* To take the test online, go to our secure Web site at www.nursingcenter.com/ce/ajn.
* To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form.
* Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.
* Registration deadline is January 31, 2016.
DISCOUNTS AND CUSTOMER SERVICE
* Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test.
* We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details.
LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC).
These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states.
The ANCC's accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.
CE TEST QUESTIONS
To present the principles of self-management of urinary, fecal, and dual incontinence, and the behaviors and skills self-managing patients need to acquire, as well as the nurse's role in reinforcing their use.
After reading this article and taking this test, you will be able to
* recognize principles of self-management and their application in treating urinary and fecal incontinence.
* identify the nurse's role in imparting self-management skills to patients and reinforcing their use.
1. What percentage of people with fecal incontinence seeks professional care for the problem?
2. Self-management mainly depends on the development of
3. Self-management interventions are most successful when both patient and health care provider
a. understand the pathophysiology of incontinence.
b. are willing to compromise in setting realistic goals.
c. share responsibility for the outcomes.
d. monitor the effects of behavioral changes.
4. A qualitative metasynthesis of self-management literature identified three processes as essential for successful self-management of a chronic illness, one of which is
a. processing emotions, adjusting to the illness, modifying lifestyle, and striving to grow.
b. integrating the biomedical model of health care.
c. evaluating the extent of learning about self-management.
d. involving family and friends in the management plan.
5. The core of self-management is
a. evidence-based knowledge.
b. community resource use.
c. a provider-designed action plan.
d. a patient-identified problem.
6. To offer optimal guidance, clinicians should have detailed discussions with patients that address items including patients’
a. previous coping abilities.
b. health literacy level.
c. anthropometric measurements.
d. peer and public interactions.
7. A reasonable time frame for assessing an action plan for urinary incontinence might be how long after initiating a pelvic floor muscle exercise regimen?
a. 2 to 3 weeks
b. 4 to 6 weeks
c. several months
d. at least 1 year
8. When complete continence isn't possible, which of the following might be a reasonable alternative goal?
a. increasing confidence in self-management
b. exploring other pharmacologic therapies
c. wearing incontinence undergarments consistently
d. limiting activities without immediate bathroom access
9. For greatest success, self-efficacy measures should
a. be outcome specific.
b. target interventions collectively.
c. be goal specific.
d. target each intervention separately.
10. Recommended strategies for promoting self-efficacy in patients include
a. acknowledging that incontinence does not always improve.
b. facilitating and organizing small discussion groups.
c. informing patients of long-term sequelae of incontinence.
d. helping patients realize and accept their limitations.
11. Means through which to support patients’ self-management behaviors include
a. family therapy.
b. surgical options.
c. newer incontinence products.
d. informative, paper-based materials.
12. Fluid management strategies that can help minimize urinary incontinence include which of the following?
a. drinking 800 to 1,200 mL of fluid per day
b. drinking 1,400 to 1,800 mL of fluid per day
c. avoiding caffeinated beverages
d. avoiding drinking plain water
13. The “Knack” maneuver involves having patients
a. sit comfortably.
b. cough before exercising.
c. rapidly contract their pelvic floor muscles before coughing.
d. empty their bladder before learning the maneuver.
14. Bladder training involves having patients
a. lie down.
b. use distraction by focusing on a challenge or counting backwards.
c. pace when the urge presents.
d. urinate partially to dispel the urge.
15. In a study of women with diabetes, which of the following was the lifestyle change that had the greatest positive impact on urinary continence recovery?
a. weight loss
b. moderate exercise
c. fluid restriction
d. constipation management
16. Which of the following dietary modifications is recommended for self-management of fecal incontinence?
a. avoiding dairy products
b. eating only when hungry
c. increasing intake of nuts and seeds
d. increasing intake of citrus fruits and juices
17. Patients who have multiple sclerosis report that the most helpful intervention for controlling fecal incontinence is
a. making dietary modifications.
b. using absorbent pads.
c. undergoing bowel habit training.
d. taking antidiarrheal medication.