NURSING 204 : Multidimensional Care 3

NURSING 204 : Multidimensional Care 3
• : Multidimensional Care 3
• 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.”

d.
“I can teach you strategies to help control your incontinence.”
Response The nurse should accept and acknowledge the patient’s concerns, and assist
Feedback:
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.
• Question 2
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.”

,NURSING 204 : Multidimensional Care 3
d.
“Make an appointment with your provider to have your
infection treated.”

Pregnant patients with a urinary tract infection require prompt
Response and aggressive treatment because cystitis can lead to acute
Feedback:
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.
• Question 3

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:
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.
• Question 4
1 out of 1 points

,NURSING 204 : Multidimensional Care 3
A nurse assesses a patient who has had two episodes of bacterial cystitis in the
last 6 months. Which questions would the nurse ask? (Select all that apply.)
Selected Answers: a.
“Are you on steroids or other immune-suppressing drugs?”
c.
“Does anyone in your family have a history of cystitis?”
e.
“Do you take estrogen replacement therapy?”
Answers: a.
“Are you on steroids or other immune-suppressing drugs?”
b.
“How much water do you drink every day?”
c.
“Does anyone in your family have a history of cystitis?”
d.
“Do you drink grapefruit juice or orange juice daily?”
e.
“Do you take estrogen replacement therapy?”
Response
Feedback:
Fluid intake, estrogen levels, and immune suppression all can
increase the chance of recurrent cystitis. Family history is usually
insignificant, and cranberry juice, not grapefruit or orange juice,
has been found to increase the acidic pH and reduce the risk for
bacterial cystitis.
• Question 5
2 out of 1 points

A nurse teaches patients about the difference between urge incontinence and
stress incontinence. Which statements would the nurse include in this
education? (Select all that apply.)
Selected
b.
Answers:
“Urge incontinence occurs due to abnormal
bladder contractions.”
e.
“Stress incontinence occurs due to weak pelvic floor muscles.”
Answers: a.
“Urge incontinence involves a post-void residual volume less
than 50 mL.”
b.
“Urge incontinence occurs due to abnormal bladder
contractions.”

, NURSING 204 : Multidimensional Care 3
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.”
Response Patients who suffer from stress incontinence have weak pelvic
Feedback:
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.
• Question 6
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.