A nurse is reinforcing teaching with a client who is preoperative for a neobladder urinary diversion. Which of the following statements should the nurse include?
"You will not be able to control your urination."
"You will have a stoma that is located in your abdomen."
"You will have an internal pouch to store your urine."
"You will wear an external collection bag to drain your urine."
The Correct Answer is C
A. "You will not be able to control your urination.":
A neobladder (orthotopic ileal neobladder) is intended to create a continent reservoir that is connected to the urethra so the patient can void more normally. While some patients experience incontinence (especially early postop) or may need intermittent catheterization initially, the goal is voluntary control rather than permanent loss of control.
B. "You will have a stoma that is located in your abdomen.":
A neobladder does not require a permanent external stoma; it is an internal urinary reservoir. (In contrast, an ileal conduit produces a stoma with an external appliance.)
C. "You will have an internal pouch to store your urine.":
A neobladder uses a segment of intestine to form an internal reservoir that stores urine and is typically anastomosed to the urethra so the patient can void through the natural route. Patients are taught voiding techniques and may need pelvic floor training or intermittent catheterization during recovery.
D. "You will wear an external collection bag to drain your urine.":
Wearing an external collection bag describes an ileal conduit (incontinent stoma), not a neobladder. A neobladder is designed to avoid the need for an external appliance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dehydration:
Prolonged diarrhea causes fluid and electrolyte losses, resulting in dehydration (dry mucous membranes, decreased skin turgor, tachycardia, hypotension, reduced urine output) - this is the most likely and clinically important finding.
B. Decreased bowel sounds:
Diarrhea is usually associated with hyperactive or increased bowel sounds due to increased intestinal motility; decreased sounds would suggest ileus or obstruction, not ongoing watery diarrhea.
C. Hypothermia:
Diarrhea does not typically cause hypothermia; fever may accompany infectious causes, but low body temperature is not an expected consequence.
D. Rigid abdomen:
A rigid, board-like abdomen suggests peritonitis or abdominal perforation - a surgical emergency - and is not a usual finding with uncomplicated, prolonged diarrhea.
Correct Answer is A
Explanation
A. Leakage of urine:
Urinary retention can cause overflow incontinence or dribbling when the bladder becomes overdistended and small amounts of urine leak past the sphincter; paradoxical leakage is a classic sign of retention.
B. Cloudy urine:
Cloudy urine may indicate infection, crystalluria, or concentrated urine, but it is not a defining sign of urinary retention. Retention predisposes to infection over time, but cloudiness is not expected in every case.
C. Blood in urine:
Hematuria is not a typical direct manifestation of uncomplicated urinary retention; it suggests trauma, infection, stone disease, or other pathology and would prompt further investigation.
D. Dark-colored urine:
Dark urine may reflect dehydration, concentrated urine, or pigments/medications; while retention can alter urine appearance indirectly, dark urine is not a characteristic finding used to diagnose urinary retention.
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