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. Toxic megacolon is characterized by severe colonic dilation, leading to a significant increase in abdominal girth. As the colon becomes distended, it can cause visible abdominal swelling and bloating, which may be accompanied by tenderness upon palpation.
A. In the context of toxic megacolon, there may be a reduction or cessation of bowel movements due to colonic dilation and paralysis.
C. In toxic megacolon, bowel sounds may initially be hyperactive due to increased peristalsis as the colon attempts to overcome the obstruction. However, as the condition progresses, bowel sounds may diminish or become absent due to colonic dilation and paralysis.
D. While fever can be present in toxic megacolon due to the underlying inflammatory process, it is not universally seen in all cases.
Correct Answer is B
Explanation
B. Rebound tenderness on abdominal palpation: Rebound tenderness, where pain increases upon release of pressure during abdominal palpation, is a classic sign of peritonitis, which can occur due to a peptic ulcer perforation. It indicates irritation of the peritoneum, the lining of the abdominal cavity, which can occur when stomach contents leak into the peritoneal cavity.
A. Numbness in the legs is not typically associated with perforation of a peptic ulcer. Perforation of a peptic ulcer usually presents with localized abdominal symptoms rather than symptoms in the legs.
C. Projectile vomiting of undigested food is not typically associated with perforation of a peptic ulcer. It is more commonly seen in conditions such as pyloric stenosis or gastrointestinal obstruction.
D. Jaundice, a yellow discoloration of the skin and sclera, is not typically associated with perforation of a peptic ulcer.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today