The nurse is assessing a client suspected of having a lower urinary tract infection (UTI). Which of the following findings should the nurse expect?
Reports of malaise.
Chills.
Reports of dysuria.
High fever.
Reports of urinary frequency.
Correct Answer : C,E
Choice A rationale
Malaise is more associated with systemic conditions, such as upper urinary tract infections or generalized illness, rather than isolated lower urinary tract infections. Lower UTIs tend to present with localized urinary symptoms rather than systemic effects.
Choice B rationale
Chills suggest systemic involvement and are characteristic of pyelonephritis or upper urinary tract infections. Lower UTIs typically do not produce systemic signs like chills, as the infection is confined to the bladder and urethra.
Choice C rationale
Dysuria is a classic symptom of lower UTIs. It results from inflammation of the bladder mucosa due to the presence of pathogenic organisms. The irritation of the urinary tract leads to painful or difficult urination, confirming the diagnosis of lower UTI.
Choice D rationale
High fever, like chills, is indicative of upper urinary tract infections, such as pyelonephritis. Lower UTIs are generally afebrile, presenting more with localized urinary symptoms rather than systemic manifestations.
Choice E rationale
Urinary frequency is another hallmark symptom of lower UTIs, caused by bladder irritation. The infection leads to an increased urge to urinate, even when little urine is produced. This symptom is specific to lower UTIs and supports the diagnosis when present.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A low sodium, high-calorie diet does not directly address severe pain caused by renal colic. Dietary interventions are long-term strategies for kidney health but are not immediate priorities for acute pain relief. Renal colic pain requires prompt management with pharmacological interventions to alleviate severe discomfort. Adjusting dietary intake may support prevention but would not resolve the acute symptoms, emphasizing that this is not the first-line measure for this clinical situation.
Choice B rationale
Increasing fluid intake to 3–4 L/day is beneficial for flushing out kidney stones and preventing further stone formation. However, this intervention does not directly alleviate severe pain experienced during an episode of renal colic. While adequate hydration is crucial for long-term management, acute pain demands immediate pharmacological relief. Therefore, fluid intake implementation is secondary when compared to pain management priorities.
Choice C rationale
Tamsulosin (Flomax) is an alpha-blocker that promotes the passage of kidney stones by relaxing the smooth muscles of the ureter. Although effective in expediting stone passage, it does not provide immediate pain relief for severe renal colic. Its role is valuable for the resolution of the obstruction but does not address acute symptoms. Administering pain medication remains a priority to manage distress caused by colic episodes.
Choice D rationale
Morphine sulfate is an opioid analgesic that directly targets severe pain associated with renal colic. It binds to mu-opioid receptors in the central nervous system, producing analgesia and a calming effect. Its rapid onset and effectiveness in severe pain management make it the first prescription to implement. Pain relief improves the client's comfort and allows for addressing underlying causes of colic after stabilizing acute distress.
Correct Answer is C
Explanation
Choice A rationale
Right and left-sided diastolic failure refers to impairment in ventricular relaxation in both sides of the heart. This prevents proper ventricular filling, leading to decreased cardiac output and congestion in pulmonary and systemic circuits. However, the condition described involves only the right heart, making this option incorrect scientifically.
Choice B rationale
Right-sided systolic and diastolic failure involves impaired right ventricular contraction (systolic) and relaxation (diastolic). Since the scenario specifically focuses on diastolic dysfunction alone due to ventricular thickening, systolic dysfunction is not implicated. Thus, this choice does not align with the clinical presentation given.
Choice C rationale
Right-sided diastolic failure is characterized by thickened ventricular walls (often due to hypertrophy or restrictive cardiomyopathy) that impair ventricular relaxation. This reduces ventricular filling, leading to systemic venous congestion. The described pathology fits this condition, making it the accurate answer according to the description of right-sided heart failure.
Choice D rationale
Right-sided systolic failure occurs when the heart cannot effectively pump blood out of the right ventricle due to weakened contraction. Since the described issue involves diastolic dysfunction from thickened myocardial walls, systolic dysfunction is not a feature here, rendering this option scientifically incorrect. .
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