A nurse on an acute medical unit of a hospital has admitted a 62 year old female from the emergency department who has been diagnosed with acute pyelonephritis. Which of the following statements most accurately conveys an aspect of the knowledge base that the nurse needs to perform adequate care and teaching?
Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis
Most cases of acute pyelonephritis are attributable to poorly controlled hypertension
Flank pain, dysuria and nausea and vomiting are likely assessment findings
The infection in the kidney is most likely a manifestation of a systemic infection
The Correct Answer is C
A. Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis: These findings are more typical of chronic pyelonephritis, which results from repeated or persistent kidney infections. Acute pyelonephritis usually presents with more subtle imaging changes.
B. Most cases of acute pyelonephritis are attributable to poorly controlled hypertension: While hypertension can complicate kidney disease, it is not a common cause of acute pyelonephritis. Most cases are due to ascending urinary tract infections, particularly from organisms like E. coli.
C. Flank pain, dysuria and nausea and vomiting are likely assessment findings: These are hallmark symptoms of acute pyelonephritis. Flank pain results from inflammation of the renal capsule, while dysuria and systemic symptoms like nausea, vomiting, and fever indicate infection.
D. The infection in the kidney is most likely a manifestation of a systemic infection: Acute pyelonephritis is typically caused by local ascending infections from the lower urinary tract, not systemic bacteremia. Though it can lead to systemic illness if not treated, its origin is usually localized.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Esophageal: Esophageal variceal bleeding is the most common and serious complication of portal hypertension. Increased pressure in the portal venous system leads to the formation of varices in the esophagus, which can rupture and cause life-threatening hemorrhage.
B. Intestinal: While portal hypertension can cause changes in intestinal blood flow, it is not the most common site for clinically significant bleeding. Intestinal bleeding related to portal hypertension is much less frequent than esophageal variceal bleeding.
C. Duodenal: Duodenal bleeding is more commonly associated with peptic ulcer disease rather than portal hypertension. It is not a typical manifestation of increased portal venous pressure.
D. Rectal: Rectal bleeding may occur due to hemorrhoids or portal hypertensive colopathy, but it is less common and less life-threatening compared to esophageal varices in portal hypertension.
Correct Answer is D
Explanation
A. Azotemia: Azotemia, or elevated blood urea nitrogen (BUN) and creatinine levels, is a common feature of glomerulonephritis due to reduced kidney filtration capacity and accumulation of nitrogenous wastes in the blood.
B. Hematuria with red cell casts: Hematuria with red blood cell casts is a classic hallmark of glomerulonephritis, indicating glomerular bleeding and inflammation. These casts are formed in the nephron and reflect active glomerular injury.
C. Oliguria and hypertension: Both are characteristic findings in glomerulonephritis. Oliguria results from impaired filtration, while hypertension develops due to fluid retention and activation of the renin-angiotensin-aldosterone system.
D. An increased glomerular filtration rate (GFR) of >100: Glomerulonephritis typically leads to a decreased GFR, not an increase. Inflammation and damage to the glomeruli impair the kidneys' ability to filter blood effectively, resulting in reduced GFR and waste accumulation.
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