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

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Administer intravenous antibiotics and observe the patient for 24 hours: IV antibiotics may be given preoperatively, but observation without surgery is not the standard treatment for confirmed appendicitis due to the risk of rupture.

B. Provide the patient with oral pain medications and discharge them with a follow-up appointment: Oral pain medications are not appropriate as the patient needs surgical intervention. Discharging the patient without surgery could result in life-threatening complications.

C. Recommend a liquid diet and bed rest to reduce inflammation: A liquid diet and bed rest will not address the underlying issue of appendicitis, which requires surgical removal of the inflamed appendix.

D. Prepare the patient for an appendectomy. The standard treatment for acute appendicitis is an appendectomy. Delaying surgery can lead to complications such as perforation, peritonitis, or abscess formation. This is the most appropriate intervention.

A. A history of chronic headaches and migraines B. A history of gastrointestinal issues such as irritable bowel syndrome C. A history of cardiovascular problems such as hypertension D. A history of frequent urinary tract infections

Correct Answer is D

Explanation

A. A history of chronic headaches and migraines: While chronic headaches and migraines can affect overall health, they are not directly related to pyelonephritis.

B. A history of gastrointestinal issues such as irritable bowel syndrome: Gastrointestinal issues like irritable bowel syndrome (IBS) are generally unrelated to kidney function or urinary tract infections.

C. A history of cardiovascular problems such as hypertension: While hypertension can have indirect effects on renal function, it is not a common historical detail specifically associated with pyelonephritis.

D. A history of frequent urinary tract infections: Frequent urinary tract infections (UTIs) are a significant risk factor for developing pyelonephritis, as the infection can ascend from the bladder to the kidneys.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

During the process of collecting a comprehensive medical history from a client who has been admitted with pyelonephritis, which of the following symptoms or historical details would the nurse most likely expect the client to report?

Correct Answer is D

Explanation

A female patient recently underwent a partial gastrectomy and is now presenting with symptoms of weakness, dizziness, and sweating, particularly after meals. Based on these symptoms, what is the most likely diagnosis?

A patient with acute pancreatitis is being discharged from the hospital. Which statement made by the patient indicates a need for further teaching regarding their discharge instructions?

A nurse is gathering data on a client who was admitted with pyelonephritis. Which of the following manifestations should the nurse expect the client to be exhibiting? (Select All that Apply.)

A nurse is caring for a client who is experiencing an acute exacerbation of ulcerative colitis. The nurse should recognize that which of the following actions is the priority?

A nurse is providing education to a client who has recently been diagnosed with Crohn's disease. Which of the following explanations by the nurse best simplifies and explains the disorder in non-medical terms?

A nurse is reinforcing dietary instructions with a client who has episodes of biliary colic from chronic cholecystitis. Which of the following diets should the nurse reinforce in the teaching plan?