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What is the most common cause of acute pyelonephritis resulting from an ascending infection from the lower urinary tract?
- A. The kidney is scarred and fibrotic.
- B. The organism is resistant to antibiotics.
- C. There is a preexisting abnormality of the urinary tract.
- D. The patient does not take all of the antibiotics for treatment of a UTI.
Correct Answer: C
Rationale: The correct answer is C. The most common cause of acute pyelonephritis from an ascending infection is a preexisting abnormality of the urinary tract. This abnormality can lead to urine stasis, making it easier for bacteria to ascend from the lower urinary tract to the kidneys. Choices A and B are incorrect because scarred kidneys and antibiotic resistance do not typically cause acute pyelonephritis. Choice D is incorrect as non-compliance with antibiotics may contribute to recurrent infections but is not the most common cause of pyelonephritis.
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The most frequent side effect of oral ampicillin is : *
- A. Nausea and vomiting
- B. Loose bowel movements
- C. Constipation
- D. Urticaria
Correct Answer: A
Rationale: The correct answer is A: Nausea and vomiting. Oral ampicillin commonly causes gastrointestinal side effects such as nausea and vomiting due to its impact on the gut flora. This side effect is a result of the antibiotic's mechanism of action and is well-documented in clinical practice. Choices B, C, and D are incorrect as loose bowel movements, constipation, and urticaria are not typically associated with oral ampicillin use.
Cloxacillin is indicated in infections caused by the following organism(s):
- A. Staphylococci
- B. Streptococci
- C. Gonococci
- D. All of the above
Correct Answer: A
Rationale: Cloxacillin is a beta-lactam antibiotic effective against Staphylococci. Staphylococci commonly cause skin and soft tissue infections. Streptococci are not typically treated with cloxacillin. Gonococci are not susceptible to cloxacillin. Therefore, the correct answer is A, as it is the only organism listed that is indicated for treatment with cloxacillin.
During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point the nurse suspects that this patient has:
- A. COM
- B. Genital warts.
- C. Herpes infection.
- D. Syphilitic chancr
Correct Answer: D
Rationale: The correct answer is D: Syphilitic chancre. The description of a red, round, superficial ulcer with a yellowish serous discharge on the penis, along with a nontender base that feels like a small button, is indicative of a primary syphilitic chancre. This lesion is typically painless and can be mistaken for other genital ulcers, but the specific characteristics described point towards syphilis. Genital warts (choice B) present as cauliflower-like growths, herpes infection (choice C) typically causes painful blisters, and chancroid (choice A) is characterized by soft, painful ulcers. Syphilitic chancre is the most likely diagnosis based on the presentation described.
The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to:
- A. Tell the patient that her examination is normal.
- B. Give her an immediate referral to a gynecologist.
- C. Suggest that she return in a month for a recheck to verify the findings.
- D. Tell the patient that she may have an ovarian cyst that should be evaluated further.
Correct Answer: B
Rationale: The correct answer is B because the findings of a firm, smooth uterine wall, palpable ovaries, and a firm, pulsating fallopian tube are concerning for possible gynecological issues such as ovarian cancer or pelvic inflammatory disease. A prompt referral to a gynecologist is necessary for further evaluation, which may include imaging studies or biopsies to rule out serious conditions. Choice A is incorrect as the findings are not normal. Choice C delays necessary evaluation, potentially leading to a progression of any underlying condition. Choice D assumes the presence of an ovarian cyst without further investigation, which is not appropriate given the pulsating fallopian tube and the need for a comprehensive assessment by a specialist.
During a physical examination, the nurse finds that a male patient’s foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is:
- A. Phimosis.
- B. Epispadias.
- C. Urethral stricture.
- D. Peyronie disease.
Correct Answer: A
Rationale: The correct answer is A: Phimosis. Phimosis is a condition where the foreskin is tight and cannot be retracted over the glans. This can lead to problems with hygiene and urination. Epispadias (B) is a congenital malformation where the urethra opens on the dorsal side of the penis. Urethral stricture (C) is a narrowing of the urethra, causing difficulty with urination. Peyronie disease (D) is the development of fibrous scar tissue inside the penis, leading to curvature during erection. In this case, the fixed and tight foreskin indicates phimosis.