A female client presents to the clinic with complaints of foul-smelling urine, a low-grade fever of 37.7° C (100° F), and dysuria for the past three days. She also reports increased urinary frequency and urgency but states that she has not noticed any blood in her urine. Upon examination. the nurse notes mild CVA tenderness on the right side. The nurse reviews the client's recent medical history, noting that she has a history of recurrent urinary tract infections (UTIs) and is currently taking no medications other than a daily multivitamin.
Vital Signs
blood pressure 120/78 mm Hg
heart rate 88 beats per minute
respiratory rate 18 breaths per minute
temperature 37.7° C (100° F)
increased fluid intake and patient education on hydration
Blood cultures
Urine culture and sensitivity testing
Repeat urinalysis after antibiotic treatment completion.
Foley catheter placement
Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin
Correct Answer : A,C,D,F
A. Increased fluid intake and patient education on hydration: Encouraging increased fluid intake helps to flush bacteria from the urinary tract and prevent further infection. Hydration is a key component of managing UTIs, as it dilutes urine and promotes frequent urination, reducing bacterial colonization.
B. Blood cultures: Blood cultures are not typically indicated for uncomplicated UTIs, especially in a patient without signs of systemic infection or sepsis (e.g., high fever, hypotension, tachycardia). Blood cultures are more relevant in severe or complicated UTIs, or when there is concern for urosepsis.
C. Urine culture and sensitivity testing: A urine culture and sensitivity is essential for identifying the specific bacteria causing the infection and determining the appropriate antibiotic for treatment. This is especially important for patients with a history of recurrent UTIs to ensure the right antibiotic is selected and to avoid antibiotic resistance.
D. Repeat urinalysis after antibiotic treatment completion: A repeat urinalysis after antibiotic treatment is often ordered to ensure that the infection has been resolved, particularly in patients with recurrent infections.
E. Foley catheter placement: A Foley catheter is not appropriate for this patient, as there is no indication of urinary retention, and catheterization increases the risk of introducing new infections.
F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin: Oral antibiotics like trimethoprim-sulfamethoxazole (TMP-SMX) or ciprofloxacin are commonly prescribed for treating uncomplicated UTIs. Given the patient’s history of recurrent UTIs, empiric antibiotic therapy is appropriate pending urine culture results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
A. "I will try not to gain weight." Weight gain can increase pressure on the diaphragm and abdomen, worsening symptoms of hiatal hernia. Maintaining a healthy weight helps reduce this pressure.
B. “I will sleep with the head of my bed elevated." Elevating the head of the bed helps prevent stomach acid from refluxing into the esophagus while lying down, a common issue in both hiatal hernia and GERD.
C. "I will drink less fluid": Reducing fluid intake is not a recommended strategy for managing hiatal hernia symptoms. Fluid is essential for digestion and overall health.
D. "I will lie down for one half hour after meals": Lying down after meals can worsen reflux symptoms because gravity is no longer helping keep stomach contents in place. Patients should remain upright after eating.
E. "I will consume less caffeine and spicy foods." Caffeine and spicy foods can increase acid production and irritate the esophagus, worsening symptoms of hiatal hernia.
Correct Answer is B
Explanation
A. "Eating contaminated food or water from an infected source can cause you to become infected with hepatitis C." This applies to hepatitis A, not hepatitis C. Hepatitis A is transmitted through the fecal-oral route, whereas hepatitis C is bloodborne.
B. "Coming into contact with infected blood, such as from that of a dirty needle, can cause you to become infected with hepatitis C." Hepatitis C is primarily spread through blood-to-blood contact, most commonly through sharing needles, blood transfusions before widespread blood screening, or needle-stick injuries.
C. "Coming into contact with an infected person's bodily fluids, such as saliva, can cause you to become infected with hepatitis C." Hepatitis C is not commonly spread through casual contact or saliva. The risk of transmission through bodily fluids other than blood is extremely low.
D. "Consuming a large amount of alcohol at one time can cause you to become infected with hepatitis C." Alcohol does not cause hepatitis C, though it can worsen liver damage in individuals already infected with the virus.
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