Chapter 55 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 55  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A female patient has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this patient?

  1. A)  Bathe daily and keep the perineal region clean.
  2. B)  Avoid voiding immediately after sexual intercourse.
  3. C)  Drink liberal amounts of fluids.
  4. D)  Void at least every 6 to 8 hours.

Ans: C

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 occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence?

  1. A)  Stress incontinence
  2. B)  Reflex incontinence
  3. C)  Overflow incontinence
  4. D)  Functional incontinence

Ans: A

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.

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3. A nurse is caring for a female patient whose urinary retention has not responded to conservative treatment. When educating this patient about self-catheterization, the nurse should encourage what practice?

  1. A)  Assuming a supine position for self-catheterization
  2. B)  Using clean technique at home to catheterize
  3. C)  Inserting the catheter 1 to 2 inches into the urethra
  4. D)  Self-catheterizing every 2 hours at home

Ans: B

Feedback:

The patient may use a “clean” (nonsterile) 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. When planning this patient’s discharge education, what is the most plausible nursing diagnosis that the nurse should address?

  1. A)  Impaired mobility related to limitations posed by the ileal conduit
  2. B)  Deficient knowledge related to care of the ileal conduit
  3. C)  Risk for deficient fluid volume related to urinary diversion
  4. D)  Risk for autonomic dysreflexia related to disruption of the sacral plexus

Ans: B

Feedback:

The patient will most likely require extensive teaching about the care and maintenance of a new urinary diversion. A diversion does not create a serious risk of fluid volume deficit. Mobility is unlikely to be impaired after the immediate postsurgical recovery. The sacral plexus is not threatened by the creation of a urinary diversion.

5. The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patient’s health education, what nutritional guidelines should the nurse provide?

  1. A)  Restrict protein intake as ordered.
  2. B)  Increase intake of potassium-rich foods.
  3. C)  Follow a low-calcium diet.
  4. D)  Encourage intake of food containing oxalates.

Ans: A

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. The patient should avoid intake of oxalate-containing foods and there is no need to increase potassium intake.

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