The nurse has taught a client with urinary incontinence about taking prescribed oxybutynin chloride.
Which of the following statements by the client would indicate a correct understanding of the teaching?

Over-the-counter Sudafed should not be taken while I am taking this medication.

I will stop taking the medication if I have any signs or symptoms of infection.

I will not combine this medication with any type of antidepressant medications.

Retention of urine can occur while taking the medication and should be reported.

Answer and Explanation

The Correct Answer is A

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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Correct Answer is D

Explanation

Choice A rationale

Asking about medication use may provide helpful information but does not address the primary concern. The symptoms of visual changes and headaches can indicate serious conditions such as increased intracranial pressure or hypertensive crisis. Immediate assessment is necessary to determine severity and prevent complications. Identifying a potential trigger does not replace the need for prompt diagnostic evaluation.

Choice B rationale

Referring the client to an eye specialist might be appropriate in cases of persistent vision issues without urgent symptoms. However, when combined with headaches, these symptoms could indicate systemic or neurological issues, such as hypertension or a brain lesion. Immediate action is required, as delayed assessment might allow for worsening of an acute condition.

Choice C rationale

Obtaining a full history and physical would provide valuable data for diagnosis. However, this approach is time-intensive and may not address the urgency of the situation. Rapid assessment, such as blood pressure measurement, takes precedence to identify conditions that could be immediately life-threatening, such as hypertensive emergencies.

Choice D rationale

Measuring blood pressure promptly assesses for hypertensive crises, a common cause of vision changes and headaches. Hypertensive crises require immediate treatment to prevent end-organ damage. Normal blood pressure ranges are typically 120/80 mmHg, and values exceeding 180/120 mmHg indicate a crisis. This action provides quick, actionable information critical for patient safety.

A. "Stones that are lodged in the ureter cause symptoms like you are describing.”. B. "You will most likely pass the stones in the next few hours.”. C. "Your symptoms are consistent with stones that are lodged in the bladder.”. D. "The stones will need to be removed through a procedure.”.

Correct Answer is A

Explanation

Choice A rationale

Stones lodged in the ureter cause severe, colicky pain due to intense peristaltic waves attempting to dislodge the obstruction. The pain often radiates down the thigh and groin as the ureter's path follows these areas. Additionally, urinary retention or frequent urges with minimal voiding occurs due to irritation and partial blockage, confirming ureteral stone involvement.

Choice B rationale

While some stones may pass spontaneously, timing varies widely depending on size, location, and hydration levels. Pain and obstruction may persist longer than a few hours, making this statement misleading without further assessment.

Choice C rationale

Bladder stones may cause lower abdominal pain, frequency, and hematuria but do not typically involve radiating pain to the groin or thigh. The described symptoms strongly suggest ureteral obstruction rather than bladder involvement.

Choice D rationale

While procedural removal is an option for large or immovable stones, initial approaches often include pain control, hydration, and medical expulsive therapy. Surgical intervention is not the first-line explanation unless conservative management fails.

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The nurse has taught a client with urinary incontinence about taking prescribed oxybutynin chloride.Which of the following statements by the client would indicate a correct understanding of the teaching?

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Naxlex Comprehensive Predictor Exams

The nurse is performing a health screening for a client at a local clinic and the client states, "I have noticed changes in my vision recently and I have also had some bad headaches.”. Which of the following actions should be a priority for the nurse to take?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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The nurse has taught a client with urinary incontinence about taking prescribed oxybutynin chloride.
Which of the following statements by the client would indicate a correct understanding of the teaching?