Nokea
A nurses colleague has applied an incontinence pad Select all that apply.
- A. Dietary history
- B. What principle
- C. Family history of renal stones
- D. Medication history
Correct Answer: A
Rationale: The correct answer is A: Dietary history. Understanding the patient's dietary habits can help identify potential triggers for incontinence, such as caffeine or alcohol intake. It also provides insight into fluid intake, which can impact incontinence.
Incorrect choices:
B: What principle - This is vague and does not provide relevant information for managing incontinence.
C: Family history of renal stones - While family history can be important for certain conditions, it is not directly related to managing incontinence.
D: Medication history - While medications can sometimes contribute to incontinence, dietary factors are typically more significant in this context.
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Which of the following methods should the nurse use to assess the kidneys for tenderness or pain?
- A. By auscultating the abdomen for bruits.
- B. By lightly striking the fist at the costovertebral angle.
- C. By observing for signs of bleeding.
- D. Monitor pressure dressing to note any frank bleeding.
Correct Answer: B
Rationale: The correct answer is B: By lightly striking the fist at the costovertebral angle. This method is known as percussion and is used to assess for kidney tenderness or pain. Percussion helps to identify any abnormalities in the kidneys or surrounding structures. Auscultation (choice A) is used to listen for sounds, not assess for tenderness. Observing for signs of bleeding (choice C) and monitoring pressure dressing (choice D) are not appropriate methods for assessing kidney tenderness or pain.
Which is incorrect regarding the investigation of UTI?
- A. The sensitivity of dipstick for nitrites is 96%.
- B. A positive dipstick for leucocyte esterase is 96% specific for >10 wbc/mm .
- C. A bacterial culture with > 10 has 95% probability of representing infection.
- D. Use of blood cultures in does not change management when urine culture is taken.
Correct Answer: B
Rationale: The correct answer is B because a positive dipstick for leucocyte esterase is not 96% specific for >10 wbc/mm³. Leucocyte esterase can indicate the presence of white blood cells, but it does not quantitatively correlate with a specific wbc count. Therefore, it cannot be used to accurately determine the exact wbc count in the urine sample.
A: The sensitivity of dipstick for nitrites being 96% means it is good at detecting nitrites, which are a sign of bacterial infection in the urine.
C: A bacterial culture with >10^5 colony-forming units has a high probability of representing infection, typically around 95%.
D: Blood cultures are not routinely used for diagnosing UTIs; urine culture is the primary method. Blood cultures are more often used for systemic infections.
What is a factor that contributes to an increased incidence of urinary tract infections in aging women?
- A. Length of the urethra
- B. Larger capacity of bladder
- C. Relaxation of pelvic floor and bladder muscles
- D. Tight muscular support at the urinary sphincter
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer):
1. Aging causes relaxation of pelvic floor and bladder muscles.
2. This relaxation can lead to incomplete emptying of the bladder.
3. Residual urine in the bladder can increase the risk of UTIs.
4. Therefore, relaxation of pelvic floor and bladder muscles contributes to increased UTI incidence.
Summary of Incorrect Choices:
A: Length of the urethra - Longer urethra typically reduces UTI risk by providing more distance for bacteria to travel.
B: Larger capacity of bladder - Larger bladder capacity does not directly increase UTI risk.
D: Tight muscular support at the urinary sphincter - Tight support does not directly impact UTI risk; relaxation is the key factor.
While caring for a 77-year-old woman who has a urinary catheter, the nurse monitors the patient for the development of a UTI. What clinical manifestations is the patient most likely to experience?
- A. Cloudy urine and fever
- B. Urethral burning and bloody urine
- C. Vague abdominal discomfort and disorientation
- D. Suprapubic pain and slight decline in body temperature
Correct Answer: A
Rationale: The correct answer is A: Cloudy urine and fever. UTI in a patient with a urinary catheter may present with cloudy urine due to pus or bacteria, and fever due to infection. Urethral burning and bloody urine (B) are more indicative of urethritis or bladder trauma. Vague abdominal discomfort and disorientation (C) are not specific to UTI. Suprapubic pain and slight decline in body temperature (D) are less likely with UTI.
A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first?
- A. Ascertain whether either of them has been using broad-spectrum antibiotics.
- B. Explain that couples are considered infertile after 1 year of unprotected intercourse.
- C. Immediately refer the woman to an expert in pelvic inflammatory disease – the most common cause of infertility.
- D. Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert.
Correct Answer: B
Rationale: The correct answer is B because it aligns with standard medical guidelines. Couples are typically considered infertile after 1 year of trying to conceive without success. This timeframe allows for natural variations in fertility and is when medical intervention is usually recommended.
A: Ascertain antibiotic use is not the first step as it may not be directly related to infertility.
C: Referring to pelvic inflammatory disease assumes a diagnosis without proper evaluation.
D: Incorrect timeline of 3 months and immediate referral to a fertility expert is premature without giving time for natural conception.