Nokea
The nurse is caring for a patient whose renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, which of the following foods should the nurse teach the patient to avoid eating?
- A. Milk and dairy products
- B. Legumes and dried fruits
- C. Organ meats and sardines
- D. Spinach, chocolate, and tea
Correct Answer: C
Rationale: Organ meats and fish such as sardines increase purine levels and uric acid. Spinach, chocolate, and tomatoes should be avoided in patients who have oxalate stones. Milk, dairy products, legumes, and dried fruits may increase the incidence of calcium-containing stones.
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The nurse is caring for a female patient who has had a urinary tract infection (UTI). Which of the following interventions should the nurse include in the plan of care?
- A. Encourage the patient to use a diaphragm for contraception.
- B. Sitz baths
- C. Encourage the patient to drink cranberry juice.
- D. Teach the patient how to do isometric perineal exercises.
Correct Answer: B
Rationale: Sitz baths can soothe the perineal area and promote voiding in patients with a UTI. Diaphragm use increases the risk for UTI and should be avoided. While cranberry juice may help prevent UTIs, evidence is inconclusive, and it is not a priority intervention. Isometric perineal exercises (e.g., Kegel exercises) are useful for stress incontinence, not UTI management.
The nurse is assessing a patient who has a history of a bladder infection. Which of the following findings indicates that the bladder infection has extended into the upper urinary tract?
- A. Dysuria
- B. Urinary frequency
- C. Flank pain
- D. Urinary urgency
Correct Answer: C
Rationale: Flank pain indicates that the patient may have developed pyelonephritis as a complication of the bladder infection. The other clinical manifestations are consistent with a lower urinary tract infection (UTI).
The nurse is caring for a patient who has bladder cancer and had a cystectomy with creation of an Indiana pouch. Which of the following topics should the nurse include in patient teaching?
- A. Application of ostomy appliances
- B. Catheterization technique and schedule
- C. Analgesic use before emptying the pouch
- D. Use of barrier products for skin protection
Correct Answer: B
Rationale: The Indiana pouch enables the patient to self-catheterize every 4-6 hours. There is no need for an ostomy device or barrier products. Catheterization of the pouch is not painful.
The nurse is caring for a patient who is two days postoperative with an ileal conduit, and the patient will not look at the stoma or participate in care and insists that no one but the ostomy nurse specialist care for the stoma. Which of the following nursing diagnoses best reflects the data that the nurse has obtained?
- A. Anxiety related to threat to current status (effects of procedure on lifestyle)
- B. Disturbed body image related to alteration in self-perception
- C. Ineffective coping related to insufficient sense of control
- D. Ineffective denial related to ineffective coping strategies (denial of altered body function)
Correct Answer: B
Rationale: The patient's unwillingness to look at the stoma or participate in care indicates that disturbed body image is the best diagnosis. No data suggest that the impact on lifestyle is a concern for the patient, or that ineffective coping is a result of an insufficient sense of control. The patient's insistence that only the ostomy nurse care for the stoma indicates that denial is not present.
Which of the following findings for a patient who has had a cystectomy with an ileal conduit the previous day is most important for the nurse to communicate to the health care provider?
- A. Cloudy appearing urine
- B. Hypotonic bowel sounds
- C. Heart rate 102 beats/minute
- D. Stoma appears pale and dry
Correct Answer: D
Rationale: A pale and dry stoma indicates poor vascularity or ischemia, which is a critical complication requiring immediate reporting to the health care provider. Cloudy urine, hypotonic bowel sounds, and a slightly elevated heart rate are common postoperative findings but are less urgent unless accompanied by other critical symptoms.