A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?

Correct Answer: D

Rationale: The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions. Choices A, B, and C are incorrect: A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis. B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis. C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.

Correct Answer: A

Rationale: The correct answer is A because prerenal oliguria is typically characterized by a low specific gravity in urine testing. This indicates that the kidneys are conserving water due to decreased blood flow or volume. Choices B and C are incorrect as they do not specifically relate to prerenal oliguria. Choice D is also incorrect as reversal of oliguria with fluid replacement is not specific to prerenal oliguria and can occur in other types of renal failure.

Correct Answer: C

Rationale: Correct Answer: C - Dextrose in a higher concentration than in the blood Rationale: 1. Dextrose in PD dialysate helps to create an osmotic gradient for fluid removal. 2. Higher dextrose concentration ensures effective ultrafiltration. 3. Dextrose is the main osmotic agent used in PD. 4. A higher concentration of dextrose in the dialysate aids in waste removal. Summary: A: Incorrect - Calcium concentration in dialysate is similar to blood to avoid imbalance. B: Incorrect - Sodium concentration is lower in dialysate to prevent sodium loading. D: Incorrect - Electrolyte concentration in dialysate is tailored to patient needs, not equal to blood.

Correct Answer: C

Rationale: The correct answer is C: Apples. Apples are acidic in nature, which can help lower the pH of urine. Consuming acidic foods can make the urine more acidic. Milk is alkaline, so it would raise the pH of urine. Tea can vary in acidity, but generally it is not chosen to lower urine pH. Meat is also not acidic and would not contribute to lowering urine pH. So, apples are the most suitable choice for lowering urine pH among the options provided.

Correct Answer: D

Rationale: The correct answer is D: a high and rising level of potassium. Dialysis is indicated in acute renal failure when the patient has severe electrolyte imbalances, especially hyperkalemia, which can lead to life-threatening arrhythmias. Potassium levels must be closely monitored, and if they are high and continue to rise despite conservative treatment, dialysis is necessary to quickly lower the potassium levels. Generalized edema (A) is a symptom of renal failure but is not the main indication for dialysis. Elevated blood pressure (B) and elevated blood calcium (C) are not direct indications for dialysis in the context of acute renal failure.