How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?
Percuss between the iliac crest and ribs at the midaxillary line.
Push fingers upward into the two lowest intercostal spaces.
Palpate along both sides of the lumbar vertebral column.
Strike a flat hand covering the costovertebral angle (CVA).
The Correct Answer is D
Choice A rationale
Percussion between the iliac crest and ribs at the midaxillary line is not the standard method for assessing flank tenderness associated with pyelonephritis. This technique may not elicit the characteristic pain of kidney inflammation.
Choice B rationale
Pushing fingers upward into the two lowest intercostal spaces is not a specific test for flank tenderness and may not accurately assess for pyelonephritis. This action is more related to assessing the integrity of the rib cage and intercostal muscles.
Choice C rationale
Palpating along both sides of the lumbar vertebral column is not the correct method for assessing flank tenderness due to pyelonephritis. This approach is more suited for assessing the musculoskeletal structure rather than the kidneys.
Choice D rationale
Striking a flat hand over the costovertebral angle is the correct method for assessing flank tenderness in cases of suspected pyelonephritis. This technique, known as costovertebral angle tenderness, elicits pain when the kidneys are inflamed, which is a common sign of pyelonephritis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
This method is the standard procedure for obtaining a clean-catch midstream urine specimen. The initial voiding washes away organisms near the meatus, and the midstream urine is less likely to be contaminated by bacteria from the skin or urethral area, providing a sample that more accurately represents the bacteria in the bladder.
Choice B rationale
Having the patient empty the bladder completely and then obtaining the next specimen does not ensure a clean-catch sample. This method could lead to contamination of the specimen with bacteria from the skin or urethral area.
Choice C rationale
Cleaning the area with povidone-iodine is not recommended for routine urine culture as it may kill some of the bacteria, leading to a false-negative result. The standard practice is to clean the area with mild soap and water.
Choice D rationale
Inserting a catheter is an invasive procedure and is not the first choice for obtaining a urine specimen. It is used when a patient is unable to provide a clean-catch specimen or if there are specific medical indications.
Correct Answer is ["B","C"]
Explanation
Choice A rationale
While infections can occur in IBD, the primary goal is not to combat infection but to manage the underlying inflammation¹.
Choice B rationale
Controlling inflammation is a key treatment goal in IBD to alleviate symptoms and induce and maintain remission².
Choice C rationale
Correcting and preventing malnutrition is essential in IBD management due to potential nutrient absorption issues¹.
Choice D rationale
Increasing stress is not a treatment goal for IBD. In fact, reducing stress can help manage IBD symptoms².
Choice E rationale
While IBD currently has no cure, the goals are to manage symptoms, induce remission, and improve quality of life².
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