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 B
Explanation
B. Increase fiber in the diet: This is the correct option. Increasing dietary fiber intake is one of the most important interventions to prevent diverticular disease and reduce the risk of diverticulitis. Adequate fiber intake promotes regular bowel movements and prevents constipation, which can help reduce pressure in the colon and minimize the formation of diverticula.
A. Nuts and seeds are excellent sources of dietary fiber, which may actually help prevent diverticular disease. Therefore, while avoiding nuts and seeds may be advised during an acute diverticulitis flare-up to reduce irritation to the colon, it is not the most important long-term preventive intervention.
C. While stress management techniques may contribute to overall health and well-being, they are not the most important intervention specifically for preventing diverticular disease.
D. While physical activity and exercise are important for overall health and may help improve bowel function, there is limited evidence to suggest that strengthening abdominal muscles alone can prevent diverticular disease.
Correct Answer is A
Explanation
A. Cleans and dries the perianal area after each diarrheal stool: This is the correct option. Effective perianal care for a client with diarrhea, such as ulcerative colitis, involves gentle cleansing and thorough drying of the perianal area after each stool. Proper hygiene helps prevent skin breakdown and irritation caused by prolonged contact with stool.
B. Alcohol can be irritating to the skin and may exacerbate perianal irritation and discomfort. Therefore, using alcohol compresses is not considered an appropriate perianal care practice.
C. While antidiarrheal medications may be prescribed for clients with ulcerative colitis to help manage symptoms, asking for medication after each stool is not a typical or recommended approach. The frequency and timing of antidiarrheal medication administration should be based on healthcare provider recommendations and individual symptom management plans.
D. While Sitz baths can provide relief from perianal discomfort and promote healing, taking an hour-long Sitz bath after each stool may be impractical and excessive. Sitz baths are typically recommended for shorter durations (e.g., 10-20 minutes) and may be used periodically rather than after every stool.
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