Randi, a 24 year old, reports that "I have been urinating two to three times an hour, and it burns and itches and smells awful. My belly feels "yucky." When you ask Randi about pain, she states: "I don't have any pain at the back of my waist." Her temperature is 99.8°F. A clean voided urine sample is positive for leukocytes and the bacterium E. coli. Randi's UTI is most likely to be a(n):
Glomerulonephritis
Kidney calculi
Lower UTI: cystitis (bladder infection) and possibly lower ureters
Upper UTI (pyelonephritis)
The Correct Answer is C
A. Glomerulonephritis: This is an immune-mediated condition involving inflammation of the glomeruli and typically presents with proteinuria, hematuria, hypertension, and edema rather than urinary frequency, burning, or foul-smelling urine. The presence of E. coli and leukocytes does not support this diagnosis.
B. Kidney calculi: Kidney stones may present with flank pain, hematuria, and sometimes nausea or vomiting, but are not usually associated with urinary frequency, burning, or bacterial growth on urine culture. Randi’s symptoms point more toward an infectious etiology rather than a structural obstruction.
C. Lower UTI: cystitis (bladder infection) and possibly lower ureters: The burning, itching, frequent urination, and foul smell are classic signs of cystitis. The absence of flank pain and only a slightly elevated temperature further supports a lower tract infection rather than an upper one.
D. Upper UTI (pyelonephritis): Pyelonephritis typically presents with fever over 101°F, chills, nausea, vomiting, and significant costovertebral angle (CVA) tenderness or back/flank pain. Since Randi denies back pain and has only a mild temperature elevation, an upper UTI is unlikely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The Somogyi effect results from an excessive insulin dose causing hypoglycemia overnight, triggering a rebound hyperglycemia via release of glucagon, cortisol, and growth hormone. In contrast, the dawn phenomenon is a natural early morning rise in blood glucose due to circadian increases in cortisol and growth hormone without preceding hypoglycemia.
B. The Somogyi effect happens only in type 2 diabetes, while the dawn phenomenon happens only in type 1 diabetes: Both effects can occur in either type 1 or type 2 diabetes depending on insulin therapy and individual physiology.
C. Both the Somogyi effect and the dawn phenomenon occur due to nighttime hyperglycemia: The Somogyi effect starts with nighttime hypoglycemia, not hyperglycemia, while the dawn phenomenon involves a gradual early morning rise in glucose levels.
D. The Somogyi effect is caused by insufficient insulin at night, while the dawn phenomenon is caused by excessive nighttime insulin: The Somogyi effect is caused by excessive insulin leading to hypoglycemia, not insufficient insulin. The dawn phenomenon is unrelated to nighttime insulin dosing and is caused by hormonal changes.
Correct Answer is A
Explanation
A. The liver metabolizes most components of food (protein, carbohydrates and fats) and also cleans the blood of bacteria and drugs: The liver plays a central role in metabolism, including converting nutrients into energy or storage forms, breaking down toxins, metabolizing drugs, and filtering bacteria from the blood via Kupffer cells.
B. The liver maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals and vitamins: While the liver stores glycogen and some vitamins and minerals, it does not directly regulate electrolyte or pH balance, which is primarily the function of the kidneys and respiratory system.
C. The liver is responsible for the absorption of most dietary nutrients as well as the production of growth hormones: Nutrient absorption is mainly the role of the small intestine. Growth hormone is produced by the pituitary gland, not the liver, making this statement inaccurate.
D. The liver contributes to the metabolism of ingested food and provides the fluids that the GI tract requires: Although the liver produces bile, which aids in fat digestion, it does not supply most of the fluids needed by the GI tract. Salivary glands, gastric glands, pancreas, and intestines contribute the majority of GI fluids.
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