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A nurse assesses a client for risk factors for bladder cancer. Which question should the nurse ask?
- A. Do you smoke cigarettes?
- B. Do you use recreational drugs?
- C. Do you consume alcohol regularly?
- D. Do you have a family history of bladder cancer?
Correct Answer: A
Rationale: Smoking is known to be a factor that greatly increases the risk of bladder cancer. Alcohol use, recreational drug use, and family history (except medications that contain phenacetin) are not known to significantly increase the risk of developing bladder cancer.
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A nurse teaches a client with a history of calcium phosphate urinary stones. Which statements should the nurse include in this client's dietary teaching?
- A. Limit your intake of food high in animal protein.
- B. Read food labels to help minimize your sodium intake.
- C. Avoid spinach, black tea, and rhubarb.
- D. Drink white wine or beer instead of red wine.
- E. Reduce your intake of milk and other dairy products.
Correct Answer: A,B,E
Rationale: Clients with calcium phosphate urinary stones should be taught to limit the intake of foods high in animal protein, sodium, and calcium. Clients with calcium oxalate stones should avoid spinach, black tea, and rhubarb.
A nurse teaches a client with functional urinary incontinence. Which statement should the nurse include in this client's teaching?
- A. You must clean around your catheter daily with soap and water.
- B. You must clean around your catheter daily with soap and water.
- C. You must clean around your catheter daily with soap and water.
- D. Operations to repair your bladder are available, and you can consider these.
- E. Buy slacks with elastic waistbands that are easy to pull down.
Correct Answer: E
Rationale: Functional urinary incontinence occurs as the result of problems not related to the client's bladder, such as trouble accessing a toilet. One goal is that the client be able to manage his or her clothing independently. Elastic waistband slacks that are easy to pull down can help the client get on the toilet in time to void. The other instructions do not relate to functional urinary incontinence.
A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of bacterial cystitis?
- A. A 36-year-old female who has never been pregnant
- B. A 42-year-old male who is prescribed cephalophamide
- C. A 34-year-old female who is not using estrogen replacement
- D. A 77-year-old male with mild congestive heart failure
Correct Answer: C
Rationale: Females at any age are more susceptible to cystitis than men because of the shorter urethra in women. Postmenopausal women who are not on hormone replacement therapy are at increased risk for bacterial cystitis because of changes in the cells of the urethra and vagina. The middle-aged woman who has never been pregnant would not have a risk potential as high as the older woman who is not using hormone replacement therapy.
After delegating care to an unlicensed assistive personnel (UAP) for a client who is prescribed habit training to manage incontinence, a nurse evaluates the UAP's understanding. Which action indicates the UAP needs additional teaching?
- A. Toileting the client after breakfast
- B. Changing the client's incontinence brief when wet
- C. Encouraging the client to drink fluids
- D. Recording the client's incontinence episodes
Correct Answer: B
Rationale: Habit training is undermined by the use of absorbent incontinence briefs or pads. The nurse should re-educate the UAP on the technique of habit training. The UAP should continue to toilet the client after meals, encourage the client to drink fluids, and record incontinence episodes.
A nurse plans care for clients with urinary incontinence. Which client is correctly paired with the appropriate intervention?
- A. A 24-year-old female post vaginal delivery: Habit training
- B. A 58-year-old postmenopausal client who is not taking estrogen therapy: Electrical stimulation
- C. A 64-year-old female with Alzheimer's-type senile dementia: Bladder training
- D. A 7-year-old female who has difficulty ambulating: Exercise therapy
Correct Answer: B
Rationale: Exercise therapy and electrical stimulation are used for clients with stress incontinence related to childbirth or low levels of estrogen after menopause. Exercise therapy increases pelvic wall strength; it does not improve ambulation. Habit training is the type of bladder training that will be most effective for cognitively impaired clients.