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The nurse is caring for a client with a urinary tract infection and a urethral stricture. Which complication of the condition is the primary cause of infection?
- A. The bladder mucosa attracts bacteria
- B. There is a backflow of urine causing a diverticulum
- C. Urine leakage occurs as urine passes through the stricture
- D. Urine production is limited due to the urine remaining in the bladder
Correct Answer: B
Rationale: It is common for a client with a stricture to have a urinary tract infection due to the backflow of urine and the stasis of the urine, causing an outpouching or diverticulum. Interstitial cystitis is an inflammatory disease where bacteria cling to the bladder mucosa. Urine leakage is characteristic in urinary incontinence. Urine production is impacted, urine excretion is impacted.
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A nurse coming from morning report is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 ml. The client denies any pain on urination. The nurse scans 250 ml of remaining urine in the bladder. Which entry is most correct when documenting the intervention?
- A. Client voided 300 ml without dysuria
- B. Client voided 500 mL of urine for the daylight shift
- C. Client voided 300 mL with 250 mL residual volume
- D. Bladder scanning resulted in 250 mL
Correct Answer: C
Rationale: When documenting the results of using a bladder scanner, it is best to note the amount voided and then the residual urine remaining in the bladder. This documentation enables the analysis of the client's ability to empty the bladder.
The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
- A. Anticholinergic
- B. Diuretics
- C. Anticonvulsant
- D. Cholinergic
Correct Answer: A
Rationale: Pharmacologic agents that can improve bladder retention, emptying, and control include anticholinergic drugs. In this classification are medications such as Detrol, Ditropan, and Urecholine. Diuretics eliminate fluid from the body but do not affect the muscles of urinary elimination. Anticonvulsant and cholinergic medications also do not directly help with control.
The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?
- A. The nursing assistant keeps the catheter and drainage bag together when moving the client
- B. The nursing assistant places the drainage bag on the client's abdomen for transport
- C. The nursing assistant places the drainage bag on the lower area of the wheelchair for transport
- D. The nursing assistant holds the drainage bag while the client moves to the wheelchair
Correct Answer: B
Rationale: The nurse would instruct the nursing assistant to maintain the drainage bag lower than the genital region to avoid a backflow of urine into the bladder. The nursing assistant is correct to move the catheter and drainage bag with the client to not put tension on the catheter, place the drainage bag on the lower area of the wheelchair, and hold the drainage bag while the client is in the process of moving.
A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?
- A. Urinary retention
- B. Fever
- C. Frequency
- D. Painless hematuria
Correct Answer: D
Rationale: The most common first symptom of a malignant tumor of the bladder is painless hematuria. Additional early symptoms include UTI with symptoms such as fever, dysuria, urgency, and frequency. Later symptoms are related to metastases and include pelvic pain, urinary retention (if the tumor blocks the bladder outlet), and urinary frequency from the tumor occupying bladder space.
The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of an early stage of malignant tumor of the bladder?
- A. Incontinence
- B. Dysuria
- C. Hematuria
- D. Frequency
Correct Answer: C
Rationale: The most common first symptom of a malignant tumor is painless hematuria. Most malignant tumors are vascular, thus, abnormal bleeding can be a first sign of abnormality. The client then has symptoms of incontinence (a later sign), dysuria, and frequency.