Gero (Vnsg 1126) Ch. 18 "elimination" Nclex-Style Questions Study Guide Graded A+

For a nursing diagnosis of urinary retention, which assessment is the nurse most likely to perform? A) Assess patient's ability to safely ambulate to the bathroom B) Inspect the skin for signs of maceration or irritation C) Gentle palpation of the area over the symphysis pubis D) Assess and monitor laboratory values, especially electrolytes {Ans: C) Gentle palpation of the area over the symphysis pubis Severe urinary retention can cause bladder distention, and the nurse would gently palpate the bladder area. (p. 297)}An older patient is trying to control episodes of incontinence by decreasing fluid intake. Which suggestion is the most helpful to the patient? A) Drink 2 liters of fluid every day unless your provider says otherwise B) Consume fluids early in the day and reduce fluid intake after 7:00 pm C) Divide total fluid into small portions spread throughout the day D) Restrict fluid intake until alternative methods are tried and successful {Ans: B) Consume fluids early in the day and reduce fluid intake after 7:00 pm Avoiding fluids after 7:00 pm helps to decrease incontinence at night, and this is a specific suggestion that helps the patient to gain some control. Drinking 2 liters per