UTI NCLEX PEARSON QUESTIONS

UTI NCLEX PEARSON QUESTIONS

A client is admitted to the emergency department for possible acute pyelonephritis. Which manifestation should the nurse consider to be consistent with this disorder? (Select all that apply.) A.Vomiting B.Urinary frequency C.Diarrhea D.Flank tenderness E.Nocturia Rationale: The nurse should monitor a client with suspected acute pyelonephritis for flank tenderness, vomiting, diarrhea, and urinary frequency. Other manifestations the client may present with are high fever, chills, costovertebral angle tenderness, and moderate to severe dehydration. Nocturia is a manifestation of cystitis, not acute pyelonephritis.The nurse is caring for a client diagnosed with a urinary tract infection (UTI). Which assessment finding supports this diagnosis?(Select all that apply.) A.Burning sensation on urination B.Clear urine C.Flank pain D.Hypothermia E.Abdominal pain Rationale: Assessment findings that support the diagnosis of a UTI include abdominal pain, flank pain, and a burning sensation when urinating. Cloudy, dark, foul-smelling urine is also expected with a UTI. Hyperthermia (fever), not hypothermia, supports the diagnosis of a UTI.The nurse is caring for a client with a urinary tract infection (UTI). Which condition should the nurse determine as a possible cause?(Select all that apply.) A.Use of antibiotics B.Vesicoureteral reflux C.Structural deviations D.Excessive oral fluid intake E.Renal scarring Rationale: The causes of UTIs include structural deviations, renal scarring, and vesicoureteral reflux. Excessive oral fluid intake or use of antibiotics does not cause UTIs.The nurse is caring for a client with pyelonephritis. Which clinical manifestation should the nurse assess in the client? (Select all that apply.) A.Fever B.Enuresis C.Flank pain

D.Vomiting E.Dysuria Rationale: Clinical manifestations that occur with pyelonephritis include fever, vomiting, and flank pain. Enuresis and dysuria occur with cystitis.The nurse is teaching the parents of an 18-month-old female toddler with a urinary tract infection (UTI). Which should be included in the teaching to prevent the future risk of a UTI?A.Increase the child's fluid intake.B.Increase the child's intake of vitamin C.C.Cleanse the perineal area front to back.D.Provide the child with a daily cup of low-sugar cranberry juice.Rationale: The incidence of UTIs in toddlers and children is higher among girls than boys because the shorter female urethra has a closer proximity to the anus and vagina, increasing the risk of contamination by fecal bacteria. When cleansing the perineal area, it is important to wipe from front to back to prevent the transfer of gastrointestinal bacteria to the urethra. Adequate fluids should be provided to prevent dehydration. Two daily cups of low-sugar cranberry juice and increased vitamin C is recommended to prevent UTIs in adults.A client asks which fluids to avoid in light of repeated urinary tract infections (UTIs). Which food should the nurse teach the client to avoid? (Select all that apply.) A.Citrus juices B.Cranberry juice C.Coffee D.Alcoholic beverages E.Milk Rationale: Avoiding citrus juices, alcoholic beverages, and coffee can help prevent UTIs. Caffeine, citrus juices, alcohol, and artificial sweeteners irritate bladder mucosa and the detrusor muscle and can increase urgency and bladder spasms.Increasing the intake of cranberry juice, not avoiding it, can help prevent UTIs because it acidifies the urine. Milk intake has no known effect in preventing UTIs.Which topic is important to include in the home care teaching for a client with a urinary tract infection (UTI)? (Select all that apply.) A.Adequate fluid consumption B.Proper nutrition C.Voiding every 5 to 6 hours D.Good hygiene methods E.Wearing polyester underwear Rationale: Home care teaching for a client with a UTI includes information about good hygiene methods, proper nutrition, and adequate fluid consumption. Increased fluids dilute the urine, reducing irritation of the inflamed bladder and urethral mucosa. Instruct women to cleanse the perineal area from front to back after voiding and defecating, to prevent the transfer of gastrointestinal bacteria to the urethra. Teach clients to void and wash the perineal area before and after sexual intercourse to flush out bacteria introduced into the urethra

and bladder. Teach measures to maintain the integrity of perineal tissues, such as avoiding bubble baths, feminine hygiene sprays, and vaginal douches, and wearing cotton briefs rather than underwear made from synthetic materials. Frequent voiding (every 3dash4 hours) is encouraged.The nurse is teaching a female client about the prevention of urinary tract infections (UTIs). Which information should the nurse include?A."Void after intercourse." B."Wash the perineum after intercourse." C."Avoid bubble baths." D."Empty the bladder every 2 hours." Rationale: The information the nurse should include in the teaching about preventing UTIs is to avoid bubble baths. Avoiding bubble baths helps to maintain the integrity of the perineum. Clients should void and wash the perineum before and after intercourse. The bladder should be emptied every 3dash4 hours.The nurse is caring for a postpartum client. Which intervention is the most important for the nurse to integrate into the plan of care to prevent a urinary tract infection (UTI)?A."Increase fluid intake." B."Change peri pads every 4 hours." C."Use an antiseptic preparation after voiding." D."Empty the bladder completely." Rationale: The postpartum woman is at an increased risk of developing urinary tract problems caused by normal postpartum diuresis, increased bladder capacity, and decreased bladder sensitivity from stretching or trauma. These factors make it essential for the mother to empty her bladder completely with each voiding. Fluid intake is important, but it is not related to the main cause of UTIs in the postpartum period. Peri pads should be changed every time the client voids, followed by perineal cleansing before placement of a new pad. Antiseptic solutions are not used on the perineum of a postpartum client.The nurse is teaching parents of school-age children practices that should decrease the risk of urinary tract infections (UTIs). Which information should the nurse include?A."Encourage the child to void five to six times a day." B."Provide drinks with sugar substitutes when possible." C."Encourage juices to increase the acidity of the child's urine." D."Avoid large amounts of dairy in the child's diet." Rationale: The information the nurse can include in the teaching to prevent UTIs in children is to encourage them to void five to six times a day. Infrequent voiding, which is common in school-age children, results in incomplete emptying of the bladder and urinary stasis, both of which are factors in the development of UTIs. Dairy is associated with an increased risk of UTIs, but it is not the major contributing factor for UTIs in children. Juices and sugar substitutes in drinks are associated with UTIs.For which client should the nurse question the healthcare provider's order for a 7- to 10-day course of antibiotics?A.A female client with uncomplicated cystitis B.A female client with urinary tract abnormalities

C.A male client with pyelonephritis D.A male client with a history of antibiotic-resistant infections Rationale: Most uncomplicated infections of the lower urinary tract can be treated with a short course of antibiotic therapy, either a single antibiotic dose or a 3-day course of treatment. Single-dose therapy is associated with a higher rate of recurrent infection and continued vaginal colonization with Escherichia coli, making a 3-day course of treatment the preferred option for uncomplicated cystitis. Men and women with pyelonephritis, urinary tract abnormalities or stones, or a history of antibiotic-resistant infections require a 7- to 10-day course of trimethoprim-sulfamethoxazole, ciprofloxacin, ofloxacin, or an alternative antibiotic.The nurse has admitted a client to the unit for treatment of acute pyelonephritis. Which collaborative intervention does the nurse anticipate initiating as a priority?A.Administration of an analgesic B.Administration of intravenous (IV) antibiotics C.Order for a urine specimen for culture and sensitivity D.Order for a complete blood count (CBC) with a differential Rationale: The nurse can anticipate an order for a urine specimen for a culture and sensitivity to identify the infecting organism before antibiotics are started. An analgesic can be given if needed, but treatment of the infection is a priority. A CBC with a differential can be obtained to examine the WBC count for changes typically associated with infection. IV antibiotics can be administered after the urine sample for a culture and sensitivity has been obtained.The nurse is caring for a client with chronic urinary tract infections (UTIs) suspected of having a vesicoureteral reflux. Which collaborative intervention should the nurse anticipate?A.Voiding cystourethrography B.Intravenous pyelography C.Renal ultrasound D.Cystoscopy Rationale: Intravenous pyelography is used to detect structural and functional abnormalities such as vesicoureteral reflux. Cystoscopy provides direct visualization of the urethra and bladder. Renal ultrasound is used to detect pyelonephritis. Voiding cystourethrography is utilized to assess structural and functional abnormalities of the bladder and urethra.The nurse is caring for a client experiencing urinary retention. Which preventive catheter-associated urinary tract infection (CAUTI) measure should the nurse take to protect the client from a urinary tract infection (UTI)?A.Consider an alternative to an indwelling catheter.B.Review the criteria for catheter insertion.C.Obtain a urine sample for a urinalysis.D.Initiate an antibiotic before inserting a catheter.Rationale: The alternative to an indwelling catheter is to use intermittent straight catheterization to relieve urinary retention. Using intermittent straight catheterization allows the bladder to fill and completely empty more normally, maintaining physiologic function. Obtaining a urine sample for a urinalysis will not address the problem of urinary retention. Reviewing the criteria for catheter insertion is a preventive CAUTI measure, but urinary retention is one of the