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Lewis Chapter 45: Renal and Urological Problems -questions and answers
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Lewis Chapter 45: Renal and Urological Problems -questions and answers
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Lewis Chapter 45: Renal and UrologicalProblems -questions and answers
A \patient \returns \to \the \clinic \with \recurrent \dysuria \after \being \treated \with \trimethoprim \and \
sulfamethoxazole \(Bactrim) \for \3 \days. \Which \action \will \the \nurse \plan \to \take?
a. \Remind \the \patient \about \the \need \to \drink \1000 \mL \of \fluids \daily.
b. \Obtain \a \midstream \urine \specimen \for \culture \and \sensitivity \testing.
c. \Teach \the \patient \to \take \the \prescribed \Bactrim \for \at \least \3 \more \days.
d. \Suggest \that \the \patient \use \acetaminophen \(Tylenol) \to \treat \the \symptoms. \- \ANSWERS✔✔ \ANS: \B
Since \uncomplicated \urinary \tract \infections \(UTIs) \are \usually \successfully \treated \with \3 \days \of \
antibiotic \therapy, \this \patient \will \need \a \urine \culture \and \sensitivity \to \determine \appropriate \
antibiotic \therapy. \Tylenol \would \not \be \as \effective \as \other \over-the-counter \(OTC) \medications \such \
as \phenazopyridine \(Pyridium) \in \treating \dysuria. \The \fluid \intake \should \be \increased \to \at \least \1800 \
mL/day. \Since \the \UTI \has \persisted \after \treatment \with \Bactrim, \the \patient \is \likely \to \need \a \
different \antibiotic.
DIF: \Cognitive \Level: \Application \REF: \1123-1125
The \nurse \determines \that \instruction \regarding \prevention \of \future \urinary \tract \infections \(UTIs) \for \
a \patient \with \cystitis \has \been \effective \when \the \patient \states,
a. \"I \can \use \vaginal \sprays \to \reduce \bacteria."
b. \"I \will \drink \a \quart \of \water \or \other \fluids \every \day."
c. \"I \will \wash \with \soap \and \water \before \sexual \intercourse."
d. \"I \will \empty \my \bladder \every \3 \to \4 \hours \during \the \day." \- \ANSWERS✔✔ \ANS: \D
Voiding \every \3 \to \4 \hours \is \recommended \to \prevent \UTIs. \Use \of \vaginal \sprays \is \dis-
couraged. \The \bladder \should \be \emptied \before \and \after \intercourse, \but \cleaning \with \soap \and \
water \is \not \necessary. \A \quart \of \fluids \is \insufficient \to \provide \adequate \urine \output \to \decrease \
risk \for \UTI.
Which \information \will \the \nurse \include \when \teaching \the \patient \with \a \urinary \tract \infection \(UTI) \
about \the \use \of \phenazopyridine \(Pyridium)?
,a. \Take \the \medication \for \at \least \7 \days.
b. \Use \sunscreen \while \taking \the \Pyridium.
c. \The \urine \may \turn \a \reddish-orange \color.
d. \Use \the \Pyridium \before \sexual \intercourse. \- \ANSWERS✔✔ \ANS: \C
Patients \should \be \taught \that \Pyridium \will \color \the \urine \deep \orange. \Urinary \analgesics \should \
only \be \needed \for \a \few \days \until \the \prescribed \antibiotics \decrease \the \bacterial \count. \Taking \
Pyridium \before \intercourse \will \not \be \helpful \in \reducing \the \risk \for \UTI. \Pyridium \does \not \cause \
photosensitivity.
A \72-year-old \who \has \benign \prostatic \hyperplasia \is \admitted \to \the \hospital \with \chills, \fever, \and \
vomiting. \Which \finding \by \the \nurse \will \be \most \helpful \in \determining \whether \the \patient \has \an \
upper \urinary \tract \infection \(UTI)?
a. \Suprapubic \pain
b. \Bladder \distention
c. \Foul-smelling \urine
d. \Costovertebral \tenderness \- \ANSWERS✔✔ \ANS: \D
Costovertebral \tenderness \is \characteristic \of \pyelonephritis. \The \other \symptoms \are \characteristic \of \
lower \UTI \and \are \likely \to \be \present \if \the \patient \also \has \an \upper \UTI.
DIF: \Cognitive \Level: \Application \REF: \1128
After \teaching \a \patient \with \interstitial \cystitis \about \management \of \the \condition, \the \nurse \
determines \that \further \instruction \is \needed \when \the \patient \says,
a. \"I \will \have \to \stop \having \coffee \and \orange \juice \for \breakfast."
b. \"I \should \start \taking \a \high \potency \multiple \vitamin \every \morning."
c. \"I \will \buy \some \calcium \glycerophosphate \(Prelief) \at \the \pharmacy."
d. \"I \should \call \the \doctor \about \increased \bladder \pain \or \odorous \urine." \- \ANSWERS✔✔ \ANS: \B
High-potency \multiple \vitamins \may \irritate \the \bladder \and \increase \symptoms. \The \other \patient \
statements \indicate \good \understanding \of \the \teaching.
When \admitting \a \patient \with \acute \glomerulonephritis, \it \is \most \important \that \the \nurse \ask \the \
patient \about
, a. \recent \sore \throat \and \fever.
b. \history \of \high \blood \pressure.
c. \frequency \of \bladder \infections.
d. \family \history \of \kidney \stones. \- \ANSWERS✔✔ \ANS: \A
Acute \glomerulonephritis \frequently \occurs \after \a \streptococcal \infection \such \as \strep \throat. \It \is \
not \caused \by \hypertension, \urinary \tract \infection \(UTI), \or \kidney \stones.
DIF: \Cognitive \Level: \Application \REF: \1131-1132
Which \finding \by \the \nurse \for \a \patient \admitted \with \glomerulonephritis \indicates \that \treatment \has
\been \effective?
a. \The \patient \denies \pain \with \voiding.
b. \The \urine \dipstick \is \negative \for \nitrites.
c. \Peripheral \and \periorbital \edema \is \resolved.
d. \The \antistreptolysin-O \(ASO) \titer \is \decreased. \- \ANSWERS✔✔ \ANS: \C
Since \edema \is \a \common \clinical \manifestation \of \glomerulonephritis, \resolution \of \the \edema \
indicates \that \the \prescribed \therapies \have \been \effective. \Antibodies \to \streptococcus \will \persist \
after \a \streptococcal \infection. \Nitrites \will \be \negative \and \the \patient \will \not \experience \dysuria \
since \the \patient \does \not \have \a \urinary \tract \infection.
DIF: \Cognitive \Level: \Application \REF: \1131-1133
A \patient \with \nephrotic \syndrome \develops \flank \pain. \The \nurse \will \anticipate \teaching \the \patient \
about \treatment \with
a. \antibiotics.
b. \anticoagulants.
c. \corticosteroids.
d. \antihypertensives. \- \ANSWERS✔✔ \ANS: \B
Flank \pain \in \a \patient \with \nephrosis \suggests \a \renal \vein \thrombosis, \and \anticoagulation \is \needed. \
Antibiotics \are \used \to \treat \a \patient \with \flank \pain \caused \by \pyelonephritis. \Antihypertensives \are \
used \if \the \patient \has \high \blood \pressure. \Corticosteroids \may \be \used \to \treat \nephrotic \syndrome \
but \will \not \resolve \a \thrombosis.
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