Pyelonephritis Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 36-year-old woman presents to the primary care clinic due to burning with urination for five days. This morning, the patient developed chills and pain in the right flank. The patient has not experienced nausea or vomiting, and review of systems is otherwise unremarkable. The patient has had three urinary tract infections in the last four years. The patient has no other significant medical history and takes no medications. Temperature is 38.2 ºC (100.8 ºF), pulse is 84/min, and blood pressure is 128/79 mmHg. On physical examination, the right costovertebral angle is tender to palpation. Pregnancy test is negative. Urine microscopy shows white blood cell casts and many bacteria. Serum white blood cell count is 14,000/mm³. Serum basic metabolic panel shows no abnormalities. Which of the following is the most appropriate next step in management?

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Prescribe seven days of nitrofurantoin

Administer intramuscular ceftriaxone and prescribe oral ciprofloxacin

Collect a urine culture and wait for results before starting antibiotics

Admit to the hospital for IV piperacillin-tazobactam therapy and IV fluids

Admit to the hospital for IV fluids and urology consultation