A nurse on an acute medical unit of a hospital has admitted a 62 year old female from the emergency department who has been diagnosed with acute pyelonephritis. Which of the following statements most accurately conveys an aspect of the knowledge base that the nurse needs to perform adequate care and teaching?

Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis

Most cases of acute pyelonephritis are attributable to poorly controlled hypertension

Flank pain, dysuria and nausea and vomiting are likely assessment findings

The infection in the kidney is most likely a manifestation of a systemic infection

Answer and Explanation

The Correct Answer is C

A. Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis: These findings are more typical of chronic pyelonephritis, which results from repeated or persistent kidney infections. Acute pyelonephritis usually presents with more subtle imaging changes.

B. Most cases of acute pyelonephritis are attributable to poorly controlled hypertension: While hypertension can complicate kidney disease, it is not a common cause of acute pyelonephritis. Most cases are due to ascending urinary tract infections, particularly from organisms like E. coli.

C. Flank pain, dysuria and nausea and vomiting are likely assessment findings: These are hallmark symptoms of acute pyelonephritis. Flank pain results from inflammation of the renal capsule, while dysuria and systemic symptoms like nausea, vomiting, and fever indicate infection.

D. The infection in the kidney is most likely a manifestation of a systemic infection: Acute pyelonephritis is typically caused by local ascending infections from the lower urinary tract, not systemic bacteremia. Though it can lead to systemic illness if not treated, its origin is usually localized.

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Correct Answer is ["A","B","C"]

Explanation

A. Clinical manifestations: hematuria (urine is smoky, brown tinged): Hematuria is a hallmark sign of acute glomerulonephritis. The smoky or cola-colored urine results from red blood cells leaking through the damaged glomeruli, often seen in post-infectious cases.

B. Clinical manifestations: oliguria: Decreased urine output is common due to impaired glomerular filtration. Oliguria reflects reduced kidney function, which contributes to fluid retention, hypertension, and accumulation of waste products.

C. Treatment: Antibiotics, corticosteroids, cytotoxic agents, anticoagulants: Depending on the cause and severity, treatment may include antibiotics for infection, corticosteroids or cytotoxic agents for inflammation, and anticoagulants if there's risk of thrombosis due to nephrotic syndrome features.

D. Treatment: Prescription dose ibuprofen: NSAIDs like ibuprofen are generally avoided in glomerulonephritis because they can reduce renal perfusion and worsen kidney injury, especially in patients already experiencing compromised kidney function.

E. Clinical manifestations: Proteinuria that exceeds 3–5g/day with albumin: This level of proteinuria is characteristic of nephrotic syndrome, not acute glomerulonephritis. While proteinuria may be present, it is typically moderate and not in the nephrotic range.

A. Changing an IV B. Disposing of food trays C. Emptying bed pans D. Taking an oral temperature

Correct Answer is C

Explanation

A. Changing an IV: This procedure involves standard precautions to avoid bloodborne infections, not primarily fecal-oral infections like hepatitis A. It is more relevant to viruses such as hepatitis B and C.

B. Disposing of food trays: While hygiene in food service is important, the nurse’s direct role in disposing of trays does not significantly contribute to HAV prevention. HAV is transmitted primarily through the fecal-oral route rather than leftover food on trays.

C. Emptying bed pans: Hepatitis A is spread via the fecal-oral route. Handling feces, especially without strict hand hygiene and appropriate protective equipment, poses a high risk for transmission. Therefore, careful attention is needed during this activity to prevent spread.

D. Taking an oral temperature: This involves mucosal contact but carries minimal risk of spreading hepatitis A, especially when using disposable covers and practicing standard precautions. It is not a primary concern for fecal-oral transmission.

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Naxlex Comprehensive Predictor Exams

Which of the following are correct about acute glomerulonephritis: (Select all that apply)

Correct Answer is ["A","B","C"]

Explanation

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Correct Answer is C

Explanation

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