Nokea
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.
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A nurse cares for clients with urinary incontinence. Which types of incontinence are correctly paired with their clinical manifestation?
- A. Stress incontinence: Urine loss with physical exertion
- B. Urge incontinence: Large amount of urine with each occurrence
- C. Functional incontinence: Urine loss results from abnormal detrusor contractions
- D. Overflow incontinence: Constant dribbling of urine
Correct Answer: A,B,D
Rationale: Stress incontinence is a loss of urine with physical exertion, coughing, sneezing, or exercising. Urge incontinence presents with an abrupt and strong urge to void and usually has a large amount of urine released with each occurrence. Overflow incontinence occurs with bladder distention and results in a constant dribbling of urine.
A nurse teaches a young female client who is prescribed amoxicillin (Amoxil) for a urinary tract infection. Which statement should the nurse include in this client's teaching?
- A. Use a second form of birth control while on this medication.
- B. You will experience increased menstrual bleeding while on this drug.
- C. You will experience increased menstrual bleeding while on this drug.
- D. Watch for blood in your urine while taking this medication.
Correct Answer: A
Rationale: The client should use a second form of birth control because penicillin seems to reduce the effectiveness of estrogen-containing contraceptives. She should not experience increased menstrual bleeding or blood in her urine while taking this drug.
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.
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.
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.