An 87-year-old male resident of an assisted living facility has ...

[krzymel]

An 87-year-old male resident of an assisted living facility has been consistently continent of urine until the last several weeks. Which of the following actions by the care providers at the facility is the most likely priority?
 
  A)
  Performing a physical examination and history to determine the exact cause and character of the incontinence
  B)
  Providing client education focusing on the fact that occasional incontinence is a normal, age-related change
  C)
  Teaching the resident about protective pads, collection devices, and medications that may be effective
  D)
  Showing the resident the correct technique for exercises to improve bladder, sphincter, and pelvic floor tone

Question 2

A 4-year-old boy who has been deaf since birth and has bilateral cataracts has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided.
 
  Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the health care team's initial differential diagnosis most likely be?
  A)
  Alport syndrome
  B)
  Systemic lupus erythematosus glomerulonephritis
  C)
  Henoch-Schnlein purpura nephritis
  D)
  Immunoglobulin A nephropathy

[jennafosdick]

Answer to Question 1

Ans:
A

Feedback:

The priority in the treatment of incontinence in the elderly is an acknowledgement that it is not an inevitability and that the exact causes should and most often can be identified. This identification by way of history-taking and examination would supersede teaching about protective devices or exercises.

Answer to Question 2

Ans:
A

Feedback:

Heavy microscopic hematuria, proteinuria, and sensorineural deafness and eye disorders are characteristic of Alport syndrome. This symptomatology is less characteristic of systemic lupus erythematosus glomerulonephritis, Henoch-Schnlein purpura nephritis, or immunoglobulin A nephropathy.

[krzymel]

TYSM

[laurnthompson]

Excellent