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On assessment of the patient with a renal calculus passing down the ureter, what should the nurse expect the patient to report?
- A. A history of chronic UTIs
- B. Dull, costovertebral flank pain
- C. Severe, colicky back pain radiating to the groin
- D. A feeling of bladder fullness with urgency and frequency
Correct Answer: C
Rationale: The correct answer is C: Severe, colicky back pain radiating to the groin. This type of pain is characteristic of renal colic caused by a renal calculus passing down the ureter. The sharp, severe pain originates in the flank and radiates to the groin as the stone moves. Choices A and D are incorrect because they do not describe the typical pain associated with renal colic. Choice B describes dull, costovertebral flank pain, which is not characteristic of the sharp, severe colicky pain seen in renal colic. Therefore, option C is the most appropriate response based on the typical presentation of a patient with a renal calculus passing down the ureter.
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Which antibiotic course is inappropriate for clinical scenario?
- A. Acute simple cystitis - trimethoprim for 3 days in otherwise well young women.
- B. Acute uncomplicated pyelonephritis - gentamycin + amoxicillin IV initially followed by 7 days of Augmentin orally.
- C. Pregnancy associated cystitis - nitrofurantoin 5 mg QID for 14 days.
- D. Acute simple cystitis in male patients - Augmentin or trimethoprim for 14 days.
Correct Answer: B
Rationale: The correct answer is B because the antibiotic regimen for acute uncomplicated pyelonephritis should not include gentamycin due to its potential toxicity and nephrotoxicity. The initial use of IV gentamycin is not recommended for uncomplicated pyelonephritis. The combination of gentamycin and amoxicillin is not the standard treatment for this condition. Gentamycin should be reserved for more serious infections. The choice of Augmentin for 7 days orally is also not the standard of care for pyelonephritis. The other choices (A, C, D) are appropriate antibiotic regimens for the corresponding clinical scenarios.
Where are the glomeruli and Bowman’s capsules found?
- A. Renal pelvis
- B. Ureter
- C. Renal cortex
- D. Renal column
Correct Answer: C
Rationale: The glomeruli and Bowman's capsules are found in the renal cortex. The renal cortex is the outer layer of the kidney where the initial stages of urine formation occur. Glomeruli are clusters of capillaries responsible for filtering blood, while Bowman's capsules surround the glomeruli and collect the filtrate. The renal pelvis (A) is the innermost part of the kidney where urine collects before entering the ureter (B). Renal columns (D) are extensions of the renal cortex that project into the renal medulla. Therefore, the correct answer is C as it accurately locates the structures involved in urine filtration.
A gerontologic nurse is assessing a patient who has
- A. The patients suprapubic region is dull on percussion. numerous comorbid health problems. What assessment
- B. The patient is uncharacteristically drowsy. findings should prompt the nurse to suspect a UTI?
- C. The patient claims to void large amounts of urine 2 to Select all that apply.
- D. Food cravings
Correct Answer: B
Rationale: The correct answer is B because uncharacteristic drowsiness can be a sign of a urinary tract infection (UTI) in older adults. UTIs can present atypically in older adults with symptoms like confusion, lethargy, and drowsiness. The other choices are incorrect because:
A: A dull suprapubic region on percussion is not specific to UTI.
C: Voiding large amounts of urine is not a typical symptom of UTI.
D: Food cravings are not associated with UTI symptoms.
A 25-year-old woman is concerned about the possibility of an STI. The nurse asks about her sexual history and recommends that she be tested for sexually transmitted infections (STIs). Which of the following STIs can be detected through a Pap smear?
- A. Chlamydia.
- B. Gonorrhea.
- C. Trichomoniasis.
- D. HPV.
Correct Answer: C
Rationale: The correct answer is C: Trichomoniasis. A Pap smear can detect abnormal changes in the cervix caused by Trichomoniasis, which is a common STI. The test can identify the presence of the parasite Trichomonas vaginalis. The other choices, A: Chlamydia, B: Gonorrhea, and D: HPV, cannot be detected through a Pap smear as they require specific tests such as urine tests, swab tests, or blood tests. Chlamydia and Gonorrhea are bacterial infections, while HPV is a viral infection that can lead to cervical cancer but is not detectable through a Pap smear alone.
The highest incidence of antibiotic associated pseudomembranous enterocolitis has been noted with the use of:
- A. Ampicillin
- B. Chloramphenicol
- C. Vancomycin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with the highest incidence of antibiotic-associated pseudomembranous enterocolitis due to its broad-spectrum activity that disrupts the normal gut flora, leading to overgrowth of Clostridium difficile. Ampicillin, Chloramphenicol, and Vancomycin are also associated with pseudomembranous enterocolitis, but the highest incidence is seen with Clindamycin due to its stronger impact on gut flora imbalance.