ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 48 Questions
Question 1 of 5
A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim-sulfamethoxazole for 3 days. Which of the following actions should the nurse plan to take?
Correct Answer: B
Rationale: Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate antibiotic therapy. Although daily intake of cranberry juice has been purported to assist in treating, there is currently no conclusive evidence to support advocating this treatment. The fluid intake should be increased to at least 1000 mL/day. Since the UTI has persisted after treatment with trimethoprim-sulfamethoxazole, the patient is likely to need a different antibiotic.
Question 2 of 5
The nurse is providing patient teaching to a patient with cystitis regarding prevention of future urinary tract infections (UTIs). Which of the following patient statements indicate that teaching has been effective?
Correct Answer: D
Rationale: Voiding every 2-4 hours is recommended to prevent UTIs. Use of vaginal sprays is discouraged. The bladder should be emptied before and after intercourse, but cleaning with soap and water is not necessary. A litre of fluids is insufficient to provide adequate urine output to decrease risk for UTI.
Question 3 of 5
The nurse is caring for a patient who has had a segmental cystectomy. Which of the following information should the nurse include in the postoperative teaching for the patient?
Correct Answer: C
Rationale: Approximately 7-10 days following tumour resection or ablation, the patient may observe dark red or rust-coloured flecks in the urine. These are anticipated and represent scabs from the healing tumour resection sites. Other postoperative instructions for a segmental cystectomy include to drink a large volume of fluid each day for the first week following the procedure and to avoid intake of alcoholic beverages. Urine is anticipated to be pink during the first several days after the procedure, but it should not be bright red or contain blood clots. The patient can be encouraged to take a 15-20-minute sitz bath two to three times a day to promote muscle relaxation and to reduce the risk of urinary retention.
Question 4 of 5
The nurse is caring for a patient with benign prostatic hyperplasia who has chills, fever, and is vomiting. Which of the following findings by the nurse is most helpful in determining whether the patient has an upper urinary tract infection (UTI)?
Correct Answer: D
Rationale: Costovertebral tenderness is characteristic of pyelonephritis. The other symptoms are characteristic of lower UTI and are likely to be present if the patient also has an upper UTI.
Question 5 of 5
The nurse is teaching a patient with interstitial cystitis about management of the condition. Which of the following patient statements indicate that further instruction is required?
Correct Answer: B
Rationale: High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient statements indicate good understanding of the teaching.