1.) The pathophysiology student identifies that the retrograde movement of this specific bacteria from the gut into the lower urinary tract is the most common infecting pathogen responsible for a UTI.
C.) Escherichia Coli
Rationale: The correct answer, C. Escherichia Coli, is the most common (80-85%) infecting microorganism that produces a urinary tract infection. This type of bacteria typically is found in the intestine. Trace amounts of this bacteria makes its way from perianal area into the urinary tract through the urethra opening and begin to multiply. Some ways this migration can occur include through sexual intercourse, poor wiping after a bowel movement, and holding urine. A. Staphylococcus Saprophyticus is the second most common bacteria found in a urinary tract infection. B. Klebsiella and D. Pseudomonas are less common.
2.) Your patient was recently diagnosed with a UTI. As the nurse practitioner, you are assessing whether the patient has any improvement with their symptoms of hematuria. What question would you ask the patient?
D.) “Is there blood in your urine?”
Rationale: D. “Is there blood in your urine?” is the correct answer. Hematuria is the presence of blood in the urine and is due to the irritation and inflammation from infection in the bladder or upper urinary structures. While the other answers are incorrect, they also are questions related to symptoms that accompany a urinary tract infection. A. Do you have pain when you urinate? Is a symptom called dysuria. Frequency with urination (answer B) and Cloudy urine (answer C) are also symptoms of a UTI.
3.) A patient wants to know if they are to considered to have recurrent UTI’s because they have had 2 UTI’s within the past year, one being in January and the other in September. What is your best response as a nurse practitioner?
B.) “No, you would need 3 or more UTI’s within the past year.”
Rationale: Answer B is correct because a recurrent UTI is defined as three or more UTI’s within 12 months, or two or more occurrences within 6 months. Answer A is incorrect because the patient needs at least 3 UTI’s within the past year, not two. Answer C is incorrect because when there is a second UTI caused by the same pathogen within 2 weeks of the original treatment, it is considered a relapse. Answer D is incorrect because a UTI that occurs more than 2 weeks after completion of treatment for the same or different pathogen is considered a reinfection.
4.) A patient you are treating in the clinic asks you what actions they can take to help prevent urinary tract infections. All of the following statements are correct, EXCEPT?
B.) Wear tight fitting clothing.
Rationale: Tight-fitting clothing can trap heat and moisture which promotes bacterial growth. This type of environment actually increases the risk for an urinary tract infection. It is recommended that individuals wear loose-fitting clothing which promotes air circulation. Answers A, C, and D are all actions that can help prevent UTIs. Answer A, Wiping from front to back after using the restroom prevents the retrograde movement of bacteria into the urinary system. Answer C, Emptying your bladder after sexual intercourse helps flush bacteria out of the urinary system and Answer D, drinking plenty of water also helps with the flushing any bacteria that may have migrated in the urethral opening away and out from the urinary system.
5.) Which of the following scenarios of patients is least likely to acquire a UTI?
A.) A 24 year old male with poor hygiene.
Rational: Individuals most at risk for urinary tract infections include women, immunocompromised individuals (Answer B), prepubescent children, patient’s with urinary catheters (Answer D), women given antibiotics that may interrupt vaginal flora, individuals with a history of diabetes mellitus (Answer C), post-menopausal women, sexually active and pregnant women. Although answer A isn’t incorrect and anyone can possibly acquire a UTI, this answer is the least likely because all other scenarios include pertinent information that put the patient at a higher risk for a urinary tract infection.