Genitourinary System Assessment

Genitourinary System Assessment Related

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A 20 year old patient presented to the ER with headache, stiff neck and fever for 3 days and is diagnosed with bacterial meningitis. Which one of the following antibiotics is the best choice to treat meningitis?

  • A. Cefuroxime
  • B. Cephalexin
  • C. Cefotaxime
  • D. Cefdinir
Correct Answer: C

Rationale: The correct answer is Cefotaxime (C) because it is a third-generation cephalosporin with excellent penetration into the cerebrospinal fluid, making it effective against bacterial meningitis pathogens. Cefotaxime covers a broad spectrum of bacteria commonly causing meningitis, including Streptococcus pneumoniae and Neisseria meningitidis.

A: Cefuroxime (A) is not the best choice as it has limited activity against some of the common pathogens causing meningitis.
B: Cephalexin (B) is a first-generation cephalosporin with poor central nervous system penetration and limited activity against meningitis pathogens.
D: Cefdinir (D) is a third-generation cephalosporin but is not the preferred choice for treating bacterial meningitis due to its inferior CNS penetration compared to cefotaxime.

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Intravenous Plain NSS infusion is the treatment of choice for the following * complications of furosemide therapy:

  • A. Hypokalemia
  • B. Severe dehydration
  • C. Dilutional hyponatremia
  • D. None of the above
Correct Answer: C

Rationale: Rationale: Intravenous Plain NSS infusion is the treatment of choice for dilutional hyponatremia, which can occur as a complication of furosemide therapy due to excessive diuresis leading to low sodium levels. This solution helps restore normal sodium levels without affecting the fluid balance.

Summary:
A: Hypokalemia - Furosemide therapy can cause hypokalemia, which is usually treated with potassium supplements, not NSS infusion.
B: Severe dehydration - NSS infusion may be used for severe dehydration but is not specific to furosemide therapy complications.
D: None of the above - Incorrect, as C is the correct answer for dilutional hyponatremia.

Superinfections are more common with:

  • A. Use of narrow spectrum antibiotics
  • B. Short courses of antibiotics
  • C. Use of antibiotics that are completely absorbed from the small intestines
  • D. Use of antibiotic combinations covering both gram positive and gram negative bacteria
Correct Answer: D

Rationale: The correct answer is D because using antibiotic combinations covering both gram positive and gram negative bacteria can disrupt the balance of normal flora in the body, leading to superinfections. Gram positive and gram negative bacteria have different susceptibility patterns, so using a combination of antibiotics increases the likelihood of killing off a wider range of bacteria, including the beneficial ones. This disruption paves the way for opportunistic pathogens to overgrow and cause superinfections. Choices A, B, and C are incorrect because narrow spectrum antibiotics target specific bacteria, short courses of antibiotics reduce the risk of resistance and overgrowth, and antibiotics completely absorbed from the small intestines have minimal impact on gut flora compared to systemic antibiotics.

Which test is required for a diagnosis of pyelonephritis?

  • A. Renal biopsy
  • B. Blood culture
  • C. Intravenous pyelogram (IVP)
  • D. Urine for culture and sensitivity
Correct Answer: D

Rationale: The correct answer is D, Urine for culture and sensitivity. This test is required for a diagnosis of pyelonephritis as it helps identify the specific bacteria causing the infection and determines the most effective antibiotic treatment. Renal biopsy (A) is not typically required for diagnosing pyelonephritis. Blood culture (B) may be helpful in severe cases but is not specific for pyelonephritis. Intravenous pyelogram (IVP) (C) is a radiological test used to visualize the urinary tract but does not confirm the diagnosis of pyelonephritis.

When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely:

  • A. From urethritis.
  • B. Sebaceous cysts.
  • C. Subcutaneous plaques.
  • D. COM
Correct Answer: B

Rationale: The correct answer is B: Sebaceous cysts. Sebaceous cysts are commonly seen as firm, nontender, yellow nodules in the scrotum. They are benign growths formed from blocked sebaceous glands. Urethritis (A) would present with symptoms such as pain or burning during urination, not as nodules on the scrotum. Subcutaneous plaques (C) are typically seen in conditions like Peyronie's disease, not as discrete nodules. COM (D) is not a recognized term in this context.

Mrs. Miller has a diagnosis of acute pyelonephritis. To prevent renal damage her plan of care should include

  • A. restricting fluid intake until symptoms are under control
  • B. reducing protein intake
  • C. understanding the necessity of continuing drug therapy indefinitely
  • D. preventing viral infections
Correct Answer: C

Rationale: Correct Answer: C

Rationale:
1. Acute pyelonephritis requires antibiotic therapy to eliminate the infection and prevent renal damage.
2. Continuing drug therapy indefinitely ensures complete eradication of the infection.
3. Stopping drug therapy prematurely can lead to recurrence and potential renal complications.
4. Understanding the necessity of drug therapy is crucial for Mrs. Miller's long-term renal health.

Summary:
A: Incorrect. Restricting fluid intake can worsen the infection and hinder recovery.
B: Incorrect. Protein intake is not directly related to the treatment of acute pyelonephritis.
D: Incorrect. Preventing viral infections is not directly relevant to the treatment of acute pyelonephritis.

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