Nokea
A nurse is caring for a client who is scheduled to undergo a surgical procedure for a urinary diversion (ileal conduit). Which statement by the nurse would be most helpful?
- A. I will ask the provider to prescribe you an antianxiety medication.
- B. Would you like to discuss the procedure with your doctor once more?
- C. I think it would be nice to not have to worry about finding a bathroom.
- D. Would you like to speak with someone who has an ileal conduit?
Correct Answer: D
Rationale: The goal for the client who is scheduled to undergo a procedure such as an ileal conduit is to have a positive self-image and a positive attitude about his or her body. Discussing the procedure candidly with someone who has undergone the same procedure will foster such feelings, especially when the client has an opportunity to ask questions and voice concerns to someone with first-hand knowledge.
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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 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 cares for a client admitted from a nursing home after several recent falls. What prescription should the nurse complete first?
- A. Obtain urine sample for culture and sensitivity.
- B. Administer intravenous antibiotics.
- C. Encourage protein intake and additional fluids.
- D. Consult physical therapy for gait training.
Correct Answer: A
Rationale: Although all interventions are or might be important, obtaining a urine sample for urinalysis takes priority. Often urinary tract infection (UTI) symptoms in older adults are atypical, and a UTI may present with new onset of confusion or falling. The urine sample should be obtained before starting antibiotics.
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.
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.