A nurse is teaching a client about bladder retraining for incontinence. Which of the following instructions should the nurse include in the teaching?

"Practice pelvic-floor exercises regularly."

"Wear a pair of disposable briefs at bedtime."

"Limit oral fluid intake to 1,000 milliliters per day."

"Drink 8 ounces of citrus juice per day."

Answer and Explanation

The Correct Answer is A

A) "Practice pelvic-floor exercises regularly.": This instruction is essential for bladder retraining. Pelvic-floor exercises, such as Kegel exercises, strengthen the muscles that support the bladder and can help improve control over incontinence.

B) "Wear a pair of disposable briefs at bedtime.": While using disposable briefs can provide comfort and protection, this approach does not contribute to bladder retraining. It may inadvertently allow the client to rely on them instead of focusing on improving bladder control.

C) "Limit oral fluid intake to 1,000 milliliters per day.": Limiting fluid intake is generally not recommended, as it can lead to concentrated urine and potential bladder irritation. Adequate hydration is important for overall health and can help maintain normal bladder function.

D) "Drink 8 ounces of citrus juice per day.": Citrus juices can irritate the bladder in some individuals, leading to increased urgency and frequency. It’s usually advisable to avoid such irritants during bladder retraining, making this instruction less appropriate.

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Correct Answer is B

Explanation

A) Exaggerated curvature of the sacrum: This is not a specific indicator of scoliosis. Scoliosis primarily involves lateral curvature of the spine, not an exaggerated curvature of the sacrum.

B) Uneven shoulder and pelvic heights: This is the correct answer. Scoliosis is characterized by an abnormal lateral curvature of the spine, which can lead to uneven shoulder and pelvic heights. This is a common clinical manifestation that nurses look for during screenings.

C) Mild pain in the hip region: While pain can sometimes accompany scoliosis, it is not a definitive clinical manifestation of the condition itself and is not typically used as an indicator during screenings.

D) Limited range-of-motion of the hips: Limited hip motion may occur due to other conditions but is not a primary sign of scoliosis. The assessment of scoliosis focuses more on spinal alignment and symmetry rather than hip mobility.

A. A client who has a hip fracture and a new onset of tachypnea. B. A client who has sinus arrhythmia and is receiving cardiac monitoring. C. A client who has diabetes mellitus and an HbA1c of 7.2% (less than 7%). D. A client who has epidural analgesia and weakness in the lower extremities.

Correct Answer is A

Explanation

A) A client with a hip fracture and new onset of tachypnea is a priority for assessment. Tachypnea can indicate respiratory distress, possible pulmonary embolism, or complications related to the fracture. Prompt evaluation is critical to ensure timely intervention and prevent further complications.

B) A client with sinus arrhythmia receiving cardiac monitoring is generally stable, as sinus arrhythmia is often benign and not immediately life-threatening. While ongoing monitoring is important, this client does not require immediate assessment over those presenting with more acute symptoms.

C) A client with diabetes mellitus and an HbA1c of 7.2% is slightly above the recommended target, but this finding does not indicate an immediate concern requiring urgent assessment. This client can be monitored but does not need priority attention compared to others with acute issues.

D) A client with epidural analgesia and weakness in the lower extremities is concerning, but if the client is stable and there are no additional alarming signs (such as respiratory distress or severe neurological changes), they can be assessed after more critical clients. Monitoring for side effects from epidural analgesia is important, but it is not as urgent as assessing new respiratory symptoms.

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A nurse is teaching a client about bladder retraining for incontinence. Which of the following instructions should the nurse include in the teaching?

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