The nurse has taught a client with urinary incontinence about managing the problem.
Which of the following statements by the client would indicate the need for more teaching?

I will decrease my caffeine intake down to one cup per day.

I should drink grapefruit juice instead of orange juice in the morning.

I will practice Kegel exercises regularly.

I should have a fixed time schedule for going to the bathroom.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Decreasing caffeine intake is a proven method for managing urinary incontinence. Caffeine stimulates bladder activity, potentially worsening symptoms. Reducing caffeine to one cup per day can decrease urgency and frequency. This recommendation aligns with the scientific understanding that caffeine is a bladder irritant and is supported by clinical guidelines on managing urinary incontinence.

Choice B rationale

Grapefruit juice is acidic and can irritate the bladder lining, worsening urinary incontinence symptoms. Substituting orange juice with grapefruit juice does not address the problem, as both are acidic and contain bladder irritants. Citrus juices, including grapefruit and orange, are often advised against for patients managing urinary incontinence due to their potential to exacerbate symptoms.

Choice C rationale

Kegel exercises strengthen the pelvic floor muscles, enhancing bladder control and reducing incontinence episodes. This evidence-based practice is recommended for individuals with urinary incontinence. Regular Kegel exercise improves urinary sphincter function and supports the overall health of pelvic muscles, which is key for managing incontinence.

Choice D rationale

Establishing a fixed schedule for bathroom visits can prevent overdistension of the bladder and manage symptoms of urinary incontinence effectively. Timed voiding helps train the bladder and reduce episodes of urgency or leakage. It is widely supported as part of behavioral therapy for urinary incontinence management.

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Correct Answer is D

Explanation

Choice A rationale

Serum electrolytes provide valuable information about fluid and electrolyte balance but are not specific markers for heart failure. Electrolyte abnormalities, such as hyponatremia, may occur but are secondary findings. Direct markers like BNP levels are more diagnostic for heart failure.

Choice B rationale

A complete blood count is used to assess infection, anemia, or inflammation but does not directly diagnose heart failure. It lacks specificity for cardiac function evaluation. Targeted testing ensures effective diagnosis and management.

Choice C rationale

Blood urea nitrogen measures renal function and is not a primary marker for heart failure. Elevated BUN may result from renal hypoperfusion secondary to heart failure but is not a definitive diagnostic indicator. Specific cardiac markers are required.

Choice D rationale

Brain natriuretic peptide is a hormone released in response to ventricular stretch from volume overload, characteristic of heart failure. Elevated BNP levels strongly correlate with heart failure severity and guide diagnosis. Normal BNP levels are typically <100 pg/mL. This test is highly specific for heart failure. .

A. Over-the-counter Sudafed should not be taken while I am taking this medication. B. I will stop taking the medication if I have any signs or symptoms of infection. C. I will not combine this medication with any type of antidepressant medications. D. Retention of urine can occur while taking the medication and should be reported.

Correct Answer is A

Explanation

Choice A rationale

Over-the-counter Sudafed contains pseudoephedrine, which can cause urinary retention by stimulating alpha-adrenergic receptors, exacerbating symptoms treated by oxybutynin. Avoiding this combination reduces the risk of adverse effects, indicating correct client understanding.

Choice B rationale

Stopping the medication due to signs of infection is incorrect. Oxybutynin addresses bladder muscle control and is not associated with infection management. Reporting adverse effects is required, but discontinuation must follow medical advice.

Choice C rationale

Antidepressants like tricyclics have anticholinergic effects similar to oxybutynin, potentially increasing adverse effects. However, abrupt contraindication is incorrect unless specified by a healthcare provider, indicating a misunderstanding.

Choice D rationale

Urinary retention is a known side effect of oxybutynin. Reporting symptoms is correct, but this statement lacks broader understanding of the medication’s use and side effect profile. .

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The nurse has taught a client with urinary incontinence about managing the problem.Which of the following statements by the client would indicate the need for more teaching?

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The nurse has taught a client with urinary incontinence about managing the problem.
Which of the following statements by the client would indicate the need for more teaching?