Which of the following methods should the nurse use to assess the kidneys for tenderness or pain?

Correct Answer: B

Rationale: The correct answer is B: By lightly striking the fist at the costovertebral angle. This method is known as percussion and is used to assess for kidney tenderness or pain. Percussion helps to identify any abnormalities in the kidneys or surrounding structures. Auscultation (choice A) is used to listen for sounds, not assess for tenderness. Observing for signs of bleeding (choice C) and monitoring pressure dressing (choice D) are not appropriate methods for assessing kidney tenderness or pain.

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.

Correct Answer: A

Rationale: The correct answer is A: Cloudy urine and fever. UTI in a patient with a urinary catheter may present with cloudy urine due to pus or bacteria, and fever due to infection. Urethral burning and bloody urine (B) are more indicative of urethritis or bladder trauma. Vague abdominal discomfort and disorientation (C) are not specific to UTI. Suprapubic pain and slight decline in body temperature (D) are less likely with UTI.