Chapter 45 Management of Patients With Urinary Disorders

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Chapter 45  Management of Patients With Urinary Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The clinic nurse is teaching a young wife about preventing recurrent urinary tract infections. What information should the nurse include?
A) Bathe daily.
B) Avoid voiding immediately after sexual intercourse.

C) Drink liberal amounts of fluids. D) Void every 6 to 8 hours.

Ans: C
Chapter: 45
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 1363, Lower Urinary Tract Infections

Feedback: The patient is encouraged to drink liberal amounts of fluids (water is the best choice) to increase urine production and flow, which flushes the bacteria from the urinary tract. Frequent voiding (every 2 to 3 hours) is encouraged to empty the bladder completely because this can significantly lower urine bacterial counts, reduce urinary stasis, and prevent reinfection. The

patient should be encouraged to shower rather than bathe.

2. A 42-year-old woman comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware this is what type of incontinence?
A) Stress incontinence
B) Reflex incontinence

C) Overflow incontinence D) Functional incontinence

Ans: A
Chapter: 45
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3
Page and Header: 1366, Urinary Incontinence

Feedback: Stress incontinence is the involuntary loss of urine through an intact urethra as a result of sudden increase in intra-abdominal pressure. Reflex incontinence is loss of urine due to hyperreflexia or involuntary urethral relaxation in the absence of normal sensations usually associated with voiding. Overflow incontinence is an involuntary urine loss associated with overdistension of the bladder. Functional incontinence refers to those instances in which the function of the lower urinary tract is intact, but other factors (outside the urinary system) make it difficult or impossible for the patient to reach the toilet in time for voiding.

3. A nurse is caring for a female patient with urinary retention. The nurse teaches this patient to follow which principle for self-catheterization?
A) Assume a supine position for self-catheterization.
B) Use a clean technique at home to catheterize.

C) Insert the catheter 1 to 2 inches into the urethra. D) Self-catheterize every 2 hours at home.

Ans: B
Chapter: 45
Client Needs: D-1
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Teaching/Learning Objective: 3

Page and Header: 1375, Catheterization

Feedback: The patient may use a “clean” (non-sterile) technique at home, where the risk of cross-contamination is reduced. The average daytime clean intermittent catheterization schedule is every 4 to 6 hours and just before bedtime. The female patient assumes a Fowler’s position and uses a mirror to help locate the urinary meatus. The nurse teaches her to catheterize herself by inserting a catheter 7.5 cm (3 inches) into the urethra, in a downward and backward direction.

4. A 52-year-old patient is scheduled to undergo ileal conduit surgery. The patient has several appropriate questions. What would be the most appropriate nursing diagnosis for this patient? A) Self-care deficit related to the surgical procedure and creation of an ileal conduit
B) Knowledge deficit about the surgical procedure and postoperative care

C) Fear and anxiety related to the surgical procedure D) Risk of infection related to the surgical procedure

Ans: B
Chapter: 45
Client Needs: B
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 7
Page and Header: 1388, Other Urinary Diversion Procedures

Feedback: The most appropriate nursing diagnosis for this patient would be knowledge deficit about the surgical procedure and postoperative care, because the information that the patient has several appropriate questions best supports this diagnosis.

5. The educator on your unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patient’s teaching what nutritional guidelines would the educator include?
A) Restrict protein intake to 60 g/d.

B) Restrict sodium intake to 5 to 6 g/d.
C) Follow a low-calcium diet.
D) Encourage intake of oxalates (peanuts, wheat bran, strawberries, rhubarb, tea, and spinach).

Ans: A
Chapter: 45 Client Needs: D-3

Cognitive Level: Application Difficulty: Difficult
Integrated Process: Teaching/Learning Objective: 6

Page and Header: 1377, Urolithiasis and Nephrolithiasis

Feedback: Protein is restricted to 60 g/d, while sodium is restricted to 3 to 4 g/d. Low-calcium diets are generally not recommended except for true absorptive hypercalciuria.

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