Nokea
A nurse assesses a male client who is recovering from a urologic procedure. Which assessment finding indicates an obstruction of urine flow?
- A. Severe pain
- B. Overflow incontinence
- C. Hypotension
- D. Blood-tinged urine
Correct Answer: B
Rationale: The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow, leading to overflow incontinence with the involuntary loss of urine when the bladder is distended.
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A nurse cares for a client with urinary incontinence. The client states, 'I am so embarrassed. My bladder leaks like a young child's bladder.' How should the nurse respond?
- A. I understand how you feel. I would be mortified.
- B. Incontinence pads will minimize leaks in public.
- C. I can teach you strategies to help control your incontinence.
- D. More women experience incontinence than you might think.
Correct Answer: C
Rationale: The nurse should accept and acknowledge the client's concerns and assist the client to learn techniques that will help control urinary incontinence.
A nurse teaches a female client who has stress incontinence. Which statements should the nurse include in this client's teaching?
- A. When you start and stop your urine stream, you are using your pelvic muscles.
- B. Tighten your pelvic muscles for a slow count of 10 and then relax for a slow count of 10.
- C. Pelvic muscle exercises should only be performed sitting straight with your feet on the floor.
- D. After you have been using these exercises for a couple days, your control of urine will improve.
- E. Like any other muscle in your body, you can make your pelvic muscles stronger by contracting them.
Correct Answer: A,B,E
Rationale: The client should be taught that the muscles used to start and stop urination are pelvic muscles, and that pelvic muscles can be strengthened by contracting and relaxing them. The client should tighten pelvic muscles for a slow count of 10 and then relax the muscles for a slow count of 10 in various positions.
An emergency department nurse assesses a client with a history of urinary incontinence who presents with extreme dry mouth, constipation, and an inability to void. Which question should the nurse ask first?
- A. Are you drinking plenty of water?
- B. What medications are you taking?
- C. Have you tried laxatives or enemas?
- D. Has this type of thing ever happened before?
Correct Answer: B
Rationale: Some types of incontinence are treated with anticholinergic medications such as propantheline (Pro-Banthine). Anticholinergic side effects include dry mouth, constipation, and urinary retention. The nurse needs to assess the client's medication list to determine whether the client is taking an anticholinergic medication.
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.
After teaching a client with bacterial cystitis who is prescribed phenazopyridine (Pyridium), the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will not take this drug with food or milk.
- B. I will not take this prep with food or milk.
- C. An orange color or my urine should not alarm me.
- D. I will drink two glasses of cranberry juice daily.
Correct Answer: C
Rationale: Phenazopyridine discolors urine, most commonly to a deep reddish orange. Many clients think they have blood in their urine when they use this. In addition, the urine can permanently stain clothing. Phenazopyridine is safe to take with food or milk, and cranberry juice is not a requirement while taking this medication.