PREP QUESTIONS AND SOLUTIONS 2026
GRADED A+
◉ Pathophysiology of UTI. Answer: Bacteria must gain access to
bladder, attach and colonize the epithelium to avoid being washed
out with voiding, invade host defenses and initiate inflammation
Routes of infection
-Up urethra (ascending)
-Through bloodstream
-By means of fistula from intestine
-Most common is transurethral from fecal contamination
◉ Clinical manifestations of uncomplicated lower UTI. Answer: 50%
asymptomatic
Uncomplicated lower UTI (cystitis)
-Pain and burning on urination
-Frequency (more than every 2/3 hours)
-Urgency (strong desire to void)
-Nocturia (night awakening)
,-Incontinence (loss or leakage of urine
-Suprapubic or pelvic/back pain
-Hematuria
-Hesitancy
◉ Clinical manifestations of UTI in the older adult. Answer: *Often
lack typical symptoms*
Nonspecific:
-Altered mental status, lethargy, fatigue, anorexia, new incontinence,
low grade fever
UTI most common cause of acute bacterial sepsis (hypotension,
tachycardia, tachypnea, fever) - mortality rate 50%
◉ Clinical manifestations of complicated UTI. Answer: Range from
asymptomatic bacteriuria to gram - sepsis w/shock
Often d/t broader spectrum of organisms and have lower response
rate to treatment
◉ Bacteriuria. Answer: >100,000 colonies of bacteria per mL of
urine
,Female samples are commonly contaminated d/t closer urethra and
rectal area
E coli , pseudomonas, and enterococcus commonly found in lower GI
tract
Indwelling cath: proteus, klebsiella, pseudomonas, or
staphylococcus
◉ Diagnostic studies for UTI. Answer: Urinalysis and urine culture
Pyuria (WBCs in urine)
Positive leukocyte esterase and nitrates
Microscopic hematuria
STD/STI screening
CT
Cystoscopy
◉ Medical management of UTI. Answer: Antibiotics (short course 3-
4 days or 7-10 days)
Ideal: eradicates bacteria from urinary tract with minimal effect on
fecal or vaginal flora, reducing risk of vaginal yeast infections
, Cranberry juice stops bacteria from adhering to the wall of the
bladder
Examples:
-trimethoprim/sulfamethoxazole (Bactrim, Septra)
-nitrofurantoin (Macrodantin)
-ampicillin, amoxicillin, cephalosporins
-ciprofloxacin (Cipro)
-amphotericin or fluconazole
-phenazopyridine (Pyridium) - analgesic
◉ Nursing management of UTI. Answer: Hx of s/s
Recognize at-risk individuals (ex. older adults, diabetes, debilitating
conditions)
Hygiene measures (wiping perineal front to beak)
Evacuating bowel regularly
Thorough preineal care for hospitalized patients
Strict aseptic technique
Cranberry juice
Pain relief