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Your patient has stress incontinence. Which of the following statements represent recommended treatment for this problem?
- A. Suggest the patient wear incontinence pads in a comfortable style with adequate absorbency.
- B. Tell the patient that there are medications available to help with stress incontinence and that the doctor will discuss them with her.
- C. Tell the patient to avoid abdominal exercises, which can cause stress incontinence.
- D. Tell the patient about Kegel exercises.
Correct Answer: A,D
Rationale: Incontinence pads manage symptoms, and Kegel exercises strengthen pelvic floor muscles to treat stress incontinence.
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Your patient has a glomerular filtration rate (GFR) of 45 mL/min over a 3-month period. What does this tell you about her kidney function?
- A. She has chronic kidney disease.
- B. She is in renal failure.
- C. She has a kidney infection.
- D. Nothing; only BUN and creatinine levels can give information about kidney function.
Correct Answer: A
Rationale: A GFR of 45 mL/min over 3 months indicates chronic kidney disease (stage 3), as it reflects persistently reduced kidney function.
You are teaching bladder retraining to the patient with incontinence. She tries the plan and reports back to you about her progress. 'I tried going to the bathroom every 2 hours like you said, but I just sit there. I'm trying now to just go when I feel the urge, which is about every 3 hours. I'm still having accidents about half the time, which is a big improvement.' Which of the following statements should you make in response to the patient's comment?
- A. That's great. Keep up that pattern. It sounds like it's working.
- B. Waiting until you feel the urge defeats the purpose of a bladder retraining program. It sounds like you haven't really implemented the program. You should go back to trying to void every 2 hours to train your bladder to empty when you want it to.
- C. It sounds like bladder retraining isn't working for you, but that paying greater attention to the urge to go is.
- D. This is good information, but waiting for the urge to go is not going to retrain your bladder. Try toileting yourself every 2½ hours. Do this for several days to a week and then let me know the results.
Correct Answer: D
Rationale: Adjusting the interval to 2½ hours may help the patient adhere to a scheduled voiding program, which is essential for bladder retraining.
Urge incontinence
- A. Incontinence related to inability to get to the bathroom
- B. The brain does not receive a message that the bladder is full
- C. Incontinence related to bladder spasms and contractions
- D. The bladder does not empty because of an obstruction
- E. Incontinence related to weak pelvic floor muscles
- F. Loss of urine with no warning
Correct Answer: C
Rationale: Urge incontinence is caused by bladder spasms and contractions, leading to sudden, uncontrollable urges to urinate.
also known as overactive bladder, is the inability to keep urine in the bladder long enough to get to the restroom.
- A. Urge incontinence
- B. Stress incontinence
- C. Overflow incontinence
- D. Functional incontinence
Correct Answer: A
Rationale: Urge incontinence is characterized by a sudden, intense urge to urinate followed by involuntary loss of urine, often due to an overactive bladder.
In addition to collecting all urine passed in a 24-hour period, one of the most important steps in obtaining a 24-hour urine sample is to
- A. Have the patient void, discard this urine, note the time, and then begin collecting.
- B. Begin the collection at 8:00 a.m.
- C. Make sure there is a preservative in the collection bottle.
- D. Keep the sample at room temperature.
Correct Answer: A
Rationale: Discarding the first void and noting the time ensures the 24-hour collection period is accurately timed.