A nurse is providing teaching to a client who has stress incontinence. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

"Perform Kegel exercises several times daily."

"Take prescribed diuretics no later than 2000."

"Maintain a daily fluid intake of 1,000 to 1,200 mL/day."

"Attempt to void every 2 hours."

"Maintain optimal body weight for height."

Answer and Explanation

Correct Answer : A,D,E

Rationale:
A. "Perform Kegel exercises several times daily.": Kegel exercises strengthen pelvic floor muscles, improving bladder control and reducing stress incontinence episodes. Regular practice is essential for effectiveness.

B. "Take prescribed diuretics no later than 2000.": Limiting evening diuretic use helps reduce nighttime incontinence but does not address stress incontinence, which is triggered by increased intra-abdominal pressure, not fluid timing.

C. "Maintain a daily fluid intake of 1,000 to 1,200 mL/day.": Restricting fluids excessively can lead to concentrated urine and urinary tract irritation. Adequate hydration is important; fluid restriction is not recommended for stress incontinence.

D. "Attempt to void every 2 hours.": Scheduled voiding helps prevent bladder overfilling, reducing leakage episodes and improving bladder control. This is an effective behavioral strategy.

E. "Maintain optimal body weight for height.": Excess weight increases intra-abdominal pressure, which can worsen stress incontinence. Maintaining a healthy weight helps reduce strain on pelvic floor muscles.

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Correct Answer is C

Explanation

Rationale:
A. Walk with feet close together for stability: Walking with feet close together increases the risk of loss of balance and falls in clients with multiple sclerosis (MS). A wider stance provides greater stability and a safer base of support when ambulating.

B. Implement a rigorous range-of-motion exercise plan: While exercise is beneficial, a rigorous plan can lead to fatigue and exacerbate MS symptoms. Activities should be moderate and spaced with rest periods to prevent overexertion, which can worsen weakness and spasticity.

C. Use a cane for support while walking: Using a cane provides additional balance and stability, helping to prevent falls. Clients with MS often experience muscle weakness and impaired coordination, so assistive devices like canes or walkers promote safe mobility and independence.

D. Avoid the use of orthotics: Orthotic devices can be very helpful for clients with MS who experience foot drop or lower extremity weakness. Avoiding orthotics removes a potential source of support and increases the risk of tripping and falling during ambulation.

A. Fibrocystic breast condition B. Hypertension C. Asthma D. Fibromyalgia

Correct Answer is B

Explanation

Rationale:
A. Fibrocystic breast condition: Fibrocystic breast changes are benign and do not contraindicate oral contraceptive use. Oral contraceptives may sometimes improve symptoms, but this condition alone is not a reason to avoid them.

B. Hypertension: Oral contraceptives can elevate blood pressure and increase the risk of cardiovascular complications. Clients with uncontrolled or severe hypertension are at higher risk and should avoid combined estrogen-progestin contraceptives, making this a significant contraindication.

C. Asthma: Asthma is not a contraindication for oral contraceptive use. Hormonal contraceptives generally do not exacerbate asthma, and clients with well-controlled asthma can safely use these medications.

D. Fibromyalgia: Fibromyalgia is a chronic musculoskeletal pain disorder that does not affect cardiovascular or thrombotic risk. It is not a contraindication for oral contraceptives, and use is generally safe in these clients.

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A nurse is providing teaching to a client who has stress incontinence. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing home care with a client who has multiple sclerosis. Which of the following precautions should the nurse recommend to promote client safety?

Correct Answer is C

Explanation

A nurse is conducting a health promotion class about the use of oral contraceptives. Which of the following disorders is a contraindication for oral contraceptive use?

Correct Answer is B

Explanation

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