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- - A nurse cares for a patient with urinary incontinence. The patient states, “I am so embarrassed. My bladder leaks like a young child’s bladder.” How would the nurse respond? Selected Answer: (^) d. “I can teach you strategies to help control your incontinence.” Answers: a. “I understand how you feel. I would be mortified.” b. “More people experience incontinence than you might think.” c. “Incontinence pads will minimize leaks in public.” Response Feedback: - Question 2 d. “I can teach you strategies to help control your incontinence.” The nurse should accept and acknowledge the patient’s concerns, and assist the patient to learn techniques that will allow control of urinary incontinence. The nurse should not diminish the patient’s concerns with the use of pads or stating statistics about the occurrence of incontinence. 0 out of 1 points A nurse provides phone triage to a pregnant patient. The patient states, “I am experiencing a burning pain when I urinate.” How would the nurse respond? Selected Answer: c. “This means labor will start soon. Prepare to go to the hospital.” Answers: a. “You probably have a urinary tract infection. Drink more cranberry juice.” b. “Your pelvic wall is weakening. Pelvic muscle exercises should help.” c. “This means labor will start soon. Prepare to go to the hospital.”
Response Feedback:
- Question 3 d. “Make an appointment with your provider to have your infection treated.” Pregnant patients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy. The nurse should encourage the patient to make an appointment and have the infection treated. Burning pain when urinating does not indicate the start of labor or weakening of pelvic muscles. 0 out of 1 points A nurse cares for a patient who has pyelonephritis. The patient states, “I am embarrassed to talk about my symptoms.” How would the nurse respond? Selected Answer: c. “You seem anxious. Would you like a nurse of the same gender to care for you?” Answers: (^) a. “Take your time. It is okay to use words that are familiar to you.” b. “I understand. Elimination is a private topic and shouldn’t be discussed.” c. “You seem anxious. Would you like a nurse of the same gender to care for you?” d. “I am a professional. Your symptoms will be kept in confidence.” Response Feedback: - Question 4 Patients may be uncomfortable discussing issues related to elimination and the genitourinary area. The nurse would encourage the patient to use language that is familiar to the patient. The nurse would not make promises that cannot be kept, like keeping the patient’s symptoms confidential. The nurse must assess the patient and cannot take the time to stop the discussion or find another nurse to complete the assessment. 1 out of 1 points
Response Feedback:
- Question 6 c. “Stress incontinence usually occurs in people with dementia.” d. “Urge incontinence can be managed by increasing fluid intake.” e. “Stress incontinence occurs due to weak pelvic floor muscles.” Patients who suffer from stress incontinence have weak pelvic floor muscles or urethral sphincter and cannot tighten their urethra sufficiently to overcome the increased detrusor pressure. Stress incontinence is common after childbirth, when the pelvic muscles are stretched and weakened from pregnancy and delivery. Urge incontinence occurs in people who cannot suppress the contraction signal from the detrusor muscle. Abnormal detrusor contractions may be a result of neurologic abnormalities including dementia, or may occur with no known abnormality. Postvoid residual is associated with reflex incontinence, not with urge incontinence or stress incontinence. Management of urge incontinence includes decreasing fluid intake, especially in the evening hours. 0 out of 1 points A nurse assesses a patient with a fungal urinary tract infection (UTI). Which assessments would the nurse complete? ( Select all that apply. ) Selected Answers: (^) b. Palpate the kidneys and bladder. c. Assess the medical history and current medical problems. d. Obtain a current list of medications. Answers: a. Inquire about recent travel to foreign countries. b. Palpate the kidneys and bladder. c. Assess the medical history and current medical problems. d. Obtain a current list of medications. e. Perform a bladder scan to assess postvoid residual.
Response Feedback:
- Question 7 Patients who are severely immunocompromised or who have diabetes mellitus are more prone to fungal UTIs. The nurse should assess for these factors by asking about medical history, current medical problems, and current medication list. A physical examination and a postvoid residual may be needed, but not until further information is obtained indicating that these examinations are necessary. Travel to foreign countries probably would not be important because, even if exposed, the patient needs some degree of compromised immunity to develop a fungal UTI. 1 out of 1 points A nurse cares for patients with urinary incontinence. Which types of incontinence are correctly paired with their clinical manifestation? ( Select all that apply. ) Selected Answers: a. Urge incontinence—loss of urine upon feeling the need to void b. Overflow incontinence—constant dribbling of urine d. Stress incontinence—urine loss with physical exertion Answers: (^) a. Urge incontinence—loss of urine upon feeling the need to void b. Overflow incontinence—constant dribbling of urine c. Functional incontinence—urine loss results from abnormal detrusor contractions d. Stress incontinence—urine loss with physical exertion e. Reflex incontinence—leakage of urine without lower urinary tract disorder Response Feedback: Stress^ incontinence^ is^ a^ loss^ of^ urine^ with^ physical^ exertion, coughing, sneezing, or exercising. Urge incontinence presents with an abrupt and strong urge to void and usually has a large amount of urine released with each occurrence. Overflow incontinence occurs with bladder distention and results in a constant dribbling of urine. Functional incontinence is the leakage of urine caused by factors other than a disorder of the lower urinary tract. Reflex
A nurse teaches a female patient who has stress incontinence. Which statements would the nurse include about pelvic muscle exercises? ( Select all that apply. ) Selected Answers: c. “Tighten your pelvic muscles for a slow count of 10 and then relax for a slow count of 10.” e. “Like any other muscle in your body, you can make your pelvic muscles stronger by contracting them.” Answers: a. “After you have been doing these exercises for a couple days, your control of urine will improve.” b. “Pelvic muscle exercises should only be performed sitting upright with your feet on the floor.” c. “Tighten your pelvic muscles for a slow count of 10 and then relax for a slow count of 10.” d. “When you start and stop your urine stream, you are using your pelvic muscles.” e. “Like any other muscle in your body, you can make your pelvic muscles stronger by contracting them.” Response Feedback:
- Question 10 The patient should be taught that the muscles used to start and stop urination are pelvic muscles, and that pelvic muscles can be strengthened by contracting and relaxing them. The patient should tighten pelvic muscles for a slow count of 10 and then relax the muscles for a slow count of 10, and perform this exercise 15 times while in lying-down, sitting-up, and standing positions. The patient should begin to notice improvement in control of urine after several weeks of exercising the pelvic muscles. 0 out of 1 points A nurse is teaching patients about different medications used to treat urinary incontinence. Which medications are paired with correct information? ( Select all that apply. ) Selected Answers: a. Anticholinergics: Assess the patient for a history of cataracts b.
Antidepressants: Warn patient to inform all providers about taking this drug Answers: a. Anticholinergics: Assess the patient for a history of cataracts b. Antidepressants: Warn patient to inform all providers about taking this drug c. Beta-blockers: Instruct the patient to obtain an annual flu vaccine d. Estrogen cream: Apply a thin layer only e. Alpha-adrenergics: Instruct the patient to monitor the blood pressure Response Feedback:
- Question 11 Estrogen cream is applied in a thin layer only to avoid excessive absorption. Alpha adrenergics can increase blood pressure. Antidepressants have many drug–drug interactions, and the patient needs to inform all his or her providers about taking this drug. Anticholinergics should not be used in patients with glaucoma. Beta-blockers can affect both blood pressure and pulse. The flu vaccine is important but not related. 0 out of 1 points After treating several young women for UTIs, the college nurse plans an educational offering on reducing the risk of getting a UTI. What information does the nurse include? ( Select all that apply. ) Selected Answers: (^) a. Wipe or clean the perineum from front to back b. Do not douche or use scented feminine products c. Wear loose-fitting nylon panties d. Void before and after each act of intercourse Answers: (^) a. Wipe or clean the perineum from front to back b. Do not douche or use scented feminine products
A nurse assesses a patient with nephrotic syndrome. For which clinical manifestations would the nurse assess? ( Select all that apply. ) Selected Answers: (^) f. Costovertebral angle (CVA) tenderness Answers: (^) a. Hypoalbuminemia b. Lipiduria c. Dysuria d. Proteinuria e. Dehydration f. Costovertebral angle (CVA) tenderness Response Feedback:
- Question 14 Nephrotic syndrome is caused by glomerular damage and is characterized by proteinuria (protein level higher than 3.5 g/ hr), hypoalbuminemia, edema, and lipiduria. Fluid overload leading to edema and hypertension is common with nephrotic syndrome; dehydration does not occur. Dysuria is present with cystitis. CVA tenderness is present with inflammatory changes in the kidney. 0 out of 1 points A nurse reviews laboratory results for a patient with glomerulonephritis. The patient’s glomerular filtration rate (GFR) is 40 mL/min as measured by a 24- hour creatinine clearance. How would the nurse interpret this finding? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. Potential for fluid overload b. Potential for dehydration c. Reduced GFR d. Normal GFR e.
Response Feedback:
- Question 15 Excessive GFR The GFR refers to the initial amount of urine that the kidneys filter from the blood. In the healthy adult, the normal GFR ranges between 100 and 120 mL/min, most of which is reabsorbed in the kidney tubules. A GFR of 40 mL/min is drastically reduced, with the patient experiencing fluid retention and risks for hypertension and pulmonary edema as a result of excess vascular fluid. 0 out of 1 points A nurse assesses a patient who is recovering from a nephrostomy. Which assessment findings would alert the nurse to urgently contact the healthcare provider? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. Bloody drainage at site b. Foul-smelling drainage c. Urine draining from site d. Clear drainage e. Patient reports headache Response Feedback: - Question 16 After a nephrostomy, the nurse would assess the patient for complications and urgently notify the provider if drainage decreases or stops, drainage is cloudy or foul smelling, the nephrostomy site leaks blood or urine, or the patient has back pain. Clear drainage is normal. A headache would be an unrelated finding. A nurse teaches a patient with polycystic kidney disease (PKD). Which 0 out of 1 points statements would the nurse include in this patient’s discharge teaching? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. “Weigh yourself at the same time each day.” b. “Assess your urine for renal stones.”
A nurse is caring for a postoperative 70-kg patient who had major blood loss during surgery. Which findings by the nurse would prompt immediate action to prevent acute kidney injury? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. Blood pressure of 90/60 mm Hg b. Large amount of sediment in the urine c. Urine output of 100 mL in 4 hours d. Amber, odorless urine e. Urine output of 500 mL in 12 hours Response Feedback:
- Question 19 The low urine output, sediment, and blood pressure would be reported to the provider. Postoperatively, the nurse would measure intake and output, check the characteristics of the urine, and report sediment, hematuria, and urine output of less than 0. mL/kg/hour for 3 to 4 hours. A urine output of 100 mL is low, but a urine output of 500 mL in 12 hours would be within normal limits. Perfusion to the kidneys is compromised with low blood pressure. The amber odorless urine is normal. 0 out of 1 points A patient is hospitalized in the oliguric phase of acute kidney injury (AKI) and is receiving tube feedings. The nurse is teaching the patient’s spouse about the kidney-specific formulation for the enteral solution compared to standard formulas. What components would be discussed in the teaching plan? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: a. Higher phosphorus b. Higher calories c. Lower sodium d. Lower potassium e.
Response Feedback:
- Question 20 Higher calcium Many patients with AKI are too ill to meet caloric goals and require tube feedings with kidney-specific formulas that are lower in sodium, potassium, and phosphorus, and higher in calories than are standard formulas. 0 out of 1 points The nurse is teaching a patient with diabetes mellitus how to prevent or delay chronic kidney disease (CKD). Which patient statements indicate a lack of understanding of the teaching? ( Select all that apply. ) Selected Answers: Answers: a. [None Given] Response Feedback: - Question 21 “Smoking should be stopped as soon as I possibly can.” b. “I can continue to take an aspirin every 4 to 8 hours for my pain.” c. “I really only need to drink a couple of glasses of water each day.” d. “I need to decrease sodium, cholesterol, and protein in my diet.” e. “My weight should be maintained at a body mass index of 30.” Weight should be maintained at a body mass index (BMI) of 22 to
- A BMI of 30 indicates obesity. The use of nonsteroidal anti- inflammatory drugs such as aspirin would be limited to the lowest time at the lowest dose due to interference with kidney blood flow. The patient should drink at least 2 L of water daily. Diet adjustments should be made by restricting sodium, cholesterol, and protein. Smoking causes constriction of blood vessels and decreases kidney perfusion, so the patient should stop smoking. 0 out of 1 points A nurse is giving discharge instructions to a patient recently diagnosed with chronic kidney disease (CKD). Which statements made by the patient indicate a correct understanding of the teaching? ( Select all that apply. ) Selected Answers: [None Given] Answers: (^) a.
- Question 23 boluses and cooling dialysate, the hemodialysis can be stopped and the healthcare provider contacted. 0 out of 1 points A patient is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. “There is less restriction of protein and fluids.” b. “It takes less time than hemodialysis treatments.” c. “You will have no risk for infection with PD.” d. “You have flexible scheduling for the exchanges.” e. “You will not need vascular access to perform PD.” Response Feedback: - Question 24 PD is based on exchanges of waste, fluid, and electrolytes in the peritoneal cavity. There is no need for vascular access. Protein is lost in the exchange, which allows for more protein and fluid in the diet. There is flexibility in the time for exchanges, but the treatment takes a longer period of time compared to hemodialysis. There still is risk for infection with PD, especially peritonitis. 0 out of 1 points The nurse is taking a history of a 68-year-old woman. What assessment findings would indicate a high risk for the development of breast cancer? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: a. Osteoporosis b. Multiparity c. Age greater than 65 years d.
Response Feedback:
- Question 25 Genetic factors e. Increased breast density The high-risk factors for breast cancer are age greater than 65 with the risk increasing until age 80; an increase in breast density because of more glandular and connective tissue; and inherited mutations of BRCA1 and/or BRCA2 genes_._ Osteoporosis and multiparity are not risk factors for breast cancer. A high postmenopausal bone density and nulliparity are moderate and low increased risk factors, respectively. 0 out of 1 points The nurse is formulating a teaching plan according to evidence-based breast cancer screening guidelines for a 50-year-old woman with low-risk factors. Which diagnostic methods would be included in the plan? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. Breast self-awareness b. Clinical breast examination c. Breast ultrasound d. Magnetic resonance imaging (MRI) e. Annual mammogram Response Feedback: - Question 26 Guidelines recommend a screening annual mammogram for women aged 40 years and older, breast self-awareness, and a clinical breast examination. An MRI is recommended if there are known high-risk factors. A breast ultrasound is used if there are problems discovered with the initial screening or dense breast tissue. 0 out of 1 points After a breast examination, the nurse is documenting assessment findings that indicate possible breast cancer. Which abnormal findings need to be included as part of the patient’s electronic medical record? ( Select all that apply. ) Selected Answers: (^) [None Given]
- Question 28 serum calcium and high platelet count would not have any contraindication for acupuncture. 0 out of 1 points A 28 - year-old patient is diagnosed with uterine leiomyoma and is experiencing severe symptoms. Which actions by the nurse are the most appropriate at this time? ( Select all that apply. ) Selected Answers: Answers: a. [None Given] Response Feedback: - Question 29 Reduce the pain by low-level heat. b. Discuss in detail the side effects of laparoscopic surgery. c. Relieve anxiety by relaxation techniques and education. d. Review complete blood count for possible iron-deficiency anemia e. Discuss the high risk of infertility with this diagnosis. With uterine leiomyoma’s or fibroids, heavy bleeding is the predominant symptom, with anxiety occurring because of fears of cancer or infertility. Interventions would be directed to the heavy bleeding and anxiety relief, such as relaxation techniques and education about the pathophysiology and possible treatment of the fibroids. The nurse could suggest resources to give more information about the diagnosis. Typically patients with uterine fibroids do not have pain. Discussion of the possibility of infertility and side effects of laparoscopic surgery is premature and may increase the anxiety. The nurse is giving discharge instructions to a patient who had a total 0 out of 1 points abdominal hysterectomy. Which statements by the patient indicate a need for further teaching? ( Select all that apply. ) Selected Answers: Answers: a. [None Given] “I will have to limit the times that I climb our stairs at home to morning and night.” b.
Response Feedback:
- Question 30 “My granddaughter weighs 23 lbs (10.5 kg) so I need to refrain from picking her up.” c. “Now that I have time off from work, I can return to my exercise routine next week.” d. “I should not have any problems driving to see my mother, who lives 3 hours away.” e. “For 1 month, I will need to refrain from sexual intercourse.” Driving and sitting for extended periods of time should be avoided until the surgeon gives permission. For 2 to 6 weeks, exercise participation should also be avoided. All of the other responses demonstrate adequate knowledge for discharge. The patient should not lift anything heavier than 10 lbs (4.5 kg), should limit stair climbing, and should refrain from sexual intercourse. 0 out of 1 points The nurse is taking the history of a 24 - year-old patient diagnosed with cervical cancer. What possible risk factors would the nurse assess? ( Select all that apply. ) Selected Answers: (^) [None Given] Answers: (^) a. Poor diet b. Multiple sexual partners c. Younger than 18 at first intercourse d. Smoking e. Nulliparity Response Feedback: - Question 31 Smoking, multiple sexual partners, poor diet, and age less than 18 for first intercourse are all risk factors for cervical cancer. Nulliparity is a risk factor for endometrial cancer. 0 out of 1 points
