ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 55 : Management of Patients with Urinary Disorders Questions
Question 1 of 5
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?
Correct Answer: B
Rationale: 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 Fowlers position and uses a mirror to help locate the urinary meatus. The nurse teaches her to catheterize herself by inserting a catheter7.5 \mathrm{~cm}$ ( 3 inches) into the urethra, in a downward and backward direction.
Question 2 of 5
A 52-year-old patient is scheduled to undergo ileal conduit surgery. When planning this patients discharge education, what is the most plausible nursing diagnosis that the nurse should address?
Correct Answer: B
Rationale: 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.
Question 3 of 5
The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patients health education, what nutritional guidelines should the nurse provide?
Correct Answer: A
Rationale: Protein is restricted to60 \mathrm{~g} / \mathrm{d}$, while sodium is restricted to 3 to4 \mathrm{~g} / \mathrm{d}$. Low-calcium diets are generally not recommended except for true absorptive hypercalciuria. The patient should avoid intake of oxalatecontaining foods and there is no need to increase potassium intake.
Question 4 of 5
The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. What instruction should the nurse give the patient?
Correct Answer: C
Rationale: The patient should report the presence of foul-smelling or cloudy urine since this is suggestive of a UTI. Unless contraindicated, the patient should be instructed to drink large quantities of fluid each day to flush the kidneys. Sand like debris is normal due to residual stone products. Hematuria is common after lithotripsy.
Question 5 of 5
A female patients most recent urinalysis results are suggestive of bacteriuria. When assessing this patient, the nurses data analysis should be informed by what principle?
Correct Answer: D
Rationale: Because urine samples (especially in women) are commonly contaminated by the bacteria normally present in the urethral area, a bacterial count exceeding10^5$ colonies/ \mathrm{mL}$ of clean-catch, midstream urine is the measure that distinguishes true bacteriuria from contamination. A diagnosis does not require three consecutive positive results and urine does not contain a normal flora in the absence of a UTI. Most UTIs have a bacterial etiology.