Chapter 69: Care of Patients with Urinary Problems

Chapter 69: Care of Patients with Urinary Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which client is at greatest risk for development of a bacterial cystitis?

ANS:  A

Females at any age are more susceptible to cystitis than men because of the shorter urethra in women. Postmenopausal women who are not on hormone replacement therapy are at increased risk for bacterial cystitis because of changes in the cells of the urethra and vagina. The middle-aged woman who has never been pregnant would not have a risk potential as high as the older woman who is using hormone replacement therapy.

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1492

TOP:   Client Needs Category: Health Promotion and Maintenance (Aging Process)

MSC:  Integrated Process: Nursing Process (Assessment)

2. A client has a fungal urinary tract infection. Which assessment by the nurse is most helpful?

ANS:  B

Clients who are severely immune compromised or who have diabetes mellitus are more prone to fungal urinary tract infection. The nurse should assess for these factors. A physical examination and a post-void residual may be needed, but not until further information is obtained. Travel to foreign countries probably would not be as important, because even if exposed, the client needs some degree of immune compromise to develop a fungal urinary tract infection.

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Assessment)

3. The nurse is assessing the laboratory findings of a client with a urinary tract infection. The laboratory report notes a “shift to the left” in a client’s white blood cell count. Which action by the nurse is most appropriate?

ANS:  B

A left shift most commonly occurs with urosepsis and is seen rarely with uncomplicated urinary tract infections. The nurse will be administering antibiotics, most likely via IV, so he or she should notify the provider and prepare to give the antibiotics. The shift to the left is part of a differential white blood cell count. The client would not need to strain urine for stones, and because sepsis carries a high mortality rate, the nurse should not just note the findings as the only action.

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Illness Management)  MSC:           Integrated Process: Nursing Process (Implementation)

4. Which client statement indicates a good understanding regarding antibiotic therapy for recurrent urinary tract infections?

ANS:  B

Antibiotic therapy is most effective, especially for recurrent urinary tract infections, when the client takes the prescribed medication for the entire course, not just when symptoms are present. The other statements demonstrate that additional teaching is needed for the client.

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)    MSC:  Integrated Process: Nursing Process (Evaluation)