NUR 150 Fundamental Concepts of Practical Nursing I
Exam 1
Question:
A nurse is providing client teaching to a woman who has recurrent urinary tract infections. Which information should the nurse include concerning the reason why women are more susceptible to urinary tract infections than men?
- Inadequate fluid intake
- Poor hygienic practices
- The length of the urethra
- The continuity of mucous membranes
Answer:
The length of the urethra
The length of the urethra is shorter in females than in males; therefore, microorganisms have a shorter distance to travel to reach the bladder. The proximity of the meatus to the anus in females also increases the incidence of urinary tract infections. Fluid intake may or may not be adequate in both males and females and does not account for the difference. Hygienic practices can be inadequate in males or females. Mucous membranes are continuous in both males and females.
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Question:
A nurse is counseling a woman who had recurrent urinary tract infections.What factor should the nurse explain is the reason why women are at a greater risk than men for contracting a urinary tract infection?
- Altered urinary Ph
- Hormonal secretions
- Juxtaposition of the bladder
- Proximity of the urethra to the anus
Answer:
Proximity of the urethra to the anus
Because the female's urethra is closer to the anus than the male's, it is at greater risk for becoming contaminated. Urinary pH is within the same range in both males and females. Hormonal secretions have no effect on the development of bladder infections. The position of the bladder is the same in males and females.
Question:
A client has been admitted with a urinary tract infection. The nurse receives a urine culture and sensitivity report that reveals the client has vancomycin resistant entercoccus (VRE). After notifying the health care provider, which action should the nurse take to decrease the risk of transmission to others?
- Move the client to a private room
- Initiate droplet precautions
- Insert a Foley catheter
- Use a HEPA respirator when entering the room
Answer:
Move the client to a private room 2 / 4
Clients with VRE should be moved to a private room to decrease transmission to others. VRE has been identified in the urine, not respiratory secretions. A Foley catheter should not be inserted as it will predispose the client to develop an additional infection. A HEPA respirator is not required when entering the room. Contact isolation should be implemented.
Question:
A client is admitted to the hospital with urinary retention, and an indwelling urinary catheter is prescribed by the health care provider. What should the nurse do to help prevent the client from developing a urinary tract infection?
- Assess urine specific gravity
- Maintain the prescribed hydration
- Collect a weekly urine specimen
- Empty the drainage bag frequently
Answer:
Maintain the prescribed hydration
Promoting hydration maintains urine production that flushes the bladder, thereby preventing urinary stasis and possible infection. Although assessing urine specific gravity may help identify a urinary tract infection, it will not prevent it. Although collecting a weekly urine specimen for culture and sensitivity may help identify a urinary tract infection, it will not prevent it.The collection bag is emptied once every shift unless the bag is full and needs to be emptied sooner; changing the bag periodically, not emptying it, may help prevent infection.
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Question:
A client will be taking nitrofurantoin (Macrobid) 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client?
- Increase the intake of fluids.
- Strain the urine for crystals and stones.
- Stop the drug if urinary output increases.
- Maintain the exact time schedule for taking the drug.
Answer:
Increase the intake of fluids.
To prevent crystal formation, the client should have sufficient intake to produce 1000 to 1500 mL of urine daily while taking this drug. Straining urine is not indicated when the client is taking a urinary antiinfective.Urinary decrease is of concern because it may indicate renal failure. If fluids are encouraged, the client's output should increase. The drug need not be taken at a strict time daily.
Question:
A lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the health care provider?
- Passage of pink-tinged urine
- Pink drainage on the dressing
- Intake of 1750 mL in 24 hours
- Urine output of 20 to 30 mL/hr
Answer:
Urine output of 20 to 30 mL/hr
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