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 D

Explanation

A) Use clothing with buttons and zippers: This may create frustration for clients with dementia, who may struggle with complex clothing. Instead, simpler clothing options, like pull-on pants, may be more suitable.

B) Engage the client in activities that increase sensory stimulation: While some sensory stimulation can be beneficial, overwhelming sensory input may lead to confusion or agitation. It’s important to find a balance that suits the individual’s needs.

C) Discourage physical activity during the day: This is incorrect. Encouraging physical activity during the day can help improve mood, reduce restlessness, and promote better sleep at night.

D) Establish a toileting schedule for the client: This is the correct answer. A consistent toileting schedule can help manage incontinence and reduce anxiety related to bathroom needs, providing a sense of routine and security for clients with dementia.

A. Premature ventricular contraction B. First-degree AV block C. Atrial fibrillation D. Sinus bradycardia

Correct Answer is B

Explanation

A) Premature ventricular contraction: A premature ventricular contraction (PVC) typically presents as an early heartbeat originating from the ventricles, often accompanied by a wide QRS complex. The heart rate in this case is regular at 69/min, and there is no indication of early beats, making this option unlikely.

B) First-degree AV block: A first-degree AV block is characterized by a prolonged PR interval greater than 0.20 seconds, which is noted at 0.24 seconds in this scenario. This indicates a delay in conduction through the AV node. While the heart rate is normal, the prolonged PR interval clearly suggests a first-degree AV block.

C) Atrial fibrillation: Atrial fibrillation typically presents with an irregularly irregular rhythm and variable heart rates. The client’s heart rate of 69/min is regular, and there is no mention of an irregular pulse or varying R-R intervals, making atrial fibrillation an unlikely diagnosis in this case.

D) Sinus bradycardia: Sinus bradycardia is defined as a heart rate of less than 60 beats per minute and is characterized by a normal PR interval. In this situation, the heart rate is 69/min, which does not meet the criteria for bradycardia, thus ruling out this option.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to family members of a client who has dementia. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

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Correct Answer is B

Explanation

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