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A nurse assesses a client with a fungal urinary tract infection (UTI). Which assessments should the nurse complete?
- A. Palpate the kidney and bladder
- B. Perform a medical history and assess current medical problems
- C. Perform a bladder scan to assess post-void residual
- D. Inquire about recent travel to foreign countries
- E. Obtain a current list of medications
Correct Answer: B,E
Rationale: Clients who are severely immunocompromised or who have diabetes mellitus are more prone to fungal UTIs. The nurse should assess for these factors by asking about medical history, current medical problems, and the current medication list.
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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.
A nurse assesses a client who presents with renal calculi. Which question should the nurse ask?
- A. Do any of your family members have this problem?
- B. Do you drink any cranberry juice?
- C. Do you urinate after sexual intercourse?
- D. Do you experience burning with urination?
Correct Answer: A
Rationale: There is a strong association between family history and stone formation and recurrence. Nephrolithiasis is associated with many genetic variations; therefore, the nurse should ask whether other family members have also had renal stones.
A nurse assesses a client who is recovering from extracorporeal shock wave lithotripsy for renal calculi. The nurse notes an ecchymotic area on the client's right lower back. Which action should the nurse take?
- A. Apply an ice pack to the site.
- B. Apply an ice pack to the site.
- C. Place the client in the prone position.
- D. Obtain serum coagulation test results.
Correct Answer: A
Rationale: The shock waves from lithotripsy can cause bleeding into the tissues through which the waves pass. Application of ice can reduce the extent and discomfort of the bruising. Although coagulation test results and fresh-frozen plasma are used to assess and treat bleeding disorders, ecchymosis after this procedure is not unusual. Obtaining serum coagulation is a higher level of intervention. Changing the client's position will not decrease bleeding.
A nurse assesses a client who has had two episodes of bacterial cystitis in the last 6 months. Which questions should the nurse ask?
- A. How much water do you drink every day?
- B. Do you take estrogen replacement therapy?
- C. Does anyone in your family have a history of cystitis?
- D. Do you take any immune-suppressing drugs?
- E. Do you drink grapefruit juice or orange juice daily?
Correct Answer: A,B,D
Rationale: Fluid intake, estrogen levels, and immune suppression all can increase the chance of recurrent cystitis. Family history is usually insignificant, and cranberry juice, not grapefruit or orange juice, has been found to increase the acidity and reduce the risk for bacterial cystitis.
A nurse cares for adult clients who experience urge incontinence. For which client should the nurse plan a habit training program?
- A. A 60-year-old female who is confused
- B. A 65-year-old female who is confused
- C. A 65-year-old female who is confused
- D. A 62-year-old female with kidney failure
Correct Answer: A
Rationale: For a bladder training program to succeed in a client with urge incontinence, the client must be alert, aware, and able to resist the urge to urinate. Habit training will work best for a confused client. This includes going to the bathroom (or being assisted to the bathroom) at set times. The other clients may benefit from another type of bladder training.