Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 43- Disorders of the Bladder and Lower Urinary Tract
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | When explaining about the passage of urine to a group of nursing students, the clinic nurse asks them which muscle is primarily responsible for micturition? Their correct reply is the | |
| A) | urinary vesicle. | |
| B) | trigone. | |
| C) | detrusor. | |
| D) | external sphincter. | |
| Ans: | C | |
| Feedback: | ||
| The detrusor muscle is the muscle of micturition. When it contracts, urine is expelled from the bladder. External sphincter is a circular muscle that surrounds the urethra distal to the base of the bladder and can stop micturition when it is occurring. Trigone is a smooth triangular area that is bounded by the ureters and the urethra. Urinary vesicle is another name for the bladder. | ||
| 2. | During male ejaculation, which of the following statements addresses why sperm is not normally seen inside the bladder? | |
| A) | The parasympathetic nervous system keeps the seminal fluid inside the urethra. | |
| B) | The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time. | |
| C) | With ejaculation, the male expels some urine along with the seminal fluid to wash any extra sperm out of the bladder. | |
| D) | The detrusor muscle relaxes allowing for the closing of the sphincter at the base of the bladder. | |
| Ans: | B | |
| Feedback: | ||
| During male ejaculation, which is mediated by the SNS, the musculature of the trigone area and that of the bladder neck and prostatic urethra contracts and prevents the backflow of seminal fluid into the bladder. | ||
| 3. | A 61-year-old woman who has had an upper respiratory infection for several weeks has presented to her family physician with complaints of a recent onset of urinary retention. She reveals to her physician that she has been taking nonprescription cold medications over and above the suggested dose for the past 2 weeks. Which of the following phenomena will her physician most likely suspect is contributing to her urinary retention? | |
| A) | Cholinergic actions of the cold medicine are triggering internal and external sphincter contraction. | |
| B) | Antihistamine effects inhibit communication between the pons and the thoracolumbar cord. | |
| C) | The anticholinergic effects of the medication are impairing normal bladder function. | |
| D) | Over-the-counter medications such as cold medicine stimulate the parasympathetic nervous system and inhibit bladder emptying. | |
| Ans: | C | |
| Feedback: | ||
| Many over-the-counter cold medications have an anticholinergic effect that interferes with normal bladder emptying. These effects on micturition are not a result of cholinergic actions or miscommunication between the pontine micturition center and the spinal cord. Stimulation of the parasympathetic nervous system would tend to increase rather than decrease bladder emptying. | ||
| 4. | An 82-year-old resident of a long-term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which of the following actions by the care team is most appropriate? | |
| A) | Uroflowmetry to determine the rate of the client’s urine flow | |
| B) | Ultrasound bladder scanning to determine the residual volume of urine after voiding | |
| C) | Renal ultrasound aimed at identifying acute or chronic kidney disease | |
| D) | Urinalysis focusing on the presence of or absence of microorganisms, blood, or white cells in the man’s urine | |
| Ans: | B | |
| Feedback: | ||
| Ultrasound bladder scanning yields a fast and noninvasive indication of whether or not an individual is adequately emptying his or her bladder with each void. Uroflowmetry would be less indicative of whether the man is retaining, and renal ultrasound would address deficits in urine production rather than bladder emptying. Urinalysis would be useful in the diagnosis of infections and/or renal issues more than deficiencies in bladder emptying. | ||
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