Urinary Tract Infections (11 Questions)

1. Mme Ginette Tremblay, an 82-year-old resident in a long-term care facility (CHSLD), has been stable with mild dementia. Today, the orderly reports that Mme Tremblay is suddenly agitated, combative, and confused, not recognizing her primary nurse. She has refused to eat breakfast and has been incontinent of urine twice this morning, which is unusual for her. Her vital signs are: BP 130/70 mmHg, HR 88 bpm, RR 20 breaths/min, and Temp 37.5°C.

Question:
Based on the client’s sudden change in mental status, what is the nurse’s priority nursing action? *

Request a prescription for a sedative to manage the agitation and ensure safety.

Initiate a neurological assessment to rule out a stroke (CVA).

Collect a urine specimen for urinalysis and culture and sensitivity.

Contact the family to sit with the client to reduce her anxiety.

2. Mme Sophie Gagnon, a 24-year-old female, presents to the walk-in clinic reporting a burning sensation during urination and frequent urgency for the past 24 hours. She is sexually active and uses a diaphragm for contraception. The physician diagnoses her with acute cystitis and prescribes Nitrofurantoin (Macrobid) 100 mg PO BID for 5 days. You are providing discharge teaching.

Question:
Which specific instruction is most important for the nurse to include to prevent recurrence of the infection? *

"You should consider switching to a different method of birth control, as diaphragms can press on the bladder neck."

"Ensure you take the antibiotic until your symptoms disappear, then you can stop."

"Limit your fluid intake to 1 liter per day to reduce the frequency of urination."

"Perform a vaginal douche daily to remove bacteria from the perineal area."

3. M. Jacques Bernier, a 55-year-old male, arrives at the Emergency Department complaining of high fever (39.2°C), severe chills, and nausea. He reports having had a "mild bladder infection" last week that he treated with cranberry juice but did not see a doctor. Upon physical assessment, M. Bernier jumps in pain when you gently percuss the area of his back at the costovertebral angle (CVA).

Question:
Based on the percussion finding and the patient's history, which condition does the nurse suspect? *

Acute Prostatitis

Acute Pyelonephritis

Renal Calculi (Kidney Stones)

Glomerulonephritis

4. Mme Marie-Eve Bouchard, who is 28 weeks pregnant, is seen for her routine prenatal visit. She feels well and reports no urinary urgency or pain. However, her routine urine culture result comes back positive for E. coli > 100,000 CFU/mL. The doctor prescribes an oral antibiotic. Mme Bouchard asks, "Why do I need medicine if I don't feel sick?"

Question:
What is the nurse’s best response? *

"It is just a precaution; you can choose to wait until you have symptoms."

"Pregnant women often have asymptomatic infections that can lead to preterm labor or kidney infection if untreated."

"The bacteria will cross the placenta and directly infect the baby’s lungs."

"This helps prevent you from developing gestational diabetes."

5. M. Pierre Dubois, a 68-year-old male, underwent a Total Hip Arthroplasty (THA) two days ago. He has an indwelling urinary catheter (Foley) in place. During your shift, you notice the urine in the collection bag has become cloudy and has a foul odor. M. Dubois has a low-grade fever of 37.9°C. The physician orders a urine sample for culture.

Question:
What is the correct technique for obtaining this specimen? *

Disconnect the drainage tube from the catheter and collect urine directly into a sterile cup.

Open the drainage port at the bottom of the bag and collect the urine.

Clamp the tubing below the port for 15 minutes, clean the port, and aspirate urine with a sterile syringe.

Insert a needle directly into the silicone catheter tubing to withdraw urine.

6. Little Émilie Roy, a 4-year-old girl, is brought to the pediatric clinic by her mother. Émilie has had three documented urinary tract infections in the past six months. She is toilet trained but has started wetting the bed again. The pediatrician suspects a structural abnormality and orders a specific diagnostic test.

Question:
Which diagnostic test should the nurse expect to explain to the mother? *

A 24-hour urine collection

A renal biopsy

A simple abdominal X-ray (KUB)

A Voiding Cystourethrogram (VCUG)

7. Mme Claudette Lefebvre, 75 years old, presents to the ER with signs of urosepsis. Her vital signs are: BP 85/50 mmHg, HR 115 bpm, Temp 39.5°C. She is lethargic. The physician writes the following orders:
*Administer IV fluid bolus 500 mL Normal Saline.
*Obtain blood and urine cultures.
*Administer IV Ceftriaxone 1g.
*Administer Acetaminophen 650mg PR.

Question:
In which order should the nurse implement these interventions? *

Tylenol, Blood Cultures, Antibiotics, IV Fluids.

Blood Cultures, IV Fluids, Antibiotics, Tylenol.

IV Fluids, Antibiotics, Tylenol, Blood Cultures.

Antibiotics, IV Fluids, Blood Cultures, Tylenol.

8. M. Luc Morin, 42 years old, visits the clinic with complaints of "passing sand" in his urine and mild dysuria. He has a history of calcium oxalate kidney stones. He asks the nurse what dietary changes he can make to prevent stone formation and subsequent infections.

Question:
What is the nurse’s best dietary recommendation? *

"Reduce your calcium intake drastically by avoiding all dairy products."

"Increase your intake of spinach, rhubarb, and nuts."

"Drink less water in the evening to prevent nocturia."

"Drink at least 3 liters of fluid per day to dilute your urine."

9. Mme Isabelle Fortin, a 22-year-old university student, comes to the health services center reporting her third UTI in 4 months. She states, "I notice I always get these infections a day or two after I have sex with my boyfriend."

Question:
Which preventive measure is most specific to this client's situation? *

"You should drink a glass of cranberry juice every morning."

"Make sure to wipe from back to front after using the toilet."

"Attempt to void immediately after sexual intercourse."

"Wash your perineum with antibacterial soap twice a day."

10. Mme Louise Côté, 50 years old, is being assessed for a potential UTI. The nurse instructs her on how to collect a "clean-catch midstream" urine specimen. Mme Côté asks why she has to let some urine go into the toilet first.

Question:
What is the correct rationale the nurse should provide? *

"The first part of the urine is too concentrated to test accurately."

"It flushes away organisms residing at the urethral meatus (opening) so they don't contaminate the sample."

"It ensures that the bladder is fully contracting to give a good sample."

"The first drops of urine usually contain too much protein."

11. Mme Valérie Gagné, a first-time mother, is preparing to be discharged from the birthing center with her 2-day-old daughter, Léa. During the discharge teaching session, the nurse observes Mme Gagné changing Léa’s diaper. The nurse intervenes gently to demonstrate the correct wiping technique. Mme Gagné asks, "Does it really matter which direction I wipe? It all seems so small down there."

Question:
What is the nurse’s best response to explain the anatomical reason for wiping from front to back? *

"Yes, wiping back to front pushes urine into the vaginal canal, which causes yeast infections."

"It is a standard preference, but as long as you use baby wipes instead of a washcloth, the risk of infection is low."

"Yes, wiping front to back helps stimulate the bladder muscles to empty completely."

"Yes, because a baby girl's urethra is very short and close to the anus, so wiping backwards prevents bacteria from the stool from causing a bladder infection."