A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?

A clean catch urinalysis and urine culture

Foley catheter placement

Broad-spectrum antibiotic

0.9% sodium chloride infusion at 100 ml/hr

WBC count

Blood cultures × 2

Answer and Explanation

Correct Answer : A,C,E

A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.

B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.

C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.

D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.

E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.

F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.

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Correct Answer is D

Explanation

A. Peripheral Artery Disease (PAD). PAD is a chronic condition related to reduced blood flow in peripheral arteries. It is not directly associated with MI complications.

B. Gastroesophageal Reflux Disease (GERD). GERD involves acid reflux and is not related to post-MI complications.

C. Hypertension. While hypertension is a risk factor for MI, it does not directly explain the symptoms of shortness of breath and irregular heartbeats following an MI.

D. Heart Failure. Heart failure is a common post-MI complication, especially if a significant portion of heart muscle is damaged. Symptoms of shortness of breath and irregular heartbeats could indicate left-sided heart failure, where fluid backs up into the lungs, or right-sided failure, which can lead to systemic congestion.

A. Keep the patient NPC (nothing by mouth) until the T-tube is removed. B. Monitor the tube drainage and document the amount and color. C. Ensure the tube is clamped for 8 hours each day. D. Flush the T-tube with normal saline every 4 hours.

Correct Answer is B

Explanation

A. Keep the patient NPO (nothing by mouth) until the T-tube is removed. Patients are generally kept NPO initially but may resume clear liquids and progress to a regular diet based on tolerance; NPO status is not required until the T-tube is removed.

B. Monitor the tube drainage and document the amount and color. Monitoring and documenting drainage from the T-tube is crucial to assess biliary function and ensure that the bile is draining properly, indicating no obstruction.

C. Ensure the tube is clamped for 8 hours each day. Clamping may be done before tube removal to test the body’s tolerance to bile drainage, but it should be done only as per physician orders, not routinely for 8 hours each day.

D. Flush the T-tube with normal saline every 4 hours. Flushing a T-tube is generally not done routinely as it could disrupt the flow of bile and cause complications.

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A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?

Nursing Test Bank

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