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Exam (elaborations)

NR 601 Final 2.0 – Questions With Appropriate Solutions

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NR 601 Final 2.0 – Questions With Appropriate Solutions

Institution
NR 601
Course
NR 601

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NR 601 Final 2.0 – Questions With Appropriate Solutions

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What are 3 screenings to consider for Depression
patients of the LQBTQ+ community? Anal cancer (HPV swab)
HIV screening 15-65 yo


People in the LGBTQ+ community have Lung cancer screening CT scan (50-80yo, 20pky, quit last 15y)
higher rates of tobacco use. What AAA screening (60-75yo who ever smoked)
screenings should be considered for this
population?


What may make WSW higher risk for breast Nulliparity (never given birth)
cancer? Alcohol use
Tobacco use
Obesity


Anal paps are recommended for HIV+ D. All the above
women with these risk factors.


A. Hx receptive anal intercourse
B. Abnormal pap
C. Hx genital warts
D. All the above


What is the cause of each type of urinary Urge - overactive detrusor
incontinence (urge, stress, mixed, overflow)? Stress - inadequate sphincter
Mixed - urge and stress
Overflow - impaired emptying (uncommon in OA)


Treatment of urge incontinence (behavioral, Behavioral: bladder training by voiding every 2 hours then
medication) increasing to every 4 hours, Kegals 8-12x TID x3-4 mo


Medication:
Oxybutynin IR 3-4x/day or ER daily (SE: Anticholinergic)
Mirabegron daily (SE: HTN)


Treatment of stress incontinence Behavioral: same as urge w/ scheduled voids and kegals
(behavioral, medication, surgery) Medication: none FDA approved
Surgery: gold-standard

, Procedures for stress incontinence Colposuspension
Sling
Botulin toxin injection - risk for retention
sacral nerve modulation
percutaneous tibial nerve stimulation


When should you consult urology for Urge - fails behavioral changes and medication
incontinence? Stress - fails behavioral changes, cx for surgery
Inadequate response to lifestyle changes (weight loss)
Acute incontinence with pain


Lifestyle changes that can help incontinence Weight loss #1
Decrease PM fluids
Avoid caffeine & alcohol


What medical conditions are associated with Cardiovascular disease, like heart failure (fluid overload)
incontinence? GI disease, like constipation (functional problem)
Metabolic disease, like diabetes (polyuria)
Mobility impairment (functional incontinence)
Neuro disease, like MS or SCI (loss of muscle control),
delirium or dementia (forget)


What medications are associated with Alcohol
incontinence? ACE inhibitors (cough -> stress I)
Anticholinergics (constipation -> incontinence)
CCB (pedal edema -> polyuria)
Estrogen (worsens stress I)
Diuretics (polyuria)


What is the best first treatment for urinary A. Timed voiding
incontinence?


A. Timed voiding
B. Medication
C. Surgical repair with bladder sling
D. Restrict fluids after 12 PM


Urinary incontinence can be exacerbated ACE inhibitors
by which medications?


A. ACE inhibitors
B. Sulfa antibiotics
C. SSRI
D. SNRI


Which medical conditions are associated B. Type 2 diabetes
with urinary incontinence?
Note, uterine fibroids and B12 deficiency can cause
A. Melanoma incontinence, not endometrial hyperplasia or vitamin A
B. Type 2 diabetes deficiency
C. Endometrial hyperplasia
D. Vitamin A deficiency


How is overactive bladder defined? 1. Urgency, usually with frequency and nocturia
2. With or without urge incontinence


Treatment for overactive bladder is the Urge incontinence
same as treatment for _____
Oxybutynin or mirabegron

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