Chapter 14: Incontinence
Linton: Medical-Surgical Nursing, 7th Edition MULTIPLE CHOICE
1. What instruction should a nurse provide to a patient scheduled for a postvoid residual (PVR) test?
a. Call the nurse immediately after voiding.
b. After voiding, wait 10 minutes and void again.
c. Void in...
what instruction should a nurse provide to a patie
bladder training instructions are being given to
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Chapter 14: Incontinence
Linton: Medical-Surgical Nursing, 7th
Edition MULTIPLE CHOICE
1. What instruction should a nurse provide to a patient scheduled for a postvoid
residual (PVR) test?
a. Call the nurse immediately after voiding.
b. After voiding, wait 10 minutes and void again.
c. Void into a flowmeter.
d. Avoid fluid intake for 8 hours before the test.
ANS: A
The nurse must catheterize the patient immediately after voiding and
measure the amount of urine.
2. Bladder training instructions are being given to a patient who has a history of
urinary incontinence. What initial instructions should the nurse give to the patient?
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.”
ANS: C
Bladder training uses scheduled voiding; the patient is encouraged to delay
voiding and void only every 2 to 3 hours while awake.
3. A male patient with urinary incontinence has been using an external (condom)
catheter. A nurse is assessing the patient’s technique of applying the device. What
techniques demonstrated by the patient would indicate the need for further
instruction?
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.
ANS: B
,Encircling the penis with tape can restrict circulation and cause damage to the
tissue.
4. 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
ANS: D
Stress incontinence is the involuntary loss of small amounts of urine during
physical activity that increases abdominal pressure, such as coughing,
laughing, sneezing, and lifting.
5. What instruction should a nurse provide to a patient who has been diagnosed
with stress incontinence?
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.”
ANS: B
Fluids such as tea, coffee, and cola have a diuretic effect and should be avoided.
6. A home health nurse is performing an evaluation of the home of an older adult patient
to assess for any safety issues. What should the nurse recognize as an environmental
factor that could lead to functional incontinence?
a. Night-light in the bathroom
b. Patient’s room located on the opposite end of the house from the bathroom
c. Handrails located around the toilet and bathtub
d. Caregiver’s room located close to the patient’s room
,ANS: B
Functional incontinence is the term used when a person voids inappropriately
because of an inability to get to the toilet or manage the mechanics of
toileting. The patient’s room should be located close to the bathroom.
7. What condition should a nurse specifically ask a patient about when taking
the medical history to reveal clues to the potential cause of urinary
incontinence?
a. Diabetes mellitus
b. Impetigo
c. Hypotension
d. Trigeminal neuralgia
ANS: A
Patients who have diabetes may develop neurologic problems that affect the
bladder and are uncontrolled; they may produce large volumes of urine.
8. A patient, talking to a home health nurse about urinary incontinence, gives the nurse
a list of the current medications she is taking. What medication should the nurse
recognize as possibly contributing to the patient’s urinary incontinence?
a. Methylcellulose (Citrucel)
b. Diazepam (Valium)
c. Simvastatin (Zocor)
d. Digoxin (Lanoxin)
ANS: B
Valium is a sedative that can increase the incidence of incontinency of urine.
9. A nurse is instructing a patient on the procedure for a clean-catch urine specimen.
The patient has tried several times but is having difficulty understanding the
instructions. What is the best action for the nurse to implement?
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.
, ANS: D
If the patient cannot cooperate with the clean-catch procedure,
catheterization may be necessary.
10. A patient who is scheduled for an urodynamic test asks the nurse why he is
having this test. What is the nurse’s best response?
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.”
ANS: C
Urodynamic procedures assess the neuromuscular function of the lower urinary
tract.
11. A nurse is asked to instruct a patient on performing Kegel exercises to improve
muscle endurance. The patient should be instructed to contract the muscles
normally used to stop the flow of urine. Which proper technique should the nurse
explain?
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.
ANS: B
Long (6-12 seconds) contractions, followed by relaxation for 6-12 seconds,
improves endurance. This patient should hold the contraction for 10 seconds
and then relax for 10 seconds. The goal is to work up to 10 repetitions three or
four times each day.
12. A patient who uses a pessary to help control incontinence is given instruction for
its care. What should these instructions 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.
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