Nokea
The nurse is preparing to conduct an annual health and physical examination on a patient who is employed as a hairdresser and has a 10 pack-year history of cigarette smoking. Which of the following conditions should the nurse plan to teach the patient about the increased risk for based upon the patient history?
- A. Renal failure
- B. Kidney stones
- C. Pyelonephritis
- D. Bladder cancer
Correct Answer: D
Rationale: Exposure to the chemicals involved with working as a hairdresser and in smoking both increase the risk of bladder cancer, and the nurse should assess whether the patient understands this risk. The patient is not at increased risk for renal failure, pyelonephritis, or kidney stones.
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The nurse is admitting an older-adult patient with benign prostatic hyperplasia. Which of the following actions should be included in the nursing plan of care?
- A. Limit fluid intake to no more than 1500 mL/day.
- B. Leave a light on in the bathroom during the night
- C. Pad the patient's bed to accommodate overflow incontinence.
- D. Ask the patient to use a urinal so that all urine can be measured.
Correct Answer: B
Rationale: The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom is appropriate. Fluids should be encouraged because dehydration is more common in older patients. The information in the question does not indicate that measurement of the patient's output is necessary or that the patient has overflow incontinence.
The nurse is preparing a patient for a cystoscopy. Which of the following information should the nurse include in patient teaching about the procedure?
- A. NPO for 8 hours to prevent nausea and vomiting.
- B. Strict bed rest for about 4-6 hours.
- C. Request prescribed opioids as necessary for pain.
- D. May experience blood-tinged urine and urinary frequency.
Correct Answer: D
Rationale: Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common, but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required following cystoscopy.
A patient's urine dipstick indicates a small amount of protein in the urine. Which of the following actions should the nurse take next?
- A. Check which medications the patient is currently taking.
- B. Obtain a clean-catch urine specimen for culture and sensitivity testing.
- C. Ask the patient about any family history of persistent renal failure.
- D. Send a urine specimen to the laboratory to test for ketones and glucose.
Correct Answer: A
Rationale: Normally the urinalysis will show zero to trace amounts of protein, but some medications may give false-positive readings. The other actions by the nurse may be appropriate, but checking for medications that may affect the dipstick accuracy should be done first.
The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a patient with a suspected urinary tract infection (UTI). Which of the following actions should the nurse implement to obtain the specimen?
- A. Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
- B. Have the patient empty the bladder completely, and then obtain the next urine specimen that the patient is able to void.
- C. Insert a short, small 'mini' catheter attached to a collecting container into the urethra and bladder to obtain the specimen.
- D. Clean the area around the meatus with a povidone-iodine swab, and then have the patient void into a sterile container.
Correct Answer: A
Rationale: Teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup best describes the technique for obtaining a clean-catch specimen. The answer beginning, 'insert a short, small, 'mini' catheter attached to a collecting container' describes a technique that would result in a sterile specimen, but a health care provider's order for a catheterized specimen would be required. Using povidone-iodine before obtaining the specimen is not necessary and might result in suppressing the growth of some bacteria. And the technique described in the answer beginning 'have the patient empty the bladder completely' would not result in a sterile specimen.
The nurse is reviewing the results of a patient's urinalysis. Which of the following information indicates that the nurse should notify the health care provider?
- A. pH 6.2
- B. Trace protein
- C. WBC: 20-26/hpf
- D. Specific gravity: 1.021
Correct Answer: C
Rationale: The increased number of white blood cells (WBCs) indicates the presence of urinary tract infection or inflammation. Normal WBC result in a urinalysis report is 0-5/hpf. The other findings are normal.