Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?
A. Percuss between the iliac crest and ribs at the midaxillary line.
Percussion between the iliac crest and ribs at the midaxillary line is not the standard method for assessing flank tenderness associated with pyelonephritis. This technique may not elicit the characteristic pain of kidney inflammation.
B. Push fingers upward into the two lowest intercostal spaces.
Pushing fingers upward into the two lowest intercostal spaces is not a specific test for flank tenderness and may not accurately assess for pyelonephritis. This action is more related to assessing the integrity of the rib cage and intercostal muscles.
C. Palpate along both sides of the lumbar vertebral column.
Palpating along both sides of the lumbar vertebral column is not the correct method for assessing flank tenderness due to pyelonephritis. This approach is more suited for assessing the musculoskeletal structure rather than the kidneys.
D. Strike a flat hand covering the costovertebral angle (CVA).
Striking a flat hand over the costovertebral angle is the correct method for assessing flank tenderness in cases of suspected pyelonephritis. This technique, known as costovertebral angle tenderness, elicits pain when the kidneys are inflamed, which is a common sign of pyelonephritis.
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Full Explanation
Choice A rationale
Percussion between the iliac crest and ribs at the midaxillary line is not the standard method for assessing flank tenderness associated with pyelonephritis. This technique may not elicit the characteristic pain of kidney inflammation.
Choice B rationale
Pushing fingers upward into the two lowest intercostal spaces is not a specific test for flank tenderness and may not accurately assess for pyelonephritis. This action is more related to assessing the integrity of the rib cage and intercostal muscles.
Choice C rationale
Palpating along both sides of the lumbar vertebral column is not the correct method for assessing flank tenderness due to pyelonephritis. This approach is more suited for assessing the musculoskeletal structure rather than the kidneys.
Choice D rationale
Striking a flat hand over the costovertebral angle is the correct method for assessing flank tenderness in cases of suspected pyelonephritis. This technique, known as costovertebral angle tenderness, elicits pain when the kidneys are inflamed, which is a common sign of pyelonephritis.
Similar Questions
Which clinical manifestation of inflammatory bowel disease is common to both patients with ulcerative colitis (UC) and Crohn's disease?
A. Diarrhea stools
Diarrhea is a common symptom in both ulcerative colitis (UC) and Crohn's disease, often presenting with urgency and frequency.
B. Lesions that penetrate the intestine
Lesions that penetrate the intestine are more characteristic of Crohn's disease, which can affect any layer of the intestinal wall and any part of the gastrointestinal tract.
C. Strictures are common
Strictures are more common in Crohn's disease due to its transmural inflammatory nature, which can lead to fibrosis and narrowing of the intestines¹.
D. Restricted to rectum
UC is restricted to the colon and often involves the rectum, but Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus and is not restricted to the rectum¹.
Full Explanation
Choice A rationale
Diarrhea is a common symptom in both ulcerative colitis (UC) and Crohn's disease, often presenting with urgency and frequency.
Choice B rationale
Lesions that penetrate the intestine are more characteristic of Crohn's disease, which can affect any layer of the intestinal wall and any part of the gastrointestinal tract.
Choice C rationale
Strictures are more common in Crohn's disease due to its transmural inflammatory nature, which can lead to fibrosis and narrowing of the intestines¹.
Choice D rationale
UC is restricted to the colon and often involves the rectum, but Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus and is not restricted to the rectum¹.
In an effort to decrease the rate of urinary tract infections, which of the following should the nurse manager teach the nursing staff? (Select all that apply)
A. Obtain orders from the health care provider to discontinue catheters as soon as possible.
Removing catheters as soon as they are no longer necessary can significantly reduce the risk of catheter-associated urinary tract infections (CAUTIs)¹.
B. Remind clients to urinate right away when they have an urge and to completely empty their bladder.
While it is important for clients to urinate when they feel the urge, this practice alone is not specifically targeted at reducing the rate of urinary tract infections.
C. Promote perineal care that includes wiping the perineum from front to back.
Teaching proper perineal care, including wiping from front to back, can help prevent the spread of bacteria to the urethra and reduce the risk of UTIs¹.
D. Encourage continuing prescribed antibiotics even if the client's symptoms have subsided.
Continuing prescribed antibiotics until the full course is completed, even if symptoms improve, is crucial to ensure all bacteria are eliminated and to prevent antibiotic resistance³.
E. Encourage adequate fluid intake every day if appropriate.
Adequate fluid intake helps flush bacteria from the urinary tract, which can decrease the incidence of UTIs¹.
Full Explanation
Choice A rationale
Removing catheters as soon as they are no longer necessary can significantly reduce the risk of catheter-associated urinary tract infections (CAUTIs)¹.
Choice B rationale
While it is important for clients to urinate when they feel the urge, this practice alone is not specifically targeted at reducing the rate of urinary tract infections.
Choice C rationale
Teaching proper perineal care, including wiping from front to back, can help prevent the spread of bacteria to the urethra and reduce the risk of UTIs¹.
Choice D rationale
Continuing prescribed antibiotics until the full course is completed, even if symptoms improve, is crucial to ensure all bacteria are eliminated and to prevent antibiotic resistance³.
Choice E rationale
Adequate fluid intake helps flush bacteria from the urinary tract, which can decrease the incidence of UTIs¹.
A nurse in a provider's office is caring for a client who has a medical history of rheumatoid arthritis and psoriasis, and a family history of heart disease and arthritis. The client has a 60-year smoking history and denies alcohol or other substance use. They are positive for Helicobacter pylori and are on medication for peptic ulcer disease (PUD). Which three findings from the client's medical record increase their risk for peptic ulcer disease?
A. Family history
While family history can contribute to the risk of developing certain conditions, it is not a direct risk factor for peptic ulcer disease.
B. Smoking history
A long-term smoking history is a known risk factor for peptic ulcer disease as it can increase gastric acid secretion and reduce the production of substances that protect the stomach lining.
C. Alcohol use
The client denies alcohol use; therefore, it is not a contributing risk factor in this case. However, alcohol use is generally a risk factor for PUD due to its irritating effect on the stomach lining.
D. Positive for H. pylori
Being positive for Helicobacter pylori is one of the strongest risk factors for peptic ulcer disease. This bacterium damages the protective mucosal layer of the stomach and duodenum, leading to chronic inflammation and allowing acid to injure the underlying tissue. It is the leading cause of most gastric and duodenal ulcers worldwide.
E. NSAID use
NSAID use is a well-established risk factor for peptic ulcer disease as these medications can disrupt the protective lining of the stomach, leading to ulcers.
Full Explanation
Choice A rationale
While family history can contribute to the risk of developing certain conditions, it is not a direct risk factor for peptic ulcer disease.
Choice B rationale
A long-term smoking history is a known risk factor for peptic ulcer disease as it can increase gastric acid secretion and reduce the production of substances that protect the stomach lining.
Choice C rationale
The client denies alcohol use; therefore, it is not a contributing risk factor in this case. However, alcohol use is generally a risk factor for PUD due to its irritating effect on the stomach lining.
Choice D rationale
Being positive for Helicobacter pylori is one of the strongest risk factors for peptic ulcer disease. This bacterium damages the protective mucosal layer of the stomach and duodenum, leading to chronic inflammation and allowing acid to injure the underlying tissue. It is the leading cause of most gastric and duodenal ulcers worldwide.
Choice E rationale
NSAID use is a well-established risk factor for peptic ulcer disease as these medications can disrupt the protective lining of the stomach, leading to ulcers.