Deck 37: Urinary Tract Infections

Question 1

All of the following are reasons why institutionalized patients have more UTIs than noninstitutionalized patients, except

A) general ill condition of institutionalized patients.
B) less frequent emptying of the bladder.
C) higher probability of urinary tract instrumentation.
D) higher incidence of urinary tract anatomic or functional abnormalities.

Answer 1

B

Question 2

What is the most common way for the renal parenchyma to become infected with gram-positive bacteria?

A) Ascending route
B) Descending route
C) Hematogenous route
D) Poor personal hygiene

Answer 2

C

Question 3

What part of the urinary tract is most susceptible to infection?

A) Urethral mucosa
B) Bladder
C) Ureters
D) Nephrons

Answer 3

A

Question 4

A young woman goes to her physician complaining of dysuria, frequency, urgency, and suprapubic pain. A urinalysis shows hematuria, positive protein, positive leukocyte esterase, and a positive nitrite. What is a probable diagnosis?

A) Pyelonephritis
B) Bacteremia
C) UTI
D) Septicemia

Question 5

What group has the most UTIs caused by Staphylococcus saprophyticus?

A) Asymptomatic older adult men
B) Symptomatic sexually active young women
C) Symptomatic middle-age men
D) Elderly women

Question 6

All of the following can contribute to reduced leukocyte chemotaxis in the renal medulla, except

A) high ammonia concentration.
B) hyperosmolarity.
C) reduced water reabsorption.
D) sluggish blood flow.

Question 7

What characteristic of urine inhibits growth of many pathogens?

A) High glucose level
B) Low pH
C) High protein level
D) High pH

Question 8

The symptoms of pyelonephritis include all the following, except

A) flank pain.
B) costovertebral angle tenderness.
C) fevers.
D) septicemia.

Question 9

When a patient has an indwelling urinary catheter, what symptoms may be present indicating a UTI?

A) Flank pain and fever
B) Urgency and dysuria
C) Frequency and flank pain
D) Costovertebral angle tenderness and fever

Question 10

What organisms growing in a urine culture can generally be considered contaminants?

A) Enterobacteriaceae
B) Streptococcus spp.
C) Fungus
D) Bacillus spp.

Question 11

Urine cultures are performed for all the following reasons, except to

A) test for Chlamydia.
B) confirm a cure of a UTI.
C) detect asymptomatic bacteriuria in pregnant women.
D) evaluate for bacteremia.

Question 12

Urinary tract infection (UTI) in children is associated with significant morbidity and long-term medical problems, including all the following, except

A) impaired renal function.
B) hypertension.
C) end-stage renal disease.
D) hemolytic-uremic syndrome.

Question 13

What might candiduria signify?

A) Bladder or renal parenchymal infection
B) Urinary tract fungus ball
C) Disseminated candidiasis
D) All of the above

Question 14

What is one factor that can contribute to the incidence of candiduria in hospitalized patients?

A) Poor personal hygiene
B) Contaminated instruments
C) Increased use of broad-spectrum antimicrobial agents
D) Multiple bacterial infections of the urinary tract

Question 15

Bacteria gain access to the urinary tract by all of the following routes, except

A) the ascending route.
B) the neurologic route.
C) the hematogenous route.
D) the lymphatic pathways.

Question 16

The atypical clinical presentation of a geriatric patient with a UTI includes all the following, except

A) burning upon urination.
B) delirium.
C) fever.
D) failure to thrive.

Question 17

The criteria used to determine the presence of a UTI include all the following, except

A) presence or absence of symptoms.
B) patient history.
C) predisposing factors.
D) the type of organism or organisms isolated.

Question 18

What organisms usually cause UTIs in older men in conjunction with prostatic hypertrophy?

A) Enterococcus spp.
B) Staphylococcus epidermidis
C) Streptococcus agalactiae
D) Escherichia coli

Question 19

What is the most common cause of uncomplicated UTIs?

A) Pseudomonas aeruginosa
B) Staphylococcus epidermidis
C) Streptococcus agalactiae
D) Escherichia coli

Question 20

While Gardnerella vaginalis can be a cause of UTIs, its presence in urine generally indicates

A) fecal contamination.
B) vaginal contamination.
C) immune suppression.
D) poor personal hygiene.

Question 21

What is the definitive method for collecting uncontaminated urine specimens?

A) Catheterized specimen
B) Suprapubic aspirate
C) First morning specimen
D) Voided midstream specimen

Question 22

What size calibrated loops should be used to inoculate a urine sample that was collected by suprapubic aspiration?

A) 0.001 mL
B) 0.01 mL
C) 0.1 mL
D) 1.0 mL

Question 23

A 22-year-old female with dysuria and urinary frequency submits a urine sample. There is no growth on routine media after 48 hours. Which of the following is the most likely explanation?

A) Asymptomatic bacteriuria
B) Symptomatic bacteriuria
C) Urethral syndrome
D) Pyelonephritis

Question 24

What do specimens with multiple uropathogens (i.e., three or more) indicate?

A) Probable contamination
B) Polymicrobial infection
C) Bacteremia
D) Septicemia

Question 25

What is the most commonly used method to collect urine samples?

A) Catheterized specimen
B) Suprapubic aspirate
C) First morning specimen
D) Voided midstream specimen

Question 26

In what type of specimen is the etiologic agent of acute prostatitis usually recovered?

A) Voided midstream urine
B) Suprapubic aspirate
C) Straight catheterization
D) All of the above

Question 27

How must urine specimens be handled after collection?

A) Store at room temperature for up to 24 hours.
B) Add a small volume to transport medium.
C) Place into incubator for up to 4 hours.
D) Immediately refrigerate.

Question 28

What additive can maintain urine sample integrity for up to 48 hours at room temperature?

A) Sodium citrate
B) Calcium citrate
C) Sodium borate
D) Ethylenediamine tetraacetic acid (EDTA)

Question 29

All of the following features should be considered in a UTI workup, except

A) colony count of a pure or predominant organism.
B) measurement of pyuria.
C) presence or absence of symptoms.
D) nitrite positive.

Question 30

Screening methods for UTIs are appropriate for which of the following?

A) Urine specimens with significant pyuria and bacteriuria
B) Straight catheterization
C) Suprapubic aspiration
D) Cystoscopy