What is the best response when a patient with uncomplicated cystitis is prescribed ciprofloxacin for only 3 days?

Correct Answer: A

Rationale: The correct answer is A because for uncomplicated cystitis, guidelines recommend a 10 to 14-day course of ciprofloxacin to ensure bacterial eradication and prevent recurrence. A 3-day course may lead to treatment failure and the development of antibiotic resistance. Choice B is incorrect as a 3-day course is inadequate. Choice C is incorrect as patient adherence doesn't justify a shorter course. Choice D is irrelevant as it pertains to nosocomial infections, not outpatient cystitis treatment.

Correct Answer: B

Rationale: The correct answer is B because palpating an empty bladder at the level of the symphysis pubis is a standard step in assessing the urinary system. This helps determine the size, shape, and tenderness of the bladder. Auscultating for fluid sounds in the lower abdominal quadrants (choice A) is incorrect as this is done to assess bowel sounds, not the urinary system. Percussing the kidney (choice C) is not a common practice as it may cause harm. Positioning the patient prone to palpate the kidneys (choice D) is incorrect as the kidneys are typically palpated with a posterior approach while the patient is in a supine or side-lying position.

Correct Answer: A

Rationale: The correct answer is A because obtaining a clean-catch midstream urine specimen for culture and sensitivity is essential to confirm the presence of a urinary tract infection (UTI) and determine the appropriate antibiotic treatment. This method helps to identify the specific bacteria causing the infection and their susceptibility to antibiotics. Choice B is incorrect as waiting for the development of severe symptoms like fever, chills, and flank pain can lead to complications and delayed treatment. Choice C is incorrect because empirical treatment without confirming the specific bacteria and their sensitivity can lead to inappropriate antibiotic use and potential antibiotic resistance. Choice D is incorrect as a blood specimen for CBC and kidney function tests is not the primary intervention for a suspected UTI.

Correct Answer: C

Rationale: Rationale for Choice C: 1. Glomerulonephritis is an immune-mediated condition where the accumulation of immune complexes in the glomeruli triggers inflammation and damages the kidney. 2. Immune complexes can form due to various reasons like infections or autoimmune disorders, leading to glomerular injury. 3. This immune complex deposition activates the complement system and attracts inflammatory cells, causing further damage to the glomeruli. Summary of Other Choices: A. Growth of microorganisms in the glomeruli is not a characteristic feature of glomerulonephritis, as it is primarily an immune-mediated condition. B. The release of bacterial substances toxic to the glomeruli is not the primary mechanism of injury in glomerulonephritis. D. Hemolysis of red blood cells circulating in the glomeruli is not a direct cause of glomerulonephritis; it is more characteristic of conditions like hemolytic uremic syndrome.

Correct Answer: D

Rationale: Rationale for correct answer (D): Chronic, recurrent nephrolithiasis is a risk factor for both kidney and bladder cancer. Kidney stones can cause chronic irritation and inflammation, leading to cell changes that increase cancer risk in the urinary system. Summary of incorrect choices: A: Smoking is a risk factor for bladder cancer, but not specifically for kidney cancer. B: Family history of cancer may increase overall cancer risk, but it is not specifically associated with kidney or bladder cancer. C: Chronic use of phenacetin is a risk factor for renal pelvis cancer, not necessarily kidney or bladder cancer.