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).

Answer and Explanation

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.

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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.

A. Increasing hemoglobin level B. Decreasing serum amylase level C. Falling serum bilirubin level D. Increasing serum alkaline phosphatase level

Correct Answer is B

Explanation

Choice A rationale

An increasing hemoglobin level does not indicate the resolution of acute pancreatitis. Hemoglobin levels can fluctuate due to various factors, including hydration status and blood loss, but are not directly related to the resolution of pancreatitis.

Choice B rationale

During an episode of acute pancreatitis, serum concentrations of amylase and lipase rise significantly, often within hours of pancreatic injury. These elevated enzyme levels are key components in diagnosing the condition. As the inflammation subsides and the pancreas begins to heal, the levels of these enzymes typically decrease, returning to normal ranges. Therefore, a declining serum amylase level suggests that the acute inflammatory process is resolving.

Choice C rationale

Serum bilirubin levels are indicative of liver function and bile metabolism. Elevated bilirubin may occur if pancreatitis leads to bile duct obstruction or liver involvement. However, a decrease in bilirubin levels addresses biliary system recovery rather than directly reflecting pancreatic inflammation resolution.

Choice D rationale

An increasing serum alkaline phosphatase level is generally associated with bile duct obstruction or bone disease and does not indicate the resolution of acute pancreatitis. This enzyme is found in several tissues throughout the body, including the liver and bones.

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How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","C"]

Explanation

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Correct Answer is B

Explanation

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