The nurse is providing patient teaching on the normal physiological changes of aging on the urinary system.
What should the nurse include in the teaching plan?
Kidneys are able to concentrate urine.
Patient may experience urinary frequency, urgency, and nocturia.
Kidney is easily palpated.
Patient will eventually require wearing a brief at all times.
The Correct Answer is B
Choice A rationale
As individuals age, the kidneys' ability to concentrate urine declines due to structural and functional changes in the renal tubules and collecting ducts, including decreased response to antidiuretic hormone. This diminished concentrating ability often leads to an increased excretion of dilute urine, rather than enhanced concentration.
Choice B rationale
Normal physiological changes of aging affecting the urinary system include decreased bladder capacity, decreased bladder muscle tone, and increased involuntary bladder contractions. These changes often result in symptoms such as urinary frequency (more frequent voiding), urgency (sudden strong urge to void), and nocturia (waking up at night to urinate).
Choice C rationale
In healthy adults, the kidneys are typically not easily palpable unless they are enlarged due to pathology, such as polycystic kidney disease or hydronephrosis. Normal kidneys are protected by the lower ribs and posterior abdominal muscles, making deep palpation challenging for identification of normal size.
Choice D rationale
While some older adults may experience increased urinary incontinence due to age-related changes or comorbidities, it is not an inevitable outcome of aging that all patients will require wearing a brief at all times. Many older adults maintain continence with proper management, exercise, and lifestyle modifications, thus avoiding dependence on briefs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Acyclovir is an antiviral drug primarily active against herpes viruses. Respiratory syncytial virus (RSV) is typically treated with ribavirin, a guanosine analog, which interferes with RNA synthesis and viral replication. Acyclovir's mechanism of action, involving thymidine kinase phosphorylation, is not effective against RSV.
Choice B rationale
Influenza is caused by influenza viruses (A, B, C) and is typically treated with neuraminidase inhibitors like oseltamivir or zanamivir, which prevent viral release from infected cells. Acyclovir's antiviral spectrum does not include influenza viruses, as their replication cycle and enzymatic targets differ significantly.
Choice C rationale
Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV), an RNA virus. Treatment for hepatitis A is primarily supportive, as there is no specific antiviral medication. Acyclovir is not effective against hepatitis A virus; its mechanism of action is specific to DNA polymerase inhibition in herpesviruses.
Choice D rationale
Acyclovir is a highly effective antiviral agent specifically indicated for the treatment of herpes zoster, commonly known as shingles. It works by inhibiting viral DNA synthesis after being phosphorylated by viral thymidine kinase, thereby impairing the replication of the varicella-zoster virus (VZV) that causes herpes zoster.
Correct Answer is C
Explanation
Choice A rationale
Breads are generally well-tolerated and do not contain substances known to irritate the bladder. They are composed primarily of carbohydrates and are not acidic or caffeinated, making them a safe dietary choice for individuals with a urinary tract infection.
Choice B rationale
While some fresh fruits are acidic, many are not strong bladder irritants and contribute to overall hydration and nutrient intake. The impact of specific fruits can vary among individuals, but generally, fresh fruits are not a universal avoidance recommendation for UTIs.
Choice C rationale
Caffeine acts as a diuretic and a bladder irritant. It can increase urinary frequency, urgency, and may exacerbate bladder discomfort and inflammation in individuals with a urinary tract infection by stimulating the bladder detrusor muscle. Therefore, it should be avoided.
Choice D rationale
Cheeses, particularly aged cheeses, do not typically contain compounds that directly irritate the bladder. They are a source of protein and fat, and generally do not contribute to urinary symptoms in the context of a urinary tract infection.
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