Nokea
You are providing care for a patient with reflex urinary incontinence. Which action is appropriately delegated to the new LPN/LVN?
- A. Teach the patient bladder emptying by the Credé method.
- B. Demonstrate how to perform intermittent self-catheterization.
- C. Discuss the side effects of bethanechol chloride (Urecholine).
- D. Reinforce the importance of proper handwashing to prevent infection.
Correct Answer: B
Rationale: The correct answer is B because demonstrating how to perform intermittent self-catheterization is within the scope of practice for an LPN/LVN. This task involves a specific skill set that can be taught and supervised by the LPN/LVN. It is essential for managing reflex urinary incontinence and maintaining bladder function. Choices A, C, and D are incorrect because teaching the patient bladder emptying by the Credé method (A) and discussing the side effects of bethanechol chloride (C) are tasks that require a higher level of nursing education and knowledge. Reinforcing the importance of proper handwashing (D) is a basic nursing task that can be performed by a nursing assistant or other unlicensed assistive personnel.
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A patient has very high plasma uric acid and has high risk of developing acute * uric acid nephropathy. Which of the following agent should be avoided?
- A. Ethacrynic acid
- B. Acetazolamide
- C. Hydrochlorothiazide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that can worsen hyperuricemia by increasing renal uric acid reabsorption. This can further exacerbate the risk of acute uric acid nephropathy. Ethacrynic acid (A), Hydrochlorothiazide (C), and Furosemide (D) are loop diuretics that can actually help in reducing uric acid levels by increasing its excretion through the urine. Therefore, they would not be contraindicated in this scenario.
During the examination of a full-term newborn male, a finding requiring investigation would be:
- A. Absent testes
- B. Meatus centered at the tip of the penis
- C. Wrinkled scrotum
- D. Penis 2 to 3 cm in length
Correct Answer: A
Rationale: The correct answer is A: Absent testes. In a full-term newborn male, the absence of testes is a concerning finding that requires immediate investigation to rule out conditions like undescended testes or any underlying genetic abnormalities. This is crucial for ensuring normal development and future fertility.
The other choices are incorrect because:
B: Meatus centered at the tip of the penis is a normal finding in a full-term newborn.
C: Wrinkled scrotum is a common and normal variation in newborns and does not typically require immediate investigation.
D: Penis 2 to 3 cm in length is within the expected range for a full-term newborn and is not a cause for concern.
What is a factor that contributes to an increased incidence of urinary tract infections in aging women?
- A. Length of the urethra
- B. Larger capacity of bladder
- C. Relaxation of pelvic floor and bladder muscles
- D. Tight muscular support at the urinary sphincter
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer):
1. Aging causes relaxation of pelvic floor and bladder muscles.
2. This relaxation can lead to incomplete emptying of the bladder.
3. Residual urine in the bladder can increase the risk of UTIs.
4. Therefore, relaxation of pelvic floor and bladder muscles contributes to increased UTI incidence.
Summary of Incorrect Choices:
A: Length of the urethra - Longer urethra typically reduces UTI risk by providing more distance for bacteria to travel.
B: Larger capacity of bladder - Larger bladder capacity does not directly increase UTI risk.
D: Tight muscular support at the urinary sphincter - Tight support does not directly impact UTI risk; relaxation is the key factor.
The nurse on a urology unit is working with a patient be the nurses best response to this finding?
- A. Perform a straight catheterization on this patient.
- B. Avoid further interventions at this time, as this is an nutritional guidelines should the nurse provide? acceptable finding.
- C. Restrict protein intake as ordere
Correct Answer: B
Rationale: The correct answer is B because hematuria (blood in the urine) is a concerning finding that may indicate a urinary tract infection, kidney stones, or other underlying issues. By avoiding further interventions, the nurse can prevent potential harm or complications to the patient. Performing a straight catheterization (Choice A) may not be necessary without further assessment. Restricting protein intake (Choice C) is not indicated based solely on the presence of hematuria.
The ________ is the endometrial layer that remains essentially unchanged during the menstrual
- A. myometrium
- B. functional layer
- C. corpus albicans
- D. basal layer
Correct Answer: D
Rationale: The correct answer is D: basal layer. The basal layer is the endometrial layer that remains essentially unchanged during the menstrual cycle. This layer serves as the foundation for the regrowth of the functional layer after menstruation. The myometrium (A) is the smooth muscle layer of the uterus, not the endometrial layer. The functional layer (B) is shed during menstruation and regenerates each cycle. The corpus albicans (C) is a remnant of the corpus luteum in the ovary, not related to the endometrium. Therefore, the basal layer is the correct answer as it is the only layer that remains unchanged during the menstrual cycle.