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NR 507 FINAL REVIEWED QUESTIONS AND ANSWERS

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NR 507 FINAL REVIEWED QUESTIONS AND ANSWERS Which of the following is true regarding a complicated urinary tract infection? - CORRECT ANSWER-Can be caused by a structural urinary tract disorder Which of the following is a risk factor for the development of a urinary tract infection (UTI)? - CORRECT ANSWER-Pregnancy A symptom of a lower urinary tract infection includes: - CORRECT ANSWER-urgency Women are at a higher risk for the development of a UTI because of having a shorter urethra. - CORRECT ANSWER-true Which of the following can help to prevent a UTI? - CORRECT ANSWER-Increase water consumption Uncomplicated UTI - CORRECT ANSWER-Occurs in the normal urinary tract Responds well to short course of antibiotic therapy Simple cystitis in non-pregnant women without any urologic abnormalities Complicated UTI - CORRECT ANSWER-UTI extends beyond the bladder Caused by structural or functional urinary tract abnormalities or untreated UTI Infants and older adults affected Associated with: indwelling catheters, renal calculi, diabetes, pregnancy A 25 year- old female presents to the primary care office with urinary burning and frequency for the last 3 days. She denies any fever, chills, back pain. Her gynecological history is negative and reports no vaginal discharge. The only new information reported is that she recently had sexual intercourse with a new male partner. The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs, nitrites, and WBCs. No casts are identified. Based on symptom presentation and UA results, the patient can be diagnosed with: - CORRECT ANSWER-cystitis J.S. is an 80 -year-old patient who resides in a local nursing home. He recently became confused and then fell while ambulating to the bathroom three days ago. Because of his confusion and fall, he was transferred to the acute care facility for evaluation and treatment. Lab work revealed that the patient was very dehydrated with hypernatremia identified and appropriate intravenous fluids started. Cystitis was also identified from the urinalysis. He was also noted to have red and excoriated skin between the buttocks and inner thighs due to urinary frequency and dribbling. To help with skin healing and to prevent further urine leakage, an indwelling catheter was inserted. Two days after the catheter was placed, the patient spiked a fever of 102 degrees Fahrenheit associated with shaking chills. An intense, foul odor was noted in the urine. On examination of the flank area, the patient yelled out when touched. A urine c - CORRECT ANSWERpyelonephritis Identify the major risk factor J.S. has that is associated with pyelonephritis: - CORRECT ANSWER-indwelling foley catheter The urinalysis of a patient with a complicated UTI will show WBCs and casts - CORRECT ANSWER-true Upon examination of a urinalysis, the NP can highly suspect that the causative bacteria are gram negative because of the presence of: - CORRECT ANSWER-nitrites A 21-year-old patient reports to the primary care clinic complaining of urinary urgency, frequency and burning. She also reports a small amount of vaginal discharge that contains an odor. It is likely that the NP will perform a vaginal exam at this visit. - CORRECT ANSWER-true The NP would know that the patient most likely has an uncomplicated UTI because: - CORRECT ANSWER-The UTI responds well to a short course of antibiotic therapy. A common organism that causes a urinary tract infection include: - CORRECT ANSWER-Staphylococcus saprophyticus. E coli The purpose of straining in BPH is to overcome the obstruction encountered during urination. - CORRECT ANSWER-true The peripheral zone of the prostate is the largest zone. - CORRECT ANSWER-true On a digital rectal exam to assess the quality of the prostate, the NP would be concerned with which of the following findings? - CORRECT ANSWER-hard nodule There is a significant risk for men with benign prostatic hyperplasia (BPH) to develop cellular mutations that lead to prostate cancer. - CORRECT ANSWER-false The patient most often develops symptoms of BPH when: - CORRECT ANSWER-The prostatic urethra becomes obstructed. Irritative symptoms - CORRECT ANSWER-urinary frequency nocturia urgency that results from bladder hypertrophy and dysfunction obstructive symptoms - CORRECT ANSWER-incomplete emptying post-void dribbling The action of a 5-Alpha-reductase inhibitor causes: - CORRECT ANSWER-Shrinkage of the prostate gland. Men who have BPH are prone to developing a UTI because: - CORRECT ANSWERStagnated urine in the bladder promotes bacterial growth. The prostate specific antigen (PSA) helps to liquefy semen post-ejaculation. - CORRECT ANSWER-true The underlying cause of BPH is that normal prostate cells respond to increases in dihydrotestosterone that causes them to live longer and multiply. - CORRECT ANSWER-true The location of the characteristic hyperplastic nodules of BPH is: - CORRECT ANSWER-In the periurethral zone. The type of stone that forms due to a urinary tract infection is: - CORRECT ANSWERStruvite stone. Renal stones are formed when calcium and oxalate in the urine combine. - CORRECT ANSWER-true Renal calculi are typically confined to the bladder. - CORRECT ANSWER-false The most common type of stone is: - CORRECT ANSWER-calcium stone The gold standard for diagnosing a renal stone is a urinalysis. - CORRECT ANSWERfalse (ct scan) A 45-year-old male presents to the primary care office with right flank pain that he describes as unremitting; he also reports nausea and vomiting. The NP performs an exam and observes him writhing in pain on the exam table with the inability to find a comfortable position. He is afebrile, BP 156/88 mmHg and HR 106/min. Right flank is mildly tender on palpation. Abdominal exam is negative for any abnormality. A urinalysis was performed and revealed 1+ blood. Urine microscopy also revealed 10-20 RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no prior history of a kidney stone. After providing the patient an analgesic, where the patient reported mild relief, the NP had the patient transferred to the emergency room for intravenous fluids, pain management and further work-up for the kidney stone. Upon follow-up in the


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