Nokea
It is 2 days after a 42-year-old male patient's urinary diversion surgery. He continues to be critical of the hospital and the nursing care, even though the staff has spent time explaining the care to him. Which explanation is most likely for his behavior?
- A. He is angry about hospital policy.
- B. He is feeling neglected by the nursing staff.
- C. He is in denial of the effects of the surgery.
- D. He is reacting to the loss of self-esteem and altered body image.
Correct Answer: D
Rationale: Persons with altered body image may react to the loss of self-esteem by behaving in a critical or derogatory manner.
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Why is a urinary disorder common in older adults?
- A. Older adults have weakened musculature in the bladder and urethra.
- B. Older adults have urinary stasis.
- C. Older adults have increased bladder capacity.
- D. Older adults have diminished neurologic sensation.
- E. The effects of medications such as diuretics that many older adults take.
Correct Answer: A,B,D,E
Rationale: Urinary frequency, urgency, nocturia, retention, and incontinence are common with aging. These occur because of weakened musculature in the bladder and urethra, diminished neurologic sensation combined with decreased bladder capacity, and the effects of medications such as diuretics. Older women are at risk for stress incontinence because of hormonal changes and weakened pelvic musculature. Inadequate fluid intake (less than 1000 to 2000 mL per 24 hours) can lead to urinary stasis. Older adults do not usually experience increased bladder capacity.
Which sign is indicative of fluid overload in the patient with chronic glomerulonephritis?
- A. Increase in blood pressure
- B. Increase in daily weight
- C. Clear lung sounds
- D. Edema
- E. Labored respirations
Correct Answer: A,B,D,E
Rationale: Signs and symptoms of fluid overload: increased blood pressure, respirations, cardiac sounds, and lung fields. Increase in daily morning weights.
The nurse reassures the patient recovering from acute glomerulonephritis that after all other signs and symptoms of the disease subside, which change in the urine is normal?
- A. proteinuria.
- B. oliguria.
- C. hematuria.
- D. anasarca.
- E. oliguria.
Correct Answer: A,C
Rationale: Proteinuria and hematuria may exist microscopically even when other symptoms subside.
The nurse is reviewing the urinalysis report on an assigned patient. The nurse recognizes which finding to be normal?
- A. Turbidity clear
- B. pH 6.0
- C. Glucose negative
- D. Red blood cells, 15 to 20
- E. White blood cells
Correct Answer: A,C
Rationale: The normal findings are: turbidity clear, and glucose negative. The other findings are abnormal.
In which way will the nurse instruct the patient to do before obtaining the urine specimen for a urine culture?
- A. Collect the urine for a 24-hour period.
- B. Obtain a clean-catch specimen.
- C. Bring in an early morning specimen.
- D. Limit fluid intake to concentrate the urine.
Correct Answer: B
Rationale: Urine cultures are dependent on a clean-catch or catheterized specimen.