A nurse is caring for a client who has urinary incontinence and notes the client has a history of urinary retention as well.
Upon assessment, findings include frequent involuntary leakage of small amounts of urine throughout the day and bladder distension.
The nurse identifies these findings are associated with which of the following types of incontinence?
Overflow incontinence.
Reflex incontinence.
Urge incontinence.
Stress incontinence.
The Correct Answer is A
Choice A rationale
Overflow incontinence occurs when the bladder becomes overly full and distended, exceeding its capacity, leading to involuntary loss of small amounts of urine frequently. This is often due to an obstruction, such as an enlarged prostate, or poor detrusor muscle contractility, resulting in incomplete bladder emptying and retention. The clinical picture of frequent leakage and bladder distension confirms this type.
Choice B rationale
Reflex incontinence involves the involuntary loss of urine that occurs at somewhat predictable intervals when the bladder volume reaches a specific level. This type is typically associated with spinal cord damage or neurological impairment above the sacral reflex arc, which causes the detrusor muscle to contract reflexively without the client's sensation of needing to void.
Choice C rationale
Urge incontinence is characterized by the sudden, strong urge to void immediately preceding an involuntary loss of urine. It is typically caused by bladder instability or overactivity of the detrusor muscle, often termed an overactive bladder. The client with urge incontinence generally does not have associated urinary retention or chronic bladder distension.
Choice D rationale
Stress incontinence involves the involuntary leakage of small amounts of urine that occurs with increased intra-abdominal pressure, such as coughing, sneezing, laughing, or physical exertion. This is usually due to weakened pelvic floor muscles and/or a deficient urethral sphincter mechanism, which cannot withstand the momentary pressure increase. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice C rationale
Hemoglobin is a complex protein found within red blood cells (erythrocytes) that is specifically responsible for oxygen transport. Each hemoglobin molecule contains four heme groups, each with an iron atom capable of binding reversibly with one molecule of oxygen. This allows oxygen picked up in the lungs to be efficiently transported to peripheral tissues where it is released for cellular use.
Choice A rationale
Platelets, also known as thrombocytes, are small, anuclear cells critical for hemostasis, the process of stopping bleeding. Their primary function involves aggregating at the site of vascular injury to form a platelet plug and releasing clotting factors to initiate the coagulation cascade. They have no role in oxygen transport.
Choice B rationale
Neutrophils are the most abundant type of white blood cell (leukocyte) and are a key component of the innate immune system. Their primary function is phagocytosis, engulfing and destroying invading pathogens like bacteria. Like other leukocytes, they are involved in immune defense, not oxygen transport.
Choice D rationale
Lymphocytes are a type of white blood cell crucial for adaptive immunity. They include T cells (involved in cell-mediated immunity) and B cells (responsible for producing antibodies in humoral immunity). Their function is centered on recognizing and destroying specific foreign antigens, not transporting respiratory gases.
Correct Answer is D
Explanation
Choice A rationale
Propranolol, a nonselective beta-adrenergic blocker, is actually often used in the prophylactic treatment of migraines due to its ability to modulate vascular tone and decrease the frequency and intensity of headache episodes. It works by blocking beta-adrenergic receptors, which can prevent the excessive vasodilation and neuronal excitability associated with migraine pathophysiology. Therefore, migraines are an indication, not a contraindication, for this medication.
Choice B rationale
While beta-blockers like propranolol can be used to treat glaucoma by decreasing the production of aqueous humor, it is not an absolute contraindication, but rather an indication in many cases. The primary contraindication for propranolol is related to conditions where sympathetic nervous system blockade would be detrimental, such as severe respiratory or cardiac compromise. Glaucoma is not a primary contraindication.
Choice C rationale
Depression is considered a potential side effect or adverse reaction associated with propranolol use, particularly in susceptible individuals or with high doses, rather than an absolute contraindication. The medication's central nervous system effects are thought to contribute to mood changes. The more significant, absolute contraindications relate to severe respiratory diseases or certain types of heart block.
Choice D rationale
Propranolol is a nonselective beta-blocker, meaning it blocks both beta-1 receptors (primarily in the heart) and beta-2 receptors (primarily in the lungs and smooth muscle). Blocking beta-2 receptors in the bronchioles causes bronchoconstriction, which can severely worsen asthma symptoms, potentially leading to a life-threatening asthma attack. For this reason, asthma is a major and absolute contraindication for nonselective beta-blockers.
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