Nokea
Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?
- A. Do you need to get up at night to urinate?
- B. Do you experience nocturnal emissions, or wet dreams?
- C. Do you know how to perform a testicular self-examination?
- D. Has anyone ever touched your genitals when you did not want them to?
Correct Answer: A
Rationale: The correct answer is A because it pertains to a common genitourinary issue in older men, nocturia. Nocturnal emissions (choice B) are not typically relevant in this context. Testicular self-examination (choice C) is more appropriate for younger men, and asking about unwanted touching (choice D) is not relevant to obtaining a genitourinary history. Asking about nocturia can provide valuable information about potential prostate issues, urinary tract infections, or other conditions commonly affecting older men.
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A-50-year-old man has a history of frequent episodes of renal colic with high calcium renal stones. The most useful agent in the treatment of recurrent calcium stones is:
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Acetazolamide
Correct Answer: C
Rationale: Rationale: The correct answer is C: Hydrochlorothiazide. It is a thiazide diuretic that reduces calcium excretion, preventing stone formation. Furosemide (A) and spironolactone (B) do not target calcium excretion specifically. Acetazolamide (D) is a carbonic anhydrase inhibitor and not commonly used for calcium stones.
A female patient with a UTI has a nursing diagnosis of risk for infection related to lack of knowledge regarding prevention of recurrence. What should the nurse include in the teaching plan instructions for this patient?
- A. Empty the bladder at least 4 times a day.
- B. Drink at least 2 quarts of water every day.
- C. Wait to urinate until the urge is very intense.
- D. Clean the urinary meatus with an antiinfective agent after voiding.
Correct Answer: B
Rationale: The correct answer is B: Drink at least 2 quarts of water every day. This answer is correct because adequate hydration helps to flush out bacteria from the urinary tract, reducing the risk of UTI recurrence. Drinking plenty of water promotes frequent urination, which helps to prevent bacteria from multiplying in the bladder.
Choice A is incorrect because the frequency of emptying the bladder does not directly impact the prevention of UTI recurrence. Choice C is incorrect as delaying urination can lead to the retention of urine, which may increase the risk of infection. Choice D is incorrect because cleaning the urinary meatus with an antiinfective agent after voiding is not recommended as it can disrupt the natural flora and irritate the area, potentially leading to more infections.
In summary, maintaining adequate hydration by drinking at least 2 quarts of water daily is the most effective method to prevent UTI recurrence, while the other choices are less relevant or potentially harmful.
The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should:
- A. Ask the patient to urinate into a sterile cup.
- B. Ask the patient to obtain a specimen of semen.
- C. Insert a cotton-tipped applicator into the urethra.
- D. Compress the glans between the examiner’s thumb and forefinger, and collect any discharge.
Correct Answer: D
Rationale: The correct answer is D because gently compressing the glans between the thumb and forefinger can help express the urethral discharge for collection. This method minimizes contamination and ensures a proper sample for microscopic examination and culture.
A: Asking the patient to urinate into a cup would not capture the discharge.
B: Semen is not relevant for urethral discharge testing.
C: Inserting a cotton-tipped applicator into the urethra may cause trauma and is not recommended for collecting urethral discharge.
What would be the best nursing action for the female client admitted following a nephrolithotomy with a urinary tract infection?
- A. Administer IV fluids and blood transfusions.
- B. Administer narcotic analgesics as prescribed.
- C. Encourage fluid intake of 3000 mL/day.
- D. Suggest taking herbs or spices to increase food palatability.
Correct Answer: C
Rationale: The correct answer is C: Encourage fluid intake of 3000 mL/day. This is important post-nephrolithotomy to prevent urinary stasis and aid in flushing out potential stone fragments. Adequate hydration also helps in preventing urinary tract infections. Administering IV fluids and blood transfusions (A) may be necessary in certain cases, but not specifically indicated for this scenario. Administering narcotic analgesics (B) may be required for pain management, but it does not address the underlying issue of preventing complications. Suggesting herbs or spices (D) is unrelated and may not be recommended due to potential interactions with medications.
A patient with HIV-AIDS being treated with combined antiviral drugs and * immunosuppressive agents, develops an opportunistic infection caused by Pneumocystis caranii. Which of the following drugs most likely be used in the treatment of pulmonary infection caused by P, caranii?
- A. Metronidazole
- B. Carbenicillin
- C. Trimthoprim /Sulfametoxazole
- D. Penicillin G
Correct Answer: C
Rationale: The correct answer is C: Trimethoprim/Sulfamethoxazole. This combination is the first-line treatment for Pneumocystis carinii pneumonia in patients with HIV-AIDS due to its efficacy against the organism. Trimethoprim inhibits bacterial folic acid synthesis, while sulfamethoxazole inhibits bacterial dihydrofolic acid formation. These drugs work synergistically to target different steps in the folic acid synthesis pathway of Pneumocystis carinii, leading to its effective eradication. Metronidazole (A) is used for anaerobic bacterial infections, Carbenicillin (B) is a penicillin derivative mainly used for Gram-negative bacteria, and Penicillin G (D) is not effective against Pneumocystis carinii.