Deck 23: Incontinence

Question 1

The patient who has been diagnosed with stress incontinence should be instructed by the nurse to:

A) "Restrict fluid intake to less than 1000 ml/day."
B) "Avoid fluids such as tea, coffee, and cola."
C) "Delay voiding until you feel the urge to void."
D) "Void no more often than every 4 hours."

Answer 1

"Avoid fluids such as tea, coffee, and cola."

Question 2

A male patient with urinary incontinence has been using an external (condom)catheter.The nurse is assessing the patient's technique of applying the device.The nurse should give the patient further instructions if he:

A) Washes the penis with warm soapy water and dries the area well before applying the device.
B) Encircles the penis with tape to secure the device.
C) Uses elastic tape, and wraps in a spiral pattern to secure the device.
D) Carefully assesses the penis for any signs of irritation before applying the device.

Answer 2

Encircles the penis with tape to secure the device.

Question 3

The patient tells the nurse that his bowel movements normally occur every morning after breakfast.The nurse understands that this is due to:

A) Fecal overflow
B) Gastrocolic reflex
C) Autonomic dysreflexia
D) Lack of sphincter control

Answer 3

Gastrocolic reflex

Question 4

The patient who has urinary incontinence is at risk for urinary tract infection and urinary calculi.The nurse should teach the patient and family that the best way to prevent these complications is to:

A) Restrict the patient's fluid intake and frequency of incontinence.
B) Be sure the patient's voiding schedule is no more often than every 4 hours.
C) Use an indwelling catheter.
D) Encourage the patient to void at least every 2 hours and to take at least 2000 ml of fluid daily.

Question 5

The home health nurse is performing an evaluation of the home of an older adult patient to assess for any safety issues.The nurse recognizes that an environmental factor that could lead to functional incontinence would be:

A) Night-light in the bathroom
B) Patient's room located on the opposite end of the house from the bathroom
C) Hand rails located around the toilet and bathtub
D) Caregiver's room located close to the patient's room

Question 6

When the nurse is teaching the patient about managing fecal overflow incontinence,she should be sure that the patient understands that one of the most essential factors is:

A) Daily use of mineral oil
B) Regular evacuation
C) Daily administration of enemas
D) Long-term use of mineral oil

Question 7

Because medical history can be reveal clues to urinary incontinence,the nurse should be sure to ask the patient specifically about:

A) Diabetes mellitus
B) Impetigo
C) Hypotension
D) Trigeminal neuralgia

Question 8

The patient who is having problems with fecal incontinence may benefit from a change in his diet.The nurse should encourage the patient to include:

A) Raw fruits and vegetables
B) Potatoes and bread
C) Coffee and tea
D) Prune and grape juice

Question 9

The patient diagnosed with anorectal incontinence should be taught by the nurse to:

A) Take a daily laxative.
B) Increase fiber in the diet.
C) Perform pelvic muscle exercises.
D) Administer daily enemas.

Question 10

The nurse has just received a patient who had a cystoscopy from the postanesthesia recovery unit.The nurse notices that the patient's urine is pink-tinged.The nurse's first action should be to:

A) Call the physician.
B) Record the assessment in the patient's record.
C) Encourage the patient to drink plenty of fluids.
D) Prepare the patient for a return to surgery.

Question 11

The nurse is asked to instruct the patient on performing Kegel exercises.The patient should be instructed to contract the muscles he or she would use to stop the flow of urine.The proper technique is to:

A) Contract for 3 to 4 seconds and relax for 10 seconds
B) Contract for 10 seconds and relax for 10 seconds
C) Contract for 10 seconds and relax for 3 to 4 seconds
D) Contract for 3 to 4 seconds and relax for 3 to 4 seconds

Question 12

A patient being assessed by the physician states,"I wet my pants every time I cough." The nurse recognizes this as which type of incontinence?

A) Reflex
B) Overflow
C) Urge
D) Stress

Question 13

The patient who is scheduled for an urodynamic test asks the nurse why he is having this test.The nurse's best response would be:

A) "To test the capacity of the bladder."
B) "To see how much urine is left in the bladder after you have voided."
C) "To test the function of the nerves and muscles of the bladder."
D) "To detect involuntary passage of urine."

Question 14

The patient,talking to the home health nurse about urinary incontinence,gives the nurse a list of the current medications.The nurse recognizes that the medication that could be contributing to the patient's urinary incontinence is:

A) Methylcellulose (Citrucel)
B) Diazepam (Valium)
C) Simvastatin (Zocor)
D) Digoxin (Lanoxin)

Question 15

The nurse is instructing the patient on the procedure for a clean-catch urine specimen.The patient has tried several times but is having difficulty understanding the instructions.The best action by the nurse would be to:

A) Take whatever specimen the patient can obtain.
B) Provide the patient with a clean bedpan to obtain the specimen.
C) Ask the laboratory personnel to come and obtain a urine specimen.
D) Call the physician for a catheterization order.

Question 16

The patient who is scheduled for a postvoid residual (PVR)test should be instructed by the nurse to:

A) Call the nurse immediately after voiding.
B) After voiding, wait 10 minutes and void again.
C) Void into a flow meter.
D) Avoid fluid intake for 8 hours before the test.

Question 17

The patient with a spinal cord injury has recently begun using reflex training to empty his bladder.The nurse is doing a catheterization to check for residual volume.The nurse understands that the reflex training is effective if the residual volume is less than: (in milliliters)

A) 100
B) 200
C) 400
D) 500

Question 18

The patient who uses a pessary to help control the incontinence is given instruction for its care,which should include:

A) Remove periodically for cleaning.
B) Douche daily with a cleansing solution.
C) Check for proper placement once a month.
D) Periodically deflate the cuff.

Question 19

The physician's admission report states that the patient has a history of tarry stools.The nurse knows that this means the stools are:

A) Brown and formed
B) Bright red and liquid
C) Black and sticky
D) Clay-colored and pasty

Question 20

Bladder training instructions are being given to a patient who has a history of urinary incontinence.The initial instructions the nurse should give the patient are to:

A) "Wait until you feel the urge to void."
B) "Don't void any more often than every 4 to 6 hours."
C) "Void every 2 to 3 hours while awake."
D) "Void any time you feel the urge."

Question 21

Prompted voiding is a habit training technique that: (Select all that apply.)

A) Is useful with cognitively impaired persons.
B) Helps the patient to recognize incontinence.
C) Is based on giving praise for staying dry.
D) Strengthens the pelvic floor.
E) Uses the Valsalva maneuver to force urine from bladder.

Question 22

The nurse instructs a patient that diarrhea can be caused by the inclusion in the diet of such foods as:

A) Cheese
B) Cabbage
C) Rice
D) Yogurt

Question 23

The patient asks the home health nurse if the periurethral bulking procedure will be a permanent remedy to urinary incontinence.The nurse bases the answer on the knowledge that the effects of this procedure:

A) Are permanent
B) Are only helpful to men
C) Usually last for approximately 6 months
D) Remain for 2 or 3 years

Question 24

The patient complains,"My allergies make me sneeze and pee in my pants.I take my allergy drug and I pee in my pants even more." The nurse assesses that the drug the patient is referring to is a(n)____________________.

Question 25

The nurse is cleaning the patient with fecal incontinence when he says,"This is so embarrassing,and it makes me really angry." The nurse's best response would be:

A) "Don't worry about it, it's my job to clean you up."
B) "If you would have called me sooner, this wouldn't have happened."
C) "Do you feel angry and embarrassed?"
D) "Would you rather let your family clean you up?"

Question 26

The nurse would evaluate the need for no further instructions if the patient says,after undergoing a cytometry,that he understands that he should: (Select all that apply.)

A) "Drink no fluids for 6 hours after the test."
B) "Report a change in my abdominal girth."
C) "Notify the doctor if I have difficulty voiding."
D) "Sleep on my stomach."
E) "Notify my doctor if I experience burning on urination."

Question 27

The nurse,instructing a patient in urge suppression,would include that when the patient is aware of the urge to void,she should: (Select all that apply.)

A) Breathe deeply and try to relax.
B) Perform several Kegel maneuvers without resting in between.
C) Walk to the bathroom at a normal pace while performing Kegel maneuvers.
D) Distract herself with a book or a television program.
E) Stop what she is doing, and sit down or stand quietly.

Question 28

The nurse explains that the normal bladder will empty when it reaches the capacity of ____________________ to ____________________ ml.

Question 29

The nurse can evaluate a positive bladder emptying if the postvoid catheterization is less than: (in milliliters)

A) 125
B) 100
C) 75
D) 50

Question 30

The nurse uses the knowledge that symptomatic incontinence is probably having symptoms as a result of:

A) Colorectal disease
B) Gastrocolic reflex
C) Constipation
D) Nerve damage

Question 31

The nurse informs the patient that the uroflowmetry diagnostic tool measures:

A) Voiding duration
B) Specific gravity of urine
C) Effectiveness of the detrusor muscle
D) General bladder tone

Question 32

The method by which a nurse manually expresses urine from the bladder by pressing gently on the lower abdomen is the___________ method.

Question 33

To protect the skin integrity of an incontinent patient,the nurse would include in the plan of care: (Select all that apply.)

A) Immediately remove wet garments and linens.
B) Wash skin with an antiseptic, and towel dry.
C) Inspect for areas of redness and breakdown every morning.
D) Apply cornstarch to the perineum to absorb moisture.
E) Apply protective creams per agency policy.

Question 34

The patient with fecal incontinence should be taught the importance of maintaining good skin integrity.The nurse's teaching should focus on teaching the patient to:

A) Cleanse the perianal area thoroughly after each stool.
B) Use a fecal pouch.
C) Change incontinence undergarments once a day.
D) Take an over-the-counter laxative daily.