A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?

A clean catch urinalysis and urine culture

Foley catheter placement

Broad-spectrum antibiotic

0.9% sodium chloride infusion at 100 ml/hr

WBC count

Blood cultures × 2

Answer and Explanation

Correct Answer : A,C,E

A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.

B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.

C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.

D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.

E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.

F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.

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Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A,B"}}

Explanation

Polyuria/Polydipsia:

Supports both DKA and HHS as both conditions typically exhibit severe dehydration and excessive thirst and urination.

Heart Rate (tachycardia):

Consistent with both DKA and HHS due to dehydration and fluid shifts, though heart rate alone does not differentiate the two.

Respirations (Kussmaul's):

Suggests DKA; deep, labored Kussmaul respirations typically help compensate for metabolic acidosis, which is characteristic of DKA.

Mental Status (confusion, lethargy):

More common in HHS, where very high glucose and osmolality levels often lead to more profound neurologic changes. Can also occur in DKA.

Serum Glucose >600 mg/dL and Serum Osmolality >320 mOsm/kg:

Consistent with both DKA and HHS, though more frequently seen in HHS given the higher osmolality. In DKA, serum glucose usually elevated but often lower than in HHS. Osmolality may be increased but not as high as in HHS.

Insidious onset (days to weeks):

Suggests HHS, as it often has a slower onset than DKA, which typically presents more acutely.

Infection as precipitating factor:

Could support either condition as infections can precipitate both DKA and HHS.

A. Include high-fat foods to maintain weight B. Eat three large meals a day to ensure adequate nutrition C. Increase intake of dairy products to boost calcium levels. D. Consume a low-fiber diet to minimize bowel irritation

Correct Answer is D

Explanation

A. Include high-fat foods to maintain weight. High-fat foods can worsen symptoms in ulcerative colitis by increasing bowel irritation and causing malabsorption. A balanced diet that is low in fat is usually recommended.

B. Eat three large meals a day to ensure adequate nutrition. Large meals can increase digestive workload and exacerbate symptoms. Smaller, more frequent meals are generally better tolerated.

C. Increase intake of dairy products to boost calcium levels. Many patients with ulcerative colitis are lactose intolerant or sensitive to dairy, which can worsen symptoms. Calcium can be obtained from other sources if needed.

D. Consume a low-fiber diet to minimize bowel irritation. A low-fiber diet can reduce mechanical irritation in the bowel, which is beneficial during flare-ups of ulcerative colitis.

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A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A,B"}}

Explanation

A nurse is providing dietary teaching to a patient with ulcerative colitis. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

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