Nokea
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.
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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.
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 who has kidney stones from secondary hyperoxaluria. Which medication should the nurse anticipate administering?
- A. Phenazopyridine (Pyridium)
- B. Propatudeline (Pro-Banthine)
- C. Tolterodine (Detrol)
- D. Allopurinol (Zyloprim)
Correct Answer: D
Rationale: Stones caused by secondary hyperoxaluria respond to allopurinol (Zyloprim). Phenazopyridine is given to clients with urinary tract infections. Propatudeline is an anticholinergic. Tolterodine is an anticholinergic with smooth muscle relaxant properties.
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.
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.