NURS 6614 FINAL Exam containing 100 Questions Answers 2024

You have a 33-year-old patient with diabetes type 2. Your patient has a fasting plasma glucose of 280 mg/dl and A1C of 10%. You want to assess your patient for diabetic nephropathy. What is the best way to assess your patient? - ANSWER- Serial random urinalysis for microalbuminuria A 33-year-old female patient presents to your clinic with a 2 day history of dysuria, urinary frequency, and incontinence. She has been afebrile and denies sexual intercourse in the past two months. This is the first such episode and she has no history of previous hospitalization or antibiotic use for any reason in the past 3 months. She has no known allergies to any medications. What is most likely to be the best option for your initial diagnostic work-up today? - ANSWER- Clean-catch, midstream urine for urinalysis A 33-year-old female patient presents to your clinic with a 2 day history of dysuria, urinary frequency, and incontinence. She has been afebrile and denies sexual intercourse in the past two months. This is the first such episode and she has no history of previous hospitalization or antibiotic use for any reason in the past 3 months. She has no known allergies to any medications. She has no pertinent positive exam findings. The urinalysis is positive for RBCs, protein, and nitrites. What is your diagnosis for this patient? - ANSWER- Lower urinary tract infection A 33-year-old female patient presents to your clinic with a 2 day history of dysuria, urinary frequency, and incontinence. She has been afebrile and denies sexual intercourse in the past two months. This is the first such episode and she has no history of previous hospitalization or antibiotic use for any reason in the past 3 months. She has no known allergies to any medications. The urinalysis is positive for blood and pyuria. Your patient does not have insurance and has financial constraints. There is no known antibiotic resistance in your area. What do you decide to order for your patient today? - ANSWERTrimethoprim-sulfamethoxazole Which of the following statements are true about uncomplicated cystitis in women? Please SELECT ALL THAT APPLY - ANSWER- Treatment can be with short-term antimicrobial therapy, which consists of singledose therapy or 1-3 days of therapy. Trimethoprim-sulfamethoxazole can be ineffective because of the emergence of resistant organisms. In elderly patients, altered mental status may be the sole manifestation and should create a high level of suspicion. Approximately 80%-90% of the uncomplicated cases are a result of the gram-negative rod bacterium, Escherichia coli. Which of the following are true regarding microalbuminuria? Please SELECT ALL THAT APPLY. - ANSWER- At least 2 of 3 spot urine collections over a 3 to 6 month period should be abnormal before a diagnosis of Chronic Kidney Disease is justified. Subsequent end-stage chronic kidney disease can be predicted by persistent urinary albumin excretion rates exceeding 30 mcg./min. Minimal but persistent amounts of albumin in the urine are associated with diabetic nephropathy and with hypertensive renal damage. An ACE inhibitor in normotensive diabetics impedes progression to proteinuria and prevents the increase in albumin excretion rate. A urine specimen that is positive for protein (in the absence of infection) negates the need for microalbumin testing. You are reviewing a patient's labwork from a clinic visit. You note that serum creatinine is elevated for the second lab draw in a row. What are you thinking about the patient's glomerular filtration rate (GFR)? - ANSWER- The patient's GFR is probably going down. Chronic renal failure (CRF) is defined as a deterioration in renal function that persists for more than three months. All of the following are possible etiologies of CRF except: - ANSWER- Lower urinary tract infections You are ordering lab work to monitor your diabetic patient. You include all of the following lab orders except: - ANSWER- Urine glucose Which of the following is the most important risk factor for nephrolithiasis in the general population? - ANSWER- Women with frequent UTI The major factor that prevents development of urinary tract infection is: - ANSWER- Maintaining sterility of the urinary tract The organism responsible for approximately 80% of urinary tract infections is: - ANSWER- Escherichia coli . . . . . . . . . .