A female client presents to the clinic with complaints of foul-smelling urine, a low-grade fever of 37.7° C (100° F), and dysuria for the past three days. She also reports increased urinary frequency and urgency but states that she has not noticed any blood in her urine. Upon examination. the nurse notes mild CVA tenderness on the right side. The nurse reviews the client's recent medical history, noting that she has a history of recurrent urinary tract infections (UTIs) and is currently taking no medications other than a daily multivitamin.

Vital Signs

blood pressure 120/78 mm Hg

heart rate 88 beats per minute

respiratory rate 18 breaths per minute

temperature 37.7° C (100° F)

increased fluid intake and patient education on hydration

Blood cultures

Urine culture and sensitivity testing

Repeat urinalysis after antibiotic treatment completion.

Foley catheter placement

Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin

Answer and Explanation

Correct Answer : A,C,D,F

A. Increased fluid intake and patient education on hydration: Encouraging increased fluid intake helps to flush bacteria from the urinary tract and prevent further infection. Hydration is a key component of managing UTIs, as it dilutes urine and promotes frequent urination, reducing bacterial colonization.

B. Blood cultures: Blood cultures are not typically indicated for uncomplicated UTIs, especially in a patient without signs of systemic infection or sepsis (e.g., high fever, hypotension, tachycardia). Blood cultures are more relevant in severe or complicated UTIs, or when there is concern for urosepsis.

C. Urine culture and sensitivity testing: A urine culture and sensitivity is essential for identifying the specific bacteria causing the infection and determining the appropriate antibiotic for treatment. This is especially important for patients with a history of recurrent UTIs to ensure the right antibiotic is selected and to avoid antibiotic resistance.

D. Repeat urinalysis after antibiotic treatment completion: A repeat urinalysis after antibiotic treatment is often ordered to ensure that the infection has been resolved, particularly in patients with recurrent infections.

E. Foley catheter placement: A Foley catheter is not appropriate for this patient, as there is no indication of urinary retention, and catheterization increases the risk of introducing new infections.

F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin: Oral antibiotics like trimethoprim-sulfamethoxazole (TMP-SMX) or ciprofloxacin are commonly prescribed for treating uncomplicated UTIs. Given the patient’s history of recurrent UTIs, empiric antibiotic therapy is appropriate pending urine culture results.

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Correct Answer is C

Explanation

A. Encouraging the patient to drink ginger tea for nausea: While ginger tea may help with nausea in some cases, it is not an appropriate intervention for acute cholecystitis, which requires more aggressive management.

B. Applying ice packs to the abdomen: Ice packs are not a standard treatment for acute cholecystitis and would not effectively alleviate the patient’s pain or inflammation.

C. Administering prescribed intravenous analgesics: The most appropriate intervention is to administer prescribed intravenous analgesics to relieve pain in patients with acute cholecystitis. Pain management is a priority to alleviate discomfort while awaiting further treatment, such as surgery or antibiotics.

D. Advising the patient to eat small, frequent meals: Dietary changes like eating small, frequent meals may be advised after the acute phase to prevent future attacks, but they are not appropriate for addressing acute symptoms.

A. Costovertebral angle tenderness B. Suprapubic tenderness C. Abdominal distention D. Lower extremity edema

Correct Answer is B

Explanation

A. Costovertebral angle tenderness: Costovertebral angle tenderness is more indicative of pyelonephritis (kidney infection) rather than cystitis, as it signals an upper urinary tract infection.

B. Suprapubic tenderness: Suprapubic tenderness is a classic sign of cystitis. This symptom, combined with dysuria and increased urinary frequency, strongly supports the diagnosis.

C. Abdominal distention: Abdominal distention is not typically associated with cystitis. It may suggest other conditions like bowel obstruction or ascites.

D. Lower extremity edema: Lower extremity edema is not a common finding in cystitis. It is more associated with systemic conditions like heart failure or kidney disease.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female patient presents with right upper quadrant pain, nausea and vomiting. She has been diagnosed with acute cholecystitis. What is the most appropriate nursing action to alleviate her symptoms?

Correct Answer is C

Explanation

A female presents to the clinic with complaints of dysuria and increased urinary frequency. Which of the following findings on physical examination would most likely support a diagnosis of cystitis?

Correct Answer is B

Explanation

A nurse practicing population health works for a local hospital's weight-loss program for bariatric patients. After assisting to implement various health-style changes in their care plans, which of the following findings would indicate to the nurse that the interventions are working?

A female patient presents with epigastric pain and is being evaluated for peptic ulcer disease (PUD). Upon reviewing her history, which of the following risk factors would be most indicative of increasing his likelihood of developing PUD?

A nurse is contributing to the plan of care for a client who has an intestinal obstruction and is receiving continuous gastrointestinal decompression using a nasogastric tube. Which of the following interventions should the nurse include in the plan of care?

A patient with suspected appendicitis is being prepared for surgery. Which of the following preoperative interventions should the nurse prioritize?

A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?

A nurse is gathering data on a client who was admitted with pyelonephritis. Which of the following manifestations should the nurse expect the client to be exhibiting? (Select All that Apply.)

A nurse is reinforcing teaching to a client who has been newly diagnosed with hepatitis C. The client asks how they could have contracted the virus. Which of the following nurse responses best explains how the client may have become infected with hepatitis C?

A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?