The nurse is caring for an 84-year-old female client who was brought to the emergency room by her daughter, who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect?
Urinary tract infection
Acute kidney failure
Septic shock
Urinary stasis
The Correct Answer is A
A. Urinary tract infection
The symptoms described, including recent mental status changes and periods of incontinence, are suggestive of a urinary tract infection (UTI) in an elderly individual. UTIs are common among older adults and can cause a variety of symptoms, including confusion, which is often the primary manifestation in the elderly population. Other symptoms can include urinary urgency, frequency, and incontinence.
B. Acute kidney failure - While acute kidney failure can cause changes in urination and mental status, it is less likely to be the primary cause of these symptoms in this scenario. UTI is a more common and immediate concern given the symptoms described.
C. Septic shock - Septic shock is a severe condition that occurs when an infection leads to a life-threatening drop in blood pressure. While septic shock can cause altered mental status, it is a critical condition that often presents with more dramatic symptoms and requires immediate intensive care management. The symptoms described are more suggestive of a UTI.
D. Urinary stasis - Urinary stasis refers to the slowing or cessation of urine flow. While urinary stasis can contribute to the development of UTIs, it is not a condition that would cause sudden and acute mental status changes and incontinence on its own. UTI is a more likely cause of the symptoms described.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Urine culture and sensitivity
Explanation: A urine culture and sensitivity test involves growing bacteria from a urine sample in a laboratory setting. Once the bacteria have grown, they are exposed to different antibiotics to see which one is most effective in inhibiting their growth. This helps healthcare providers identify the specific strain of bacteria causing the infection and choose the most appropriate antibiotic treatment.
B. Serum creatinine level
Explanation: Serum creatinine level is a blood test used to measure kidney function. It evaluates how well the kidneys are filtering waste from the blood. While important for assessing kidney health, it does not determine the specific bacteria causing a urinary tract infection or the appropriate antibiotic treatment.
C. Urinalysis
Explanation: Urinalysis is a broad screening test that assesses various components in the urine, such as red and white blood cells, protein, glucose, and bacteria. While it can detect signs of a urinary tract infection (such as the presence of bacteria and white blood cells), it does not identify the specific bacterial strain causing the infection or provide information about antibiotic sensitivity.
D. Kidney scan
Explanation: A kidney scan, also known as a renal scan, is a medical imaging technique used to assess the structure and function of the kidneys. It can help diagnose conditions like kidney stones, urinary obstruction, or kidney infections. However, it does not determine the strain of bacteria causing a urinary tract infection or guide antibiotic treatment.
Correct Answer is ["200"]
Explanation
To calculate the rate at which the nurse should program the pump in milliliters per hour, you can use the following formula:
Rate (mL/hour) = Volume (mL) / Time (hours)
In this case, the volume is 1,000 mL (1 liter), and the time is 5 hours. Plugging these values into the formula:
Rate (mL/hour) = 1,000 mL / 5 hours = 200 mL/hour
So, the nurse should program the pump to administer the normal saline at a rate of 200 milliliters per hour.
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