Test Bank For Medical-Surgical Nursing: Assessment and
Management of Clinical Problems 9th Edition By Sharon Lewis,
Shannon Dirksen, Margaret Heitkemper, Linda Bucher
9780323086783 Chapter 1-69 Complete Guide .
A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and
sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take?
a. Remind the patient about the need to drink 1000 mL of fluids daily.
b. Obtain a midstream urine specimen for culture and sensitivity testing.
c. Teach the patient to take the prescribed Bactrim for at least 3 more days.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms. - ANSWER: Answer:
b. Obtain a midstream urine specimen for culture and sensitivity testing.
Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of
antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate
antibiotic therapy. Tylenol would not be as effective as other over-the-counter (OTC) medications
such as phenazopyridine (Pyridium) in treating dysuria. The fluid intake should be increased to at least
1800 mL/day. Since the UTI has persisted after treatment with Bactrim, the patient is likely to need a
different antibiotic.
The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) for
a patient with cystitis has been effective when the patient states,
a. "I can use vaginal sprays to reduce bacteria."
b. "I will drink a quart of water or other fluids every day."
c. "I will wash with soap and water before sexual intercourse."
d. "I will empty my bladder every 3 to 4 hours during the day." - ANSWER: Answer: d. "I will empty my
bladder every 3 to 4 hours during the day."
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal sprays is discouraged. The
bladder should be emptied before and after intercourse, but cleaning with soap and water is not
necessary. A quart of fluids is insufficient to provide adequate urine output to decrease risk for UTI.
Which information will the nurse include when teaching the patient with a urinary tract infection (UTI)
about the use of phenazopyridine (Pyridium)?
a. Take the medication for at least 7 days.
b. Use sunscreen while taking the Pyridium.
c. The urine may turn a reddish-orange color.
d. Use the Pyridium before sexual intercourse. - ANSWER: Answer: c. The urine may turn a reddish-
orange color.
Patients should be taught that Pyridium will color the urine deep orange. Urinary analgesics should
only be needed for a few days until the prescribed antibiotics decrease the bacterial count. Taking
Pyridium before intercourse will not be helpful in reducing the risk for UTI. Pyridium does not cause
photosensitivity.
A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital with chills, fever, and
vomiting. Which finding by the nurse will be most helpful in determining whether the patient has an
upper urinary tract infection (UTI)?
a. Suprapubic pain
, b. Bladder distention
c. Foul-smelling urine
d. Costovertebral tenderness - ANSWER: Answer: d. Costovertebral tenderness
Costovertebral tenderness is characteristic of pyelonephritis. The other symptoms are characteristic
of lower UTI and are likely to be present if the patient also has an upper UTI.
After teaching a patient with interstitial cystitis about management of the condition, the nurse
determines that further instruction is needed when the patient says,
a. "I will have to stop having coffee and orange juice for breakfast."
b. "I should start taking a high potency multiple vitamin every morning."
c. "I will buy some calcium glycerophosphate (Prelief) at the pharmacy."
d. "I should call the doctor about increased bladder pain or odorous urine." - ANSWER: Answer: b. "I
should start taking a high potency multiple vitamin every morning."
High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient
statements indicate good understanding of the teaching.
When admitting a patient with acute glomerulonephritis, it is most important that the nurse ask the
patient about:
a. recent sore throat and fever.
b. history of high blood pressure.
c. frequency of bladder infections.
d. family history of kidney stones. - ANSWER: Answer: a. recent sore throat and fever.
Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is
not caused by hypertension, urinary tract infection (UTI), or kidney stones.
Which finding by the nurse for a patient admitted with glomerulonephritis indicates that treatment
has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. Peripheral and periorbital edema is resolved.
d. The antistreptolysin-O (ASO) titer is decreased. - ANSWER: Answer: c. Peripheral and periorbital
edema is resolved.
Since edema is a common clinical manifestation of glomerulonephritis, resolution of the edema
indicates that the prescribed therapies have been effective. Antibodies to streptococcus will persist
after a streptococcal infection. Nitrites will be negative and the patient will not experience dysuria
since the patient does not have a urinary tract infection.
A patient with nephrotic syndrome develops flank pain. The nurse will anticipate teaching the patient
about treatment with:
a. antibiotics.
b. anticoagulants.
c. corticosteroids.
d. antihypertensives. - ANSWER: Answer: b. anticoagulants.
Flank pain in a patient with nephrosis suggests a renal vein thrombosis, and anticoagulation is
needed. Antibiotics are used to treat a patient with flank pain caused by pyelonephritis.
Antihypertensives are used if the patient has high blood pressure. Corticosteroids may be used to
treat nephrotic syndrome but will not resolve a thrombosis.
Management of Clinical Problems 9th Edition By Sharon Lewis,
Shannon Dirksen, Margaret Heitkemper, Linda Bucher
9780323086783 Chapter 1-69 Complete Guide .
A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and
sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take?
a. Remind the patient about the need to drink 1000 mL of fluids daily.
b. Obtain a midstream urine specimen for culture and sensitivity testing.
c. Teach the patient to take the prescribed Bactrim for at least 3 more days.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms. - ANSWER: Answer:
b. Obtain a midstream urine specimen for culture and sensitivity testing.
Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of
antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate
antibiotic therapy. Tylenol would not be as effective as other over-the-counter (OTC) medications
such as phenazopyridine (Pyridium) in treating dysuria. The fluid intake should be increased to at least
1800 mL/day. Since the UTI has persisted after treatment with Bactrim, the patient is likely to need a
different antibiotic.
The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) for
a patient with cystitis has been effective when the patient states,
a. "I can use vaginal sprays to reduce bacteria."
b. "I will drink a quart of water or other fluids every day."
c. "I will wash with soap and water before sexual intercourse."
d. "I will empty my bladder every 3 to 4 hours during the day." - ANSWER: Answer: d. "I will empty my
bladder every 3 to 4 hours during the day."
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal sprays is discouraged. The
bladder should be emptied before and after intercourse, but cleaning with soap and water is not
necessary. A quart of fluids is insufficient to provide adequate urine output to decrease risk for UTI.
Which information will the nurse include when teaching the patient with a urinary tract infection (UTI)
about the use of phenazopyridine (Pyridium)?
a. Take the medication for at least 7 days.
b. Use sunscreen while taking the Pyridium.
c. The urine may turn a reddish-orange color.
d. Use the Pyridium before sexual intercourse. - ANSWER: Answer: c. The urine may turn a reddish-
orange color.
Patients should be taught that Pyridium will color the urine deep orange. Urinary analgesics should
only be needed for a few days until the prescribed antibiotics decrease the bacterial count. Taking
Pyridium before intercourse will not be helpful in reducing the risk for UTI. Pyridium does not cause
photosensitivity.
A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital with chills, fever, and
vomiting. Which finding by the nurse will be most helpful in determining whether the patient has an
upper urinary tract infection (UTI)?
a. Suprapubic pain
, b. Bladder distention
c. Foul-smelling urine
d. Costovertebral tenderness - ANSWER: Answer: d. Costovertebral tenderness
Costovertebral tenderness is characteristic of pyelonephritis. The other symptoms are characteristic
of lower UTI and are likely to be present if the patient also has an upper UTI.
After teaching a patient with interstitial cystitis about management of the condition, the nurse
determines that further instruction is needed when the patient says,
a. "I will have to stop having coffee and orange juice for breakfast."
b. "I should start taking a high potency multiple vitamin every morning."
c. "I will buy some calcium glycerophosphate (Prelief) at the pharmacy."
d. "I should call the doctor about increased bladder pain or odorous urine." - ANSWER: Answer: b. "I
should start taking a high potency multiple vitamin every morning."
High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient
statements indicate good understanding of the teaching.
When admitting a patient with acute glomerulonephritis, it is most important that the nurse ask the
patient about:
a. recent sore throat and fever.
b. history of high blood pressure.
c. frequency of bladder infections.
d. family history of kidney stones. - ANSWER: Answer: a. recent sore throat and fever.
Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is
not caused by hypertension, urinary tract infection (UTI), or kidney stones.
Which finding by the nurse for a patient admitted with glomerulonephritis indicates that treatment
has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. Peripheral and periorbital edema is resolved.
d. The antistreptolysin-O (ASO) titer is decreased. - ANSWER: Answer: c. Peripheral and periorbital
edema is resolved.
Since edema is a common clinical manifestation of glomerulonephritis, resolution of the edema
indicates that the prescribed therapies have been effective. Antibodies to streptococcus will persist
after a streptococcal infection. Nitrites will be negative and the patient will not experience dysuria
since the patient does not have a urinary tract infection.
A patient with nephrotic syndrome develops flank pain. The nurse will anticipate teaching the patient
about treatment with:
a. antibiotics.
b. anticoagulants.
c. corticosteroids.
d. antihypertensives. - ANSWER: Answer: b. anticoagulants.
Flank pain in a patient with nephrosis suggests a renal vein thrombosis, and anticoagulation is
needed. Antibiotics are used to treat a patient with flank pain caused by pyelonephritis.
Antihypertensives are used if the patient has high blood pressure. Corticosteroids may be used to
treat nephrotic syndrome but will not resolve a thrombosis.
