A patient presents with urinary incontinence. Which of the following expected findings would the nurse most likely assess?

Urinary urgency without frequency

Loss of urine when laughing, coughing, sneezing

Urinary hesitancy

Hematuria

Answer and Explanation

The Correct Answer is B

A.   Urinary urgency refers to a sudden, compelling need to urinate, which may or may not be accompanied by frequency (i.e., the need to urinate often). Urgency alone does not necessarily indicate urinary incontinence but rather may suggest conditions like overactive bladder or urge incontinence. This finding is not the most characteristic sign of urinary incontinence but rather a symptom of specific types of incontinence or bladder conditions.
B.   Loss of urine when laughing, coughing, or sneezing is indicative of stress urinary incontinence. This type of incontinence occurs when physical activities that increase abdominal pressure (such as coughing, sneezing, or laughing) lead to involuntary leakage of urine. It is a common and classic symptom of stress urinary incontinence.
C.   Urinary hesitancy refers to difficulty starting the urine stream or a delay in beginning urination. This symptom is more commonly associated with obstructive urinary conditions or prostatic issues in males rather than incontinence. It does not typically characterize urinary incontinence, which is more related to involuntary leakage rather than difficulties initiating urination.
D.   Hematuria is the presence of blood in the urine and can be a sign of various urological issues such as infections, stones, or tumors. It is not a typical finding associated with urinary incontinence, which involves involuntary leakage rather than the presence of blood.

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Correct Answer is C

Explanation

A. This refers to irregular bleeding between menstrual periods. While anorexia nervosa can lead to amenorrhea (the absence of menstruation) due to hormonal imbalances from severe weight loss and malnutrition, metrorrhagia is not a typical finding associated with anorexia nervosa.
B. This is a condition characterized by elevated levels of potassium in the blood. It is not a common finding in anorexia nervosa. Instead, clients with anorexia nervosa are more likely to have electrolyte imbalances such as hypokalemia (low potassium levels), especially if they engage in behaviors like vomiting or excessive use of laxatives.
C. This is a common finding in clients with anorexia nervosa. Constipation occurs due to inadequate intake of food and fluids, which results in decreased bowel motility. Malnutrition and dehydration from restricted intake can also contribute to this problem.
D. This refers to an abnormally fast heart rate. While tachycardia can occur in various conditions, in the context of anorexia nervosa, clients may actually exhibit bradycardia (slow heart rate) rather than tachycardia. The low body weight and malnutrition associated with anorexia can lead to a slowed heart rate as part of the body's response to starvation and decreased metabolic activity.

A. Palpate the client's pedal pulses. B. Ask the client how strong she feels today. C. Ask the client to touch her finger to her nose. D. Ask the client to push her feet against the nurse's palms.

Correct Answer is D

Explanation

A. Palpating the pedal pulses is important for assessing circulation and vascular status, not for evaluating muscle strength. This action helps in determining blood flow to the lower extremities but does not provide information about the client’s muscle strength or ability to ambulate.
B. Asking the client how strong she feels provides subjective information about her perceived strength but does not objectively assess muscle strength. This method relies on the client's self-assessment, which may not always be accurate or reliable.
C. Touching the finger to the nose is a test of coordination and can help assess motor function and neurological status. While it provides information about coordination, it does not specifically measure the client’s overall muscle strength, especially in the lower extremities, which is critical for safe ambulation.
D. Asking the client to push her feet against the nurse’s palms is an effective way to assess lower
extremity muscle strength. This action allows the nurse to gauge the client’s ability to exert force with
their legs, which is essential for ambulation and overall mobility.

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A patient presents with urinary incontinence. Which of the following expected findings would the nurse most likely assess?

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