For which patient with incontinence would a bladder-training program be an appropriate intervention?

Correct Answer: C

Rationale: The correct answer is C: the patient with urge incontinence and abnormal detrusor muscle contractions. Bladder training is an appropriate intervention for this patient because it aims to increase the bladder capacity and decrease the frequency of abnormal contractions. The program involves scheduled voiding and delaying urination to gradually increase the time between bathroom visits. This helps to retrain the bladder muscles and improve control over urination. A: Functional incontinence due to mental status changes is not typically addressed through bladder training. B: Stress incontinence due to weakened bladder neck support is better treated with pelvic floor exercises and lifestyle modifications. D: Transient incontinence due to inability to get to toileting facilities requires environmental modifications and timed toileting, not bladder training.

Correct Answer: A

Rationale: The correct answer is A: Inability to void. Urinary retention refers to the inability to empty the bladder completely. The nurse should explain to the student that this condition causes difficulty in urination and can lead to discomfort and complications if not addressed. Choices B, C, and D are incorrect because urinary retention does not refer to the absence of urine formation, large urine output, or increased urination frequency. It specifically relates to the inability to void urine from the bladder.

Correct Answer: C

Rationale: The correct answer is C. The most common cause of acute pyelonephritis from an ascending infection is a preexisting abnormality of the urinary tract. This abnormality can lead to urine stasis, making it easier for bacteria to ascend from the lower urinary tract to the kidneys. Choices A and B are incorrect because scarred kidneys and antibiotic resistance do not typically cause acute pyelonephritis. Choice D is incorrect as non-compliance with antibiotics may contribute to recurrent infections but is not the most common cause of pyelonephritis.

Correct Answer: D

Rationale: The correct answer is D because APSGN (Acute Poststreptococcal Glomerulonephritis) is caused by an immune response to a streptococcal infection. Therefore, the nurse must understand the pathophysiology, signs/symptoms, treatment, and potential complications associated with APSGN to provide effective care. Choice A, B, and C may not directly address the specific knowledge needed to care for a patient with APSGN, making them incorrect options.

Correct Answer: A

Rationale: The correct answer is A: Reflex incontinence. This type of incontinence occurs due to a lack of voluntary control over the bladder, usually resulting from a spinal cord lesion. In this case, the thoracic spinal cord lesion is causing the incontinence. The fact that incontinence occurs equally during the day and night suggests a lack of awareness or sensation of bladder fullness, characteristic of reflex incontinence. Summary of other choices: B: Overflow incontinence is due to bladder overdistension and is commonly associated with conditions like BPH or spinal cord injuries at the sacral level. C: Functional incontinence is when a person is unable to reach the toilet in time due to physical or cognitive impairments. D: Incontinence after trauma is a broad term and does not specifically address the pattern of incontinence described in the question.