After delegating to an unlicensed assistive personnel (UAP) the task of completing a bladder scan examination for a client, the nurse evaluates the UAP's performance. Which action by the UAP indicates the nurse must provide additional instructions when delegating this task?

Correct Answer: A

Rationale: The correct answer is A because the UAP should select the female icon for women who have not had a hysterectomy to allow the scanner to subtract the volume of the uterus from readings. If a woman has had a hysterectomy, the UAP should choose the male icon. Choice B is incorrect as it is essential for the UAP to explain the procedure to the client to ensure understanding. Choice C is incorrect because applying ultrasound gel to the scanning head and cleaning it after use are appropriate actions. Choice D is incorrect as it is necessary for the UAP to take at least two readings using the aiming icon to position the scanning head accurately for an effective bladder scan examination.

Correct Answer: B

Rationale: The correct action that indicates the UAP needs additional teaching is choice B, 'Changing the client's incontinence brief when wet.' Habit training is a technique used to manage incontinence, and it is undermined by the use of absorbent incontinence briefs or pads. The nurse should re-educate the UAP on the technique of habit training, which involves scheduled toileting and promoting bladder control. Choices A, C, and D are appropriate actions that support the client's care: toileting the client after meals, encouraging fluid intake, and documenting incontinence episodes are all important aspects of managing incontinence and monitoring the client's condition.

Correct Answer: A

Rationale: In this scenario, the priority intervention is to obtain a urine sample for culture and sensitivity. Older adults with recent falls may have atypical symptoms of urinary tract infection (UTI), which can present as new-onset confusion or falling. It is crucial to rule out UTI before initiating antibiotics. While administering antibiotics, encouraging protein intake, fluids, and consulting physical therapy are important interventions, they should follow the urine sample collection to ensure accurate diagnosis and appropriate treatment.

Correct Answer: D

Rationale: Functional urinary incontinence is not related to bladder issues but rather to difficulties with ambulation or accessing the toilet. The goal is to help the client manage clothing independently. Elastic waistband slacks that are easy to pull down facilitate timely access to the toilet. Choices A and B are unrelated and not applicable to functional urinary incontinence. Choice C is incorrect as surgeries to repair the bladder are not indicated for functional urinary incontinence.

Correct Answer: C

Rationale: The correct response is option C: "I can teach you strategies to help control your incontinence." This response is the most therapeutic and client-centered approach. By offering to teach the client strategies to manage their incontinence, the nurse empowers the client to take control of their condition and promotes self-care and independence. It also shows empathy and support for the client's feelings of embarrassment. Option A, "I understand how you feel. I would be mortified," may validate the client's feelings but does not provide any practical solutions or support for managing the incontinence. Option B, "Incontinence pads will minimize leaks in public," offers a solution but does not address the client's emotional concerns or provide education on managing the condition beyond using pads. Option D, "More women experience incontinence than you might think," while providing some reassurance that the client is not alone, does not address the client's immediate needs for management strategies or emotional support. In an educational context, it is essential for nursing students to understand the importance of holistic care when addressing clients with urinary incontinence. Teaching clients self-management strategies, providing emotional support, and promoting dignity and independence are crucial aspects of nursing care in this context.