Nokea
A 45-year-old mother of two children is seen at the clinic for complaints of “losing my urine when I sneeze.†The nurse documents that she is experiencing:
- A. Urinary frequency.
- B. Enuresis.
- C. Stress incontinence.
- D. Urge incontinence.
Correct Answer: C
Rationale: The correct answer is C: Stress incontinence. This type of incontinence is characterized by leakage of urine during activities that increase intra-abdominal pressure, such as sneezing, coughing, or laughing. In this case, the woman is experiencing urine loss specifically when she sneezes, which aligns with the definition of stress incontinence. Other choices are incorrect because urinary frequency (choice A) refers to a frequent need to urinate, enuresis (choice B) is involuntary urination during sleep, and urge incontinence (choice D) is the sudden, strong need to urinate followed by involuntary leakage.
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The nurse is performing a focused genitourinary and the flank and lower abdomen. The patient is being renal assessment of a patient. Where should the nurse assessed for renal calculi. The nurse recognizes that the assess for pain at the costovertebral angle? stone is most likely in what anatomic location?
- A. At the umbilicus and the right lower quadrant of the
- B. Meatus
- C. Bladder
- D. Ureter
Correct Answer: D
Rationale: The correct answer is D: Ureter. The nurse should assess for pain at the costovertebral angle to check for renal calculi because the ureters connect the kidneys to the bladder and flank pain at this angle can indicate ureteral obstruction from a renal stone. Assessing at the umbilicus (choice A) or meatus (choice B) would not provide information specific to renal calculi. Assessing at the bladder (choice C) would be more relevant for bladder issues, not renal calculi.
Carol Carson was taught self breast examination (SBE) during her last hospitalization and tells you that she has been doing the examination every month without difficulty. Which statement by Mrs. Carson would indicate to you that she does NOT have a complete understanding of the self breast examination technique?
- A. I do the examination every month a few days after my period.
- B. I use my fingertips to examine all of the breast tissues.
- C. I begin the examination by inspecting my breasts with hands at my side.
- D. I especially check the upper, outer quadrants and under my arms.
Correct Answer: C
Rationale: The correct answer is C. Mrs. Carson's statement indicates a lack of understanding because she mentions beginning the examination by inspecting her breasts with hands at her side. The correct technique for self breast examination (SBE) involves inspecting the breasts visually in front of a mirror with hands on hips or raised above the head. This position allows for better visualization and palpation of the breast tissue. Starting the examination with hands at the sides may result in missing important areas for inspection. Choices A, B, and D are incorrect because they all align with proper SBE techniques such as timing the examination, using fingertips to examine all breast tissues, and focusing on specific areas like the upper, outer quadrants, and underarms.
During the interview, a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse's most appropriate response to this would be:
- A. Oh, don't worry. Some cyclic vaginal discharge is normal.
- B. Have you been engaging in unprotected sexual intercourse?
- C. I'd like some information about the discharge. What color is it?
- D. Have you had any urinary incontinence associated with the discharge?
Correct Answer: C
Rationale: The correct answer is C because it focuses on gathering more information about the vaginal discharge, which is essential in assessing the patient's condition. By asking about the color of the discharge, the nurse can gather valuable information to help determine if it might be related to a sexually transmitted infection or another issue. This approach shows a patient-centered and thorough assessment.
Choice A is incorrect as it dismisses the patient's concerns without obtaining further information. Choice B jumps to conclusions about unprotected sexual intercourse without first assessing the situation. Choice D is unrelated to the patient's primary concern about vaginal discharge and urinary incontinence.
Your patient does not seem to be responding to conservative treatment for acute renal failure, and dialysis is being considered. You understand that the main indication for dialysis is
- A. generalized edema
- B. elevated blood pressure
- C. elevated blood calcium
- D. a high and rising level of potassium
Correct Answer: D
Rationale: The correct answer is D: a high and rising level of potassium. Dialysis is indicated in acute renal failure when the patient has severe electrolyte imbalances, especially hyperkalemia, which can lead to life-threatening arrhythmias. Potassium levels must be closely monitored, and if they are high and continue to rise despite conservative treatment, dialysis is necessary to quickly lower the potassium levels. Generalized edema (A) is a symptom of renal failure but is not the main indication for dialysis. Elevated blood pressure (B) and elevated blood calcium (C) are not direct indications for dialysis in the context of acute renal failure.
The first physical sign associated with puberty in boys is:
- A. Height spurt
- B. Penis lengthening
- C. Sperm production
- D. Pubic hair development
Correct Answer: E
Rationale: I'm sorry, but it seems there might be a mistake in the question as there is no option E provided. However, I can provide a rationale for each option based on the typical sequence of physical changes during puberty in boys. The first physical sign associated with puberty in boys is usually pubic hair development (D), followed by penis lengthening (B), height spurt (A), and lastly sperm production (C). Pubic hair development is often the initial visible sign of puberty due to hormonal changes. Height spurt and penis lengthening occur later in puberty, while sperm production typically begins towards the end of puberty.