Family Nurse Practitioner Exam

A 21-year-old female has dysuria and urgency. What is the most appropriate follow-up?

1. Order a urinalysis and treat with antibiotics

2. Order a urine culture and wait for results

3. Treat with a 7-day course of antibiotics immediately

4. Treat with a stronger drug for 10 days

The correct answer is: Order a urinalysis and treat with antibiotics

Ordering a urinalysis is an appropriate first step in managing a patient with dysuria and urgency, as it allows for the initial evaluation of the urinary tract. A urinalysis can help identify signs of infection, such as the presence of nitrites, leukocyte esterase, or white blood cells, which are indicators of a urinary tract infection (UTI). If the urinalysis indicates an infection, treating with antibiotics can provide timely relief and address the underlying cause of the symptoms. This choice aligns well with clinical practice, which recommends assessing for UTI through urinalysis before initiating treatment. Because immediate treatment can be beneficial, though cultures could also be considered, urinalysis serves as a valuable initial screening tool that can guide further management effectively. It's important in such cases to balance prompt treatment with appropriate diagnostic steps, making this approach both practical and rational in primary care settings.