IGGY CH 66: CARE OF PATIENTS WITH
URINARY PROBLEMS ACTUAL
QUESTIONS AND CORRECT ANSWERS
A 53-year-old postmenopausal woman reports "leaking urine" when she laughs and is diagnosed
with stress incontinence. What does the nurse tell the client about how certain drugs may be able
to help with her stress incontinence?
a. "They can relieve your anxiety associated with incontinence."
b. "They help your bladder to empty."
c. "They may be used to improve urethral resistance."
d. "They decrease your bladder's tone." - Correct answers✔✔c. "They may be used to improve
urethral resistance."
Rationale
The nurse tells the 53-year-old postmenopausal woman with stress incontinence that certain
drugs may be used to improve urethral resistance. Bladder pressure is greater than urethral
resistance so drugs may be used to improve urethral resistance.Relieving anxiety has not been
shown to improve stress incontinence. No drugs have been shown to promote bladder emptying,
and this is not usually the problem with stress incontinence. Emptying the bladder is
accomplished by the individual or, if that is not possible, by using a catheter. Decreasing bladder
tone would not be a desired outcome for a woman with incontinence.
A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and
some discomfort upon urination. Her vital signs are stable except for a temperature of 100°F
(37.8°C). Which drug does the primary health care provider prescribe?
a. Nitrofurantoin (Macrodantin) after intercourse
b. Estrogen (Premarin)
c. Trimethoprim/sulfamethoxazole (Bactrim)
,d. Phenazopyridine (Pyridium) with intercourse - Correct answers✔✔c.
Trimethoprim/sulfamethoxazole (Bactrim)
Rationale
The primary health care provider prescribes trimethoprim/sulfamethoxazole to a 32-year-old
woman with a UTI who reports urinary frequency, urgency, and some discomfort upon urination.
Guidelines indicate that a 3-day course of trimethoprim/sulfamethoxazole is effective in treating
uncomplicated, community-acquired UTI in women.Drugs from the same class as nitrofurantoin
reduce bacteria in the urinary tract by inhibiting bacterial reproduction (bacteriostatic action).
This client needs a drug that will kill bacteria. Estrogen cream may help prevent recurrent UTIs
in postmenopausal women, which this client is not (at age 32). Use of Premarin is related to
problems with incontinence. Phenazopyridine (Pyridium) is not used to treat infection, but
symptoms of a UTI.
What information will the nurse provide to a client who is scheduled for extracorporeal shock
wave lithotripsy?
Select all that apply.
a. "Your urine will be strained after the procedure."
b. "Be sure to finish all of your antibiotics."
c. "Immediately call the primary health care provider if you notice bruising."
d. "Remember to drink at least 3 liters of fluid a day to promote urine flow."
e. "You will need to change the incisional dressing once a day." - Correct answers✔✔a. "Your
urine will be strained after the procedure."
b. "Be sure to finish all of your antibiotics."
d."Remember to drink at least 3 liters of fluid a day to promote urine flow."
Rationale
The nurse tells the client scheduled for an extracorporeal shock wave, "Your urine will be
strained after the procedure," "Be sure to finish all of your antibiotics," and "Remember to drink
at least 3 liters of fluid a day to promote urine flow." After lithotripsy, urine is strained to monitor
, the passage of stone fragments. clients must finish the entire antibiotic prescription to decrease
the risk of developing a urinary tract infection. Drinking at least 3 L of fluid a day dilutes
potential stone-forming crystals, prevents dehydration, and promotes urine flow.Bruising on the
flank of the affected side is expected after lithotripsy as a result of the shock waves that break the
stone into small fragments. The client must notify the primary health care provider if he or she
develops pain, fever, chills, or difficulty with urination because these signs and symptoms may
signal the beginning of an infection or the formation of another stone. There is no incision with
extracorporeal shock wave lithotripsy. There may be a small incision when intracorporeal
lithotripsy is performed.
The nurse is instructing an older adult female client about interventions to decrease the risk for
cystitis. Which client comment indicates that the teaching was effective?
a. "I must avoid drinking carbonated beverages."
b. "I need to douche vaginally once a week."
c. "I need to drink 2½ liters of fluid every day."
d. "I will not drink fluids after 8 PM each evening." - Correct answers✔✔c. "I need to drink 2½
liters of fluid every day."
Rationale
Teaching an older female about interventions to decrease the risk for cystitis is effective when
the client says, "I need to drink 2½ liters of fluid every day." Drinking this much fluid each day
flushes out the urinary system and helps reduce the risk for cystitis.Avoiding carbonated
beverages is not necessary to reduce the risk for cystitis. Douching is not a healthy behavior
because it removes beneficial organisms as well as the harmful ones. Avoiding fluids after 8:00
p.m. would help prevent nocturia but not cystitis. It is recommended that clients with
incontinence problems limit their late-night fluid intake to 120 mL.
What does the nurse teach a client to do to decrease the risk for urinary tract infection (UTI)?
a. Limit fluid intake.
b. Increase caffeine consumption.
c. Limit sugar intake.
URINARY PROBLEMS ACTUAL
QUESTIONS AND CORRECT ANSWERS
A 53-year-old postmenopausal woman reports "leaking urine" when she laughs and is diagnosed
with stress incontinence. What does the nurse tell the client about how certain drugs may be able
to help with her stress incontinence?
a. "They can relieve your anxiety associated with incontinence."
b. "They help your bladder to empty."
c. "They may be used to improve urethral resistance."
d. "They decrease your bladder's tone." - Correct answers✔✔c. "They may be used to improve
urethral resistance."
Rationale
The nurse tells the 53-year-old postmenopausal woman with stress incontinence that certain
drugs may be used to improve urethral resistance. Bladder pressure is greater than urethral
resistance so drugs may be used to improve urethral resistance.Relieving anxiety has not been
shown to improve stress incontinence. No drugs have been shown to promote bladder emptying,
and this is not usually the problem with stress incontinence. Emptying the bladder is
accomplished by the individual or, if that is not possible, by using a catheter. Decreasing bladder
tone would not be a desired outcome for a woman with incontinence.
A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and
some discomfort upon urination. Her vital signs are stable except for a temperature of 100°F
(37.8°C). Which drug does the primary health care provider prescribe?
a. Nitrofurantoin (Macrodantin) after intercourse
b. Estrogen (Premarin)
c. Trimethoprim/sulfamethoxazole (Bactrim)
,d. Phenazopyridine (Pyridium) with intercourse - Correct answers✔✔c.
Trimethoprim/sulfamethoxazole (Bactrim)
Rationale
The primary health care provider prescribes trimethoprim/sulfamethoxazole to a 32-year-old
woman with a UTI who reports urinary frequency, urgency, and some discomfort upon urination.
Guidelines indicate that a 3-day course of trimethoprim/sulfamethoxazole is effective in treating
uncomplicated, community-acquired UTI in women.Drugs from the same class as nitrofurantoin
reduce bacteria in the urinary tract by inhibiting bacterial reproduction (bacteriostatic action).
This client needs a drug that will kill bacteria. Estrogen cream may help prevent recurrent UTIs
in postmenopausal women, which this client is not (at age 32). Use of Premarin is related to
problems with incontinence. Phenazopyridine (Pyridium) is not used to treat infection, but
symptoms of a UTI.
What information will the nurse provide to a client who is scheduled for extracorporeal shock
wave lithotripsy?
Select all that apply.
a. "Your urine will be strained after the procedure."
b. "Be sure to finish all of your antibiotics."
c. "Immediately call the primary health care provider if you notice bruising."
d. "Remember to drink at least 3 liters of fluid a day to promote urine flow."
e. "You will need to change the incisional dressing once a day." - Correct answers✔✔a. "Your
urine will be strained after the procedure."
b. "Be sure to finish all of your antibiotics."
d."Remember to drink at least 3 liters of fluid a day to promote urine flow."
Rationale
The nurse tells the client scheduled for an extracorporeal shock wave, "Your urine will be
strained after the procedure," "Be sure to finish all of your antibiotics," and "Remember to drink
at least 3 liters of fluid a day to promote urine flow." After lithotripsy, urine is strained to monitor
, the passage of stone fragments. clients must finish the entire antibiotic prescription to decrease
the risk of developing a urinary tract infection. Drinking at least 3 L of fluid a day dilutes
potential stone-forming crystals, prevents dehydration, and promotes urine flow.Bruising on the
flank of the affected side is expected after lithotripsy as a result of the shock waves that break the
stone into small fragments. The client must notify the primary health care provider if he or she
develops pain, fever, chills, or difficulty with urination because these signs and symptoms may
signal the beginning of an infection or the formation of another stone. There is no incision with
extracorporeal shock wave lithotripsy. There may be a small incision when intracorporeal
lithotripsy is performed.
The nurse is instructing an older adult female client about interventions to decrease the risk for
cystitis. Which client comment indicates that the teaching was effective?
a. "I must avoid drinking carbonated beverages."
b. "I need to douche vaginally once a week."
c. "I need to drink 2½ liters of fluid every day."
d. "I will not drink fluids after 8 PM each evening." - Correct answers✔✔c. "I need to drink 2½
liters of fluid every day."
Rationale
Teaching an older female about interventions to decrease the risk for cystitis is effective when
the client says, "I need to drink 2½ liters of fluid every day." Drinking this much fluid each day
flushes out the urinary system and helps reduce the risk for cystitis.Avoiding carbonated
beverages is not necessary to reduce the risk for cystitis. Douching is not a healthy behavior
because it removes beneficial organisms as well as the harmful ones. Avoiding fluids after 8:00
p.m. would help prevent nocturia but not cystitis. It is recommended that clients with
incontinence problems limit their late-night fluid intake to 120 mL.
What does the nurse teach a client to do to decrease the risk for urinary tract infection (UTI)?
a. Limit fluid intake.
b. Increase caffeine consumption.
c. Limit sugar intake.
