family medicine
21-year-old male with soft, non-tender mass on the posterior aspect of the left testicle
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A 46-year-old kindergarten teacher with type 2 diabetes was recently treated for an episode of acute otitis media (AOM) of the right ear. During her follow-up visit, she denies ear pain but reports that she has new onset of dysuria and frequency.
The urine dipstick result shows 3+ leukocytes and is positive for nitrites. On further questioning, the patient denies flank pain and fever but reports that her A1C is 8.5%. She has a sulfa allergy and may also be allergic to penicillins.
Which of the following is the best initial intervention?
- Send a urine specimen for culture and sensitivity to the laboratory and treat the patient for a urinary tract infection (UTI)
- Treat the patient for acute otitis media (AOM) and an acute urinary tract infection (UTI)
- Recheck the urine by sending another specimen to the laboratory and evaluate the patient further
- Advise the patient that she needs further evaluation
This question appears in Med-Challenger Adult-Gerontology Primary Care Nurse Practitioner Review with CME
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