Chapter 49 Management of Patients With Urinary Disorders
Multiple Choice
1. When teaching the patient about preventing recurrent urinary tract infections, the nurse
should include the following statements:
A) Bathe daily.
B) Avoid voiding immediately after sexual
intercourse. C) Drink liberal amounts of fluids.
D) Void every 6 to 8
hours. Ans: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: B-2
Feedback: The patient is encouraged to drink liberal amounts of fluids (water is the best
choice) to increase urine production and flow which flushes the bacteria from the urinary tract.
Frequent voiding (every 2 to 3 hours) is encouraged to empty the bladder completely because
this can significantly lower urine bacterial counts, reduce urinary stasis, and prevent reinfection.
The patient should be encouraged to shower rather than bathe.
2. How might the nurse best prevent infection in a patient with an indwelling urinary catheter?
A) Vigorously clean the meatus area daily.
B) Apply powder to the perineal area twice daily.
C) Empty the drainage bag at least every 8 hours.
D) Irrigate the catheter every 8 hours with normal saline.
Ans: C
Cognitive Level: Application
,Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-3
Feedback: Vigorous cleaning of the meatus while the catheter is in place is discouraged,
because the cleaning action can move the catheter, increasing the risk of infection. To reduce the
risk of bacterial proliferation, empty the collection bag at least every 8 hours. Irrigation of the
catheter opens the closed system, increasing the likelihood of infection.
3. A 37-year-old multipara woman arrives to the clinic with complaints of intermittent
urine incontinence when she sneezes. The nurse is aware this is what type of incontinence?
A) Stress incontinence
B) Reflex incontinence
C) Overflow incontinence
D) Functional incontinence
Ans: A
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-4
Feedback: Stress incontinence is the involuntary loss of urine through an intact urethra as a
result of sudden increase in intra-abdominal pressure. Reflex incontinence is loss of urine due to
hyperreflexia or involuntary urethral relaxation in the absence of normal sensations usually
associated with voiding. Overflow incontinence is an involuntary urine loss associated with
overdistension of the bladder. Functional incontinence refers to those instances in which the
function of the lower urinary tract is intact, but other factors (outside the urinary system) make
it difficult or impossible for the patient to reach the toilet in time for voiding.
,4. What measures might the nurse provide to encourage a patient who is having
difficulty voiding?
A) Use a slipper bedpan.
B) Apply a cold compress to the perineum.
C) Have the patient lie in a supine position.
D) Provide privacy for the patient.
Ans: D
, Cognitive Level: Application
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-1
Feedback: To encourage a patient to void, the nurse may provide privacy, pour warm water
over the perineum, and encourage the patient to sit in an upright position.
5. An 85-year-old patient experiences urinary incontinence. The nurse is aware
that: A) Antispasmodics are often prescribed to decrease urinary incontinence.
B) Restricting fluid intake is recommended.
C) Reflux incontinence is common in the elderly.
D) Urinary incontinence is not a consequence of aging.
Ans: D
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-1
Feedback: Patients who have mixed incontinence (both stress and urge incontinence) need to
understand that anticholinergic and antispasmodic agents can help decrease urinary urgency,
frequency, and urge incontinence, but they do not decrease the urinary incontinence related
to stress incontinence. Nursing management is based on the premise that incontinence is not
inevitable with illness or aging and that it is often reversible and treatable.
6. To manage urinary incontinence, the nurse should teach the patient to consider which of
the following strategies:
Multiple Choice
1. When teaching the patient about preventing recurrent urinary tract infections, the nurse
should include the following statements:
A) Bathe daily.
B) Avoid voiding immediately after sexual
intercourse. C) Drink liberal amounts of fluids.
D) Void every 6 to 8
hours. Ans: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: B-2
Feedback: The patient is encouraged to drink liberal amounts of fluids (water is the best
choice) to increase urine production and flow which flushes the bacteria from the urinary tract.
Frequent voiding (every 2 to 3 hours) is encouraged to empty the bladder completely because
this can significantly lower urine bacterial counts, reduce urinary stasis, and prevent reinfection.
The patient should be encouraged to shower rather than bathe.
2. How might the nurse best prevent infection in a patient with an indwelling urinary catheter?
A) Vigorously clean the meatus area daily.
B) Apply powder to the perineal area twice daily.
C) Empty the drainage bag at least every 8 hours.
D) Irrigate the catheter every 8 hours with normal saline.
Ans: C
Cognitive Level: Application
,Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-3
Feedback: Vigorous cleaning of the meatus while the catheter is in place is discouraged,
because the cleaning action can move the catheter, increasing the risk of infection. To reduce the
risk of bacterial proliferation, empty the collection bag at least every 8 hours. Irrigation of the
catheter opens the closed system, increasing the likelihood of infection.
3. A 37-year-old multipara woman arrives to the clinic with complaints of intermittent
urine incontinence when she sneezes. The nurse is aware this is what type of incontinence?
A) Stress incontinence
B) Reflex incontinence
C) Overflow incontinence
D) Functional incontinence
Ans: A
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-4
Feedback: Stress incontinence is the involuntary loss of urine through an intact urethra as a
result of sudden increase in intra-abdominal pressure. Reflex incontinence is loss of urine due to
hyperreflexia or involuntary urethral relaxation in the absence of normal sensations usually
associated with voiding. Overflow incontinence is an involuntary urine loss associated with
overdistension of the bladder. Functional incontinence refers to those instances in which the
function of the lower urinary tract is intact, but other factors (outside the urinary system) make
it difficult or impossible for the patient to reach the toilet in time for voiding.
,4. What measures might the nurse provide to encourage a patient who is having
difficulty voiding?
A) Use a slipper bedpan.
B) Apply a cold compress to the perineum.
C) Have the patient lie in a supine position.
D) Provide privacy for the patient.
Ans: D
, Cognitive Level: Application
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-1
Feedback: To encourage a patient to void, the nurse may provide privacy, pour warm water
over the perineum, and encourage the patient to sit in an upright position.
5. An 85-year-old patient experiences urinary incontinence. The nurse is aware
that: A) Antispasmodics are often prescribed to decrease urinary incontinence.
B) Restricting fluid intake is recommended.
C) Reflux incontinence is common in the elderly.
D) Urinary incontinence is not a consequence of aging.
Ans: D
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-1
Feedback: Patients who have mixed incontinence (both stress and urge incontinence) need to
understand that anticholinergic and antispasmodic agents can help decrease urinary urgency,
frequency, and urge incontinence, but they do not decrease the urinary incontinence related
to stress incontinence. Nursing management is based on the premise that incontinence is not
inevitable with illness or aging and that it is often reversible and treatable.
6. To manage urinary incontinence, the nurse should teach the patient to consider which of
the following strategies:
