A client comes to the Urgent Care center complaining of urinary frequency accompanied by pain when voiding. Which clinical manifestation would make the nurse suspect acute pyelonephritis rather than cystitis?
Urinary urgency
Increased WBCs in urinalysis
Costovertebral tenderness
Hematuria
The Correct Answer is C
C. Costovertebral tenderness, which is tenderness over the costovertebral angle (where the ribs meet the vertebral column) on palpation, is more indicative of acute pyelonephritis rather than cystitis. In acute pyelonephritis, inflammation of the kidney parenchyma and surrounding tissues can lead to tenderness in this area.
A. Both acute pyelonephritis and cystitis can present with urinary urgency, as it is a common symptom of urinary tract infections (UTIs) in general.
B. Increased WBCs in urinalysis: While an increased number of white blood cells (WBCs) in the urinalysis can indicate a urinary tract infection, it is not specific to either acute pyelonephritis or cystitis.
D. Hematuria can occur in both acute pyelonephritis and cystitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Abdominal pain and cramping are common symptoms of diverticular disease, particularly diverticulosis and diverticulitis. The pain is often located in the lower left abdomen and can range from mild to severe. Cramping may occur due to inflammation or spasms in the affected colon segment.
A. Frequent urination is not a common symptom of diverticular disease. Diverticular disease typically involves symptoms related to the gastrointestinal tract, such as abdominal pain, changes in bowel habits, and rectal bleeding.
C. Symptoms related to the chest are more commonly associated with cardiovascular or respiratory conditions rather than gastrointestinal conditions like diverticular disease.
D. Joint stiffness is more commonly associated with musculoskeletal conditions such as arthritis or other inflammatory disorders.
Correct Answer is B
Explanation
B. After ESWL for a urinary stone, it is essential to monitor the client's urine characteristics (such as color, clarity, and presence of blood) and output. The presence of hematuria is a common and expected finding after ESWL due to the disruption of tissue and blood vessels during the procedure. Monitoring urine output helps assess renal function and ensures adequate hydration, which is crucial for flushing out stone fragments.
A. While monitoring urine specific gravity can provide information about the concentration of urine, and assessing antigen levels may be relevant in certain contexts, these parameters are not typically the most important information to collect immediately after extracorporeal shock-wave lithotripsy (ESWL) for a urinary stone.
C. While it is important to monitor the surgical site for signs of infection or complications after any procedure, ESWL is a non-invasive procedure performed externally, typically without any incisions.
D. While obtaining clean catch urine specimens for urinalysis and culture may be relevant for assessing urinary tract infection or other urinary abnormalities, it is not typically the most important information to collect immediately after ESWL.
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