A client comes to the Urgent Care center complaining of urinary frequency accompanied by pain when voiding. Which clinical manifestation would make the nurse suspect acute pyelonephritis rather than cystitis?
Urinary urgency
Increased WBCs in urinalysis
Costovertebral tenderness
Hematuria
The Correct Answer is C
C. Costovertebral tenderness, which is tenderness over the costovertebral angle (where the ribs meet the vertebral column) on palpation, is more indicative of acute pyelonephritis rather than cystitis. In acute pyelonephritis, inflammation of the kidney parenchyma and surrounding tissues can lead to tenderness in this area.
A. Both acute pyelonephritis and cystitis can present with urinary urgency, as it is a common symptom of urinary tract infections (UTIs) in general.
B. Increased WBCs in urinalysis: While an increased number of white blood cells (WBCs) in the urinalysis can indicate a urinary tract infection, it is not specific to either acute pyelonephritis or cystitis.
D. Hematuria can occur in both acute pyelonephritis and cystitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Before taking further action, the nurse should investigate whether there have been any changes in the client's diet, exercise routine, or lifestyle that may have contributed to the plateau in weight loss. Understanding any modifications made by the client can provide valuable insights into potential factors affecting their weight loss progress.
B. Bariatric surgery is a significant decision that requires careful consideration and evaluation of various factors. It is not appropriate to jump to this option without first exploring other potential reasons for the lack of weight loss.
C. While it's essential to review diet and exercise guidelines periodically to ensure the client is following appropriate recommendations, this option may not address the underlying cause of the recent lack of weight loss.
D. Regular weight monitoring is an important component of weight management and can provide valuable information about the client's progress. However, instructing the client to record weight weekly alone may not address the underlying reason for the lack of weight loss.
Correct Answer is B
Explanation
B. Taking pantoprazole before the first meal of the day allows for optimal acid suppression during the period of increased gastric acid production after waking up. This timing helps maximize the medication's effectiveness in reducing stomach acid and promoting ulcer healing.
A. Pantoprazole is a proton pump inhibitor (PPI) medication used to reduce stomach acid production and promote healing of gastric ulcers. It is typically taken once daily, usually in the morning before the first meal of the day. Taking pantoprazole before bedtime may not provide optimal acid suppression throughout the day when gastric acid production is typically higher.
C. Pantoprazole does not coat the ulcer; rather, it works by inhibiting the proton pumps in the stomach lining that produce acid. By reducing acid production, pantoprazole helps to create an environment in which the ulcer can heal more effectively.
D. While some individuals with conditions such as gastroesophageal reflux disease (GERD) or chronic gastric ulcers may require long-term or even lifelong pantoprazole therapy to manage their symptoms and prevent ulcer recurrence, the duration of treatment varies depending on the underlying condition, the severity of symptoms, and the response to treatment.
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