NR507 ACTUAL EXAM LATEST 2024/2025 WITH DETAILED
QUESTIONS AND ANSWERS/ ALREADY GRADED A++
Which of the following can help to prevent a UTI?
A. Use spermicides during sexual intercourse
B. Taking more Vitamin D
C. Douching to prevent the growth of bacteria
D. Increase water consumption - ANSWER D. Increase water consumption
Water consumption prevents UTI as it keeps bacteria flushed out of the
urinary tract.
A symptom of a lower urinary tract infection includes:
A. Fever
B. Urgency
C. Flank pain
D. Decreased Urination - ANSWER B. Urgency is a symptom of lower tract
UTI.
Which of the following is a risk factor for the development of a urinary tract
infection (UTI)?
A. Pregnancy
B. Perimenopause
C. Marathon running
D. Frequent showering - ANSWER A. Pregnancy is a risk factor the
development of a UTI.
Women are at a higher risk for the development of a UTI because of having
a shorter urethra.
True
False - ANSWER True, women have a shorter urethra that puts them at
higher risk for developing a UTI.
Which of the following is true regarding a complicated urinary tract
infection?
A. It is usually asymptomatic
B. Bacteria is located mostly in the lower urinary tract
C. Is associated with young adults
,D. Can be caused by a structural urinary tract disorder - ANSWER D. A
complicated UTI can be caused by a structural issue in the urinary tract.
UTI Risk Factors - ANSWER Pregnancy
Women short ureter
Decreased estrogen in post-menopausal women
Sexual intercourse
Use of spermicide
Indwelling urinary catheterization
UTI Lower vs. Upper Tract Disorders - ANSWER Upper Urinary Tract
Disorder
When bacteria ascend from the bladder (lower urinary organs) to the
kidney. Classic triad: vomiting, flank pain and fever.
Upper Urinary Tract Symptoms:
All the symptoms associated with cystitis including
Fever
Flank pain
Costovertebral angle (CVA) tenderness
Nausea
Vomiting
Malaise
Condition of Upper UTI
Pyelonephritis.
Lower Urinary Tract Symptoms:
Urgency
Burning on urination
Frequency
Dysuria
Suprapubic Pain
Cloudy urine
Odorous.
Condition of Lower UTI
Cystitis
Urethritis
,Urethritis - ANSWER The infection occurs at the opening of the urethra
Cystitis - ANSWER Denotes a bladder infection
Pyelonephritis - ANSWER Inflammation of kidneys
Diagnostic UTI - ANSWER Urine dipstick
Urinalysis - used to diagnose a UTI
Urine Culture & Sensitivity
Urine Dipstick - ANSWER -Urine Dipstick can be observed for the presence
of leukocyte esterase and nitrites.
-A urine dipstick can be performed to identify hematuria, proteinuria, and
the presence of nitrites. The presence of nitrites i.s highly specific for
bacterial infection
-Note that an individual can have a negative urine dipstick but still present
with signs and symptoms of a UTI. If this is the case, then the NP can send
the urine for a culture and sensitivity (C&S) test and microscopy.
Blood Culture - ANSWER If sepsis is suspected, a blood culture may be
drawn to identify the causative organism or rule it out.
Urine Culture & Sensitivity - ANSWER Patient with cystitis will have a white
blood cell (WBC) count of greater than 5000 high power field (hpf) and
hematuria.
Patient with pyelonephritis, the urine will present with WBC casts. The
presence of casts in the urine indicates that the protein in the lumen of the
kidney tubules has solidified, especially in the nephron. This indicates
kidney disease rather than a lower UTI.
Urine can also be examined microscopically to determine the presence of a
lower or upper UTI. The following may be seen in urine examined under
microscopy:
- RBCs (red blood cells): greater than 3 RBCs/hpf is considered abnormal.
Abnormal morphology of the RBC strongly suggests glomerular disease.
RBCs are often present with a UTI (hematuria).
-WBCs: greater than 5 WBCs/hpf is considered abnormal. These will be
present in a UTI.
, -Bacteria: will be present
-Crystals: these are microscopic solids composed of a small number of
different ions and molecules. These are common in the urine and if they
remain small, are not pathologic.
-Casts: are long cylindrical structures formed in the renal tubules due to the
precipitation of Tamm-Horsfall mucoprotein. It is the most abundant protein
excreted by the urine. Casts form in concentrated and/or acidic urine. The
most common casts are hyaline casts that only consist of Tamm-Horsfall
protein without other constituents. They are non-specific and may be seen
in dehydration. Muddy brown casts suggest acute tubular necrosis. Waxy
casts are suggestive of acute and chronic renal failure. Fatty casts are
suggestive of nephrotic syndrome; RBC casts suggest glomerulonephritis
and WBC casts suggest interstitial inflammation.
Complicate vs. Uncomplicated UTI - ANSWER UTI may be classified as
complicated or uncomplicated in terms of its severity:
Complicated UTI, there is decreased renal function and an abnormal
urinary tract
-The more intervention required, the more complicated the infection
-Exception would be during pregnancy due to the ureteral dilation that
occurs that increases the risk for pyelonephritis. Even though she may be
asymptomatic, treatment would be initiated to prevent damage to the fetus
in utero.
-Complicated UTI (pyelonephritis) will require intravenous (IV antibiotics)
until the patient is afebrile, followed by a course of oral antibiotics. Overall,
the course of antibiotics for a complicated infection is longer than in an
individual that has an uncomplicated infection.
Uncomplicated UTI indicates that the urinary tract and renal function is
normal
-An uncomplicated, symptomatic UTI (cystitis) will typically require a 3-7
days course of appropriate antibiotic therapy.
Complicate vs. Uncomplicated UTI - ANSWER Complicated
-A UTI that extends beyond the bladder
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