Deck 37: Urinary Tract Infections

Question 1

What is the cause of most uncomplicated urinary tract infections (UTIs)?

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

Answer 1

D
Of the Enterobacteriaceae, antibiotic-susceptible strains of E.coli that emanate from the patient's own fecal flora cause most uncomplicated UTIs.

Question 2

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

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

Answer 2

B
Bacteria gain access to the urinary tract by three different routes, the ascending route, the hematogenous route, and the lymphatic pathways.

Question 3

What may candiduria signify?

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

Answer 3

D
Candiduria may be an indication of bladder or renal parenchymal infection, a urinary tract fungus ball, or disseminated candidiasis.Predisposing factors include diabetes mellitus, antibiotic and corticosteroid therapy, female gender, instrumentations, and disturbance of urine flow.

Question 4

What characteristic of urine inhibits growth of many pathogens?

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

Question 5

The criteria used to determine the presence of a urinary tract infection (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 6

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)Urinary tract infection (UTI)
D)Septicemia

Question 7

What group has more urinary tract infections (UTIs) caused by Staphylococcus saprophyticus?

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

Question 8

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

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

Question 9

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

Question 10

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 11

What organisms usually cause urinary tract infections (UTIs) in older men in conjunction with prostatic hypertrophy?

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

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

A)Poor personal hygiene
B)Contaminated instruments
C)Increased use of broad-spectrum antibiotics
D)Increased use of multidrug regimens in hospitalized patients

Question 14

Because the urethra is shorter in women, bacteria are easily introduced into the bladder by:

A)fecal contamination.
B)vaginal contamination.
C)sexual intercourse.
D)poor personal hygiene.

Question 15

The atypical clinical presentation of a geriatric patient with a urinary tract infection (UTI) includes all the following except:

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

Question 16

All of the following are reasons why institutionalized patients have more urinary tract infections (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.

Question 17

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

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

Question 18

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

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

Question 19

The symptoms of pyelonephritis include all the following except:

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

Question 20

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

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

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

All of the following features should be considered in a urinary tract infection (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 23

Because urine is an excellent supportive medium for bacteria growth, how must urine specimens be handled after collection?

A)Store at room temperature for up to 24 hours.
B)Process the refrigerated specimen within 24 hours.
C)Store in the refrigerator for 48 hours.
D)Immediately refrigerate.

Question 24

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 25

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 26

Screening methods for urinary tract infections are appropriate for which of the following?

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

Question 27

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 28

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 29

What specimen reduces the risk of contamination with urethral flora?

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

Question 30

In what patient population is a colony count on a urine culture significant?

A)Young, sexually active women with cystitis
B)Elderly men with prostatitis
C)Asymptomatic individuals with pyelonephritis
D)Elderly women with candiduria

Question 31

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

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