Med Surg Exam UTI

UTI 1. Which client is at highest risk for developing a hospital-acquired infection? a. A client with a laceration to the left hand b. A client who's taking prednisone (Deltasone) c. A client with an indwelling urinary catheter d. A client with Crohn's disease 2. A 25-year-old sexually active female client diagnosed with cystitis tells the nurse that she doesn’t understand why she has these infections yearly because she tries to avoid them by drinking very little at work so she doesn’t have to use the “dirty” public toilet. Which suggestions or actions by the nurse are most likely to help this client reduce her risk for cystitis? (Select all that apply.) a. Reinforce her choice to avoid using a public toilet b. Suggest that she drink at least 2-3 L of fluid throughout the day c. Urge her to change her method of birth control from oral contraceptives to a barrier method d. Instruct her to always wipe her perineum from front to back after each toilet use e. Reinforce that she should complete the entire course of antibiotics as prescribed 3. You're assessing your patients during morning rounding. Which patient below is at MOST risk for developing a urinary tract infection? a. A 25 year old patient who finished a regime of antibiotics for strep throat 10 weeks ago. b. A 55 year old female who is post-op day 7 from hip surgery. c. A 68 year old male who is experiencing nausea and vomiting. d. A 87 year old female with Alzheimer’s disease who is experiencing bowel incontinence. 4. During a head-to-toe assessment on a patient with a possible urinary tract infection, you perform costovertebral angle percussion. The costovertebral angle is found? a. between the bottom of the 12th rib and spine b. between the right upper quadrant and umbilicus c. between the sternal notch and angle of Louis d. between the ischial spine and umbilicus 5. Pyelonephritis can be differentiated from cystitis? a. Presence of dysuria, frequency, and urgency b. The causative organism c. Bladder tenderness with palpation d. Fever, flank pain, and WBC casts in the urine 6. The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). Which concepts does the nurse explain in the presentation? a. Dysuria b. Enuresis c. Frequency d. Nocturia e. Urgency f. Polyuria 7. A 36 year old female, who is 29 weeks pregnant, reports she is experiencing burning when voiding. The physician orders a urinalysis. Which statement by the patient demonstrates she understands how to collect the specimen? a. "I’ll hold the cup firmly against the urethra while collecting the sample." b. "I will cleanse back to front with the antiseptic wipe before peeing in the cup." c. "First, I will pee a small amount of urine in the toilet and then collect the rest in the cup." d. "I will be sure to drink a lot of fluids to keep the urine diluted before peeing into the cup." 8. A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and some discomfort upon urination. Her vital signs are stable except for a temperature of 100°F (37.8°C). Which drug does the primary health care provider prescribe? a. Nitrofurantoin (Macrodantin) b. Estrogen (Premarin) c. Trimethoprim/sulfamethoxazole (Bactrim) d. Phenazopyridine (Pyridium) 9. A patient, who is having spasms and burning while urinating due to a UTI, is prescribed "Pyridium" (Phenazopyridine). Which option below is a normal side effect of this drug? a. Hematuria b. Crystalluria c. Urethra mucous d. Orange colored urine 10. You're caring for a patient with an indwelling catheter. The patient complains of spasm like pain at the catheter insertion site. Which of the following options below are other signs and symptoms the patient could experience or the nurse could observe if a urinary tract infection was present? SELECT-ALL-THAT-APPLY: a. Increased WBC b. Crystalluria c. Positive McBurney's Sign d. Feeling the need to void even though a catheter is present e. Dark and cloudy urine 11. On your nursing care plan for a patient with a urinary tract infection, which of the following would be appropriate nursing interventions? SELECT-ALL-THAT-APPLY: a. Encourage voiding every 2-3 hours while awake. b. Restrict fluid intake to 1-2 liters per day. c. Monitor intake and output daily. d. The patient verbalizes the importance of using vaginal sprays to decrease reoccurrence of urinary tract infections prior to discharge home 12. A 76 year old female is admitted due to a recent fall. The patient is confused and agitated. The family members report that this is not normal behavior for the patient. They explain that the patient is very active in the community and cares for herself. Based on the information you have gathered about the patient, which physician's order takes priority? a. "Collect a urinalysis" b. "Collect a T3 and T4 level" c. d. "Insert a Foley Catheter" "Keep patient NPO" 13. The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which client statement shows a correct understanding of what the nurse has taught? a. “I need to be drinking at least 1.5 to 2.5 liters of fluids every day.” b. “It is a good idea for me to reduce germs by taking a tub bath daily.” c. “Trying to get to the bathroom to urinate every 6 hours is important for me.” d. “Urinating 1000 mL on a daily basis is a good amount for me.” 14. A client who was previously diagnosed with a urinary tract infection (UTI) and started on antibiotics returns to the clinic 3 days later with the same symptoms. When asked about the previous UTI and medication regimen, the client states, “I only took the first dose because after that, I felt better.” How does the nurse respond? a. “Not completing your medication can lead to return of your infection.” b. “That means your treatment will be prolonged with this new infection.” c. “This means you will now have to take two drugs instead of one.” d. “What you did was okay; however, let’s get you started on something else.” 15. A nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which point should the nurse include? a. Limit fluid intake to reduce the need to urinate. b. Take medication ordered for a UTI until the symptoms subside. c. Notify the physician if urinary urgency, burning, frequency, or difficulty occurs. d. Wear only nylon underwear to reduce the chance of irritation 16. A client who was previously diagnosed with a urinary tract infection (UTI) and started on antibiotics returns to the clinic 3 days later with the same symptoms. When asked about the previous UTI and medication regimen, the client states, “I only took the first dose because after that, I felt better.” How does the nurse respond? a. “Not completing your medication can lead to return of your infection.” b. “That means your treatment will be prolonged with this new infection.” c. “This means you will now have to take two drugs instead of one.” d. “What you did was okay; however, let’s get you started on something else.”