The Na+Cl- transporter in the distal convoluted tubule of the kidney is blocked by:

Correct Answer: B

Rationale: The correct answer is B: Thiazides. Thiazides work by inhibiting the Na+/Cl- transporter in the distal convoluted tubule, leading to decreased sodium reabsorption and increased urine output. This results in decreased blood volume and lower blood pressure. Spironolactone (A) works by blocking aldosterone receptors, affecting potassium and sodium balance. Furosemide (C) and Ethacrynic acid (D) act on the loop of Henle, inhibiting the Na+/K+/2Cl- transporter. Therefore, the correct answer is B because thiazides specifically target the Na+/Cl- transporter in the distal convoluted tubule.

Correct Answer: B

Rationale: The correct answer is B: Help flush the stones through the urinary tract. Increasing fluid intake can help dilute the urine, preventing stone formation and aiding in the passage of existing stones. Adequate hydration promotes frequent urination, which can help flush out the stones and reduce the risk of complications. Choices A, C, and D are incorrect. A: Concentrating the urine can actually exacerbate stone formation. C: Struvite crystals are not typically formed in nephrolithiasis. D: Breaking down stones requires medical intervention, not just increased fluid intake.

Correct Answer: C

Rationale: The correct answer is C because a history of intermittent catheterization increases the risk of urinary tract infections due to potential introduction of bacteria into the urinary system. This directly supports the diagnosis of a urinary tract infection. A: The wife's history is irrelevant unless the patient had direct contact or shared personal items with her. B: Prostate disease does not directly correlate with a urinary tract infection. D: Kidney stones are not directly related to urinary tract infections unless there was an associated infection during the stone removal.

Correct Answer: B

Rationale: The correct answer is B because demonstrating how to perform intermittent self-catheterization is within the scope of practice for an LPN/LVN. This task involves a specific skill set that can be taught and supervised by the LPN/LVN. It is essential for managing reflex urinary incontinence and maintaining bladder function. Choices A, C, and D are incorrect because teaching the patient bladder emptying by the Credé method (A) and discussing the side effects of bethanechol chloride (C) are tasks that require a higher level of nursing education and knowledge. Reinforcing the importance of proper handwashing (D) is a basic nursing task that can be performed by a nursing assistant or other unlicensed assistive personnel.

Correct Answer: C

Rationale: Rationale for Choice C (Correct Answer): 1. Aging causes relaxation of pelvic floor and bladder muscles. 2. This relaxation can lead to incomplete emptying of the bladder. 3. Residual urine in the bladder can increase the risk of UTIs. 4. Therefore, relaxation of pelvic floor and bladder muscles contributes to increased UTI incidence. Summary of Incorrect Choices: A: Length of the urethra - Longer urethra typically reduces UTI risk by providing more distance for bacteria to travel. B: Larger capacity of bladder - Larger bladder capacity does not directly increase UTI risk. D: Tight muscular support at the urinary sphincter - Tight support does not directly impact UTI risk; relaxation is the key factor.