarding the color and odor associated with urine are appropriate when assessing urine characteristics.
D)When assessing the client's voiding pattern it is appropriate for the nurse to ask how many times the client voids in a 24-hour period; if the pattern of urination has change frequently; and how often the client gets out of bed at night to urinate. Questions regarding the color and odor associated with urine are appropriate when assessing urine characteristics.
E)When assessing the client's voiding pattern it is appropriate for the nurse to ask how many times the client voids in a 24-hour period; if the pattern of urination has change frequently; and how often the client gets out of bed at night to urinate. Questions regarding the color and odor associated with urine are appropriate when assessing urine characteristics.

Question 19

The nurse is interviewing a client who is experiencing constipation. During the interview, the client states, "I don't understand what is going on. I feel the urge to go to the bathroom but, once I am in there and I begin pushing with my abdominal muscles, nothing happens." Which of the following represents the nurse's best response to the client?

Accepted Answer

A)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.
B)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.
C)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.
D)Clients should be instructed to use caution when straining the abdominal muscles during defecation, because it may close the anal sphincter rather than allowing feces to pass through. Bismuth salts are antidiarrheals-not laxatives-and would likely compound the client's problem. Certain medications can lead to constipation in some clients, but it is not appropriate for the nurse to encourage the discontinuation of all medications. Skin care is a concern for clients who are experiencing diarrhea or fecal incontinence, and is not typically an issue for patients with constipation.

Question 20

The nurse is reviewing information about four clients who are coming in to the office today due to concerns about bowel elimination. Which of these clients is most likely to have a daily stool softener added to their treatment regimen?

Accepted Answer

A)Clients taking opioids have an increased risk of developing constipation and may prevent it by taking daily stool softeners. Breastfed infants typically have soft, liquid stools and would not benefit from a stool softener. Leakage of feces from the anus is indicative of bowel incontinence-not constipation-and would not be treated with a stool softener. Anemia and blood in the stool are indicators of potential bowel cancer or other serious conditions; this client would likely undergo testing rather than be prescribed a stool softener.
B)Clients taking opioids have an increased risk of developing constipation and may prevent it by taking daily stool softeners. Breastfed infants typically have soft, liquid stools and would not benefit from a stool softener. Leakage of feces from the anus is indicative of bowel incontinence-not constipation-and would not be treated with a stool softener. Anemia and blood in the stool are indicators of potential bowel cancer or other serious conditions; this client would likely undergo testing rather than be prescribed a stool softener.
C)Clients taking opioids have an increased risk of developing constipation and may prevent it by taking daily stool softeners. Breastfed infants typically have soft, liquid stools and would not benefit from a stool softener. Leakage of feces from the anus is indicative of bowel incontinence-not constipation-and would not be treated with a stool softener. Anemia and blood in the stool are indicators of potential bowel cancer or other serious conditions; this client would likely undergo testing rather than be prescribed a stool softener.
D)Clients taking opioids have an increased risk of developing constipation and may prevent it by taking daily stool softeners. Breastfed infants typically have soft, liquid stools and would not benefit from a stool softener. Leakage of feces from the anus is indicative of bowel incontinence-not constipation-and would not be treated with a stool softener. Anemia and blood in the stool are indicators of potential bowel cancer or other serious conditions; this client would likely undergo testing rather than be prescribed a stool softener.

Quiz 5: Elimination