Nokea
Contraction of which muscle causes the bladder to empty?
- A. Internal urinary sphincter
- B. Detrusor
- C. External urinary sphincter
- D. Peristalsis
Correct Answer: B
Rationale: The detrusor muscle contracts to expel urine from the bladder during voiding.
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The nursing assistant tells you that Mrs. White gained 3 pounds since her daily weigh the previous morning. You are most concerned that Mrs. White
- A. Has been eating too many calories in the past 24 hours.
- B. Is retaining approximately 1.5 liters of fluid since yesterday.
- C. Is not getting enough movement and exercise while in the hospital.
- D. Was dehydrated yesterday and has replaced needed fluids.
Correct Answer: B
Rationale: A 3-pound weight gain in 24 hours likely indicates fluid retention (1 kg ? 1 liter), equivalent to about 1.5 liters, which requires further assessment.
In catheters, the greater the size number, the larger the catheter.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Catheter size is measured in French (Fr) units, where a higher number indicates a larger diameter.
You have just inserted an indwelling catheter in a 56-year-old male patient with urinary retention due to an enlarged prostate. You notice that the drainage bag is filling quickly, with 750 mL of urine almost immediately draining into it. Which of these actions will you take?
- A. Clamp the catheter after 1,000 mL has drained to prevent bladder collapse.
- B. Clamp the catheter after 1,200 mL has drained to prevent hematuria.
- C. Take no action because the patient is tolerating rapid bladder decompression without problems.
- D. Remove the catheter after 1,500 mL has drained and call the health-care provider.
Correct Answer: C
Rationale: Rapid drainage is normal in urinary retention, and no action is needed if the patient is tolerating it without symptoms like pain or hematuria.
How long can a urine specimen sit unrefrigerated before it is analyzed?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: B
Rationale: Urine specimens should be analyzed within 1 hour if unrefrigerated to prevent bacterial growth and degradation.
You are teaching bladder retraining to the patient with incontinence. She tries the plan and reports back to you about her progress. 'I tried going to the bathroom every 2 hours like you said, but I just sit there. I'm trying now to just go when I feel the urge, which is about every 3 hours. I'm still having accidents about half the time, which is a big improvement.' Which of the following statements should you make in response to the patient's comment?
- A. That's great. Keep up that pattern. It sounds like it's working.
- B. Waiting until you feel the urge defeats the purpose of a bladder retraining program. It sounds like you haven't really implemented the program. You should go back to trying to void every 2 hours to train your bladder to empty when you want it to.
- C. It sounds like bladder retraining isn't working for you, but that paying greater attention to the urge to go is.
- D. This is good information, but waiting for the urge to go is not going to retrain your bladder. Try toileting yourself every 2½ hours. Do this for several days to a week and then let me know the results.
Correct Answer: D
Rationale: Adjusting the interval to 2½ hours may help the patient adhere to a scheduled voiding program, which is essential for bladder retraining.