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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. I should eat large meals to reduce the frequency of acid reflux: Large meals can worsen GERD by increasing stomach pressure and acid production, leading to reflux. Small, frequent meals are recommended instead.
B. I should drink peppermint tea after meals to help with digestion: While peppermint may help with general digestion, it can relax the lower esophageal sphincter (LES), making GERD worse by allowing acid to reflux into the esophagus.
C. I should lie down immediately after eating to prevent heartburn: Lying down after meals increases the likelihood of acid reflux due to gravity, especially if the stomach is full, and should be avoided.
D. I should avoid eating meals at least 2-3 hours before bedtime. Avoiding meals 2-3 hours before bedtime helps reduce acid reflux by preventing the stomach from being full and producing excess acid when lying down.
Correct Answer is A
Explanation
A. Measure abdominal girth daily. Measuring abdominal girth daily helps assess for changes in distention, which is important in monitoring the effectiveness of the decompression.
B. Moisten the client's lips with lemon-glycerin swabs: This is incorrect because lemon-glycerin swabs can dry the oral mucosa. Using plain water or normal saline swabs would be more appropriate.
C. Maintain the client in Fowler's position: This is appropriate as it helps promote drainage from the nasogastric tube and reduces the risk of aspiration.
D. Use sterile water to irrigate the nasogastric tube: Irrigation is typically done with normal saline to maintain electrolyte balance. Sterile water is not recommended for this purpose.
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