Explanation:

The correct answer is "pyelonephritis." This is the correct answer because the patient's presentation with dysuria that progresses to include fever, chills, and lower back pain, is a very classic presentation of pyelonephritis. Pyelonephritis is an infection of the renal parenchyma, most commonly due to an ascending urinary tract infection. In this patient, who is a female (which places her at a greater risk for UTI's as compared to males due to females having shorter urethras than males) who initially has dysuria, this is a convincing story for a UTI. Further, the fact that the symptoms of fever, chills, and lower back pain are not present initially with the dysuria, but develop over the next day, is further evidence that pyelonephritis is the likely diagnosis. The physical exam finding of unilateral costovertebral angle tenderness also is highly suggestive of pyelonephritis. 

The other choices are incorrect. Spinal stenosis is not a common diagnosis in young, otherwise healthy patients, and would not account for dysuria and unilteral costovertebral angle tenderness. A pneumothorax would not cause dysuria and would likely present with shortness of breath. Primary syphilis and genital herpes would not account for dysuria, lower back pain, or costovertebral angle tenderness.

Explanation:

The correct answer is "primary syphilis." This is the correct answer as the classic presentation of primary syphilis is a painless chancre found on the base, shaft, or glans of the penis. The other choices are incorrect. A urinary tract infection would not present with a chancre, and would typically present with dysuria. Chlamydia or gonorrhea would typically present with penile discharge in males, not a painless chancre. Genital herpes would typically present with one or multiple painful ulcers on the penis, not a single painless chancre.

Explanation: Eye lubricants are not used to achieve miosis during eye surgery. Eye lubricants are frequently used to treat dry eyes in cases where tears need to be replaced, to moisten contact lenses, or to protect eyes during surgery.

Explanation: Stage 1 is called early localized Lyme disease. The infection is not yet widespread throughout the body. This is treated with a topical antihistamine to reduce symptoms.

Explanation:

Presbyopia, or farsightedness, is caused by a loss of elasticity in the lens of the eye, and is considered a normal change with aging.

Glaucoma, blepharitis, and cataracts all carry increased risk with advanced age, but are considered to be abnormal and/or pathological changes.

Explanation:

Cigarette smoking and other poor lifestyle choices have been shown to cause decreased fertility in men. Surgeries such as hernia repair can also have a negative effect on male fertility. Sexually transmitted infection can cause fertility problems, especially if left untreated, in males and females. Frequent hot tub or spa use has also not recommended. Mild levels of sun exposure are the least likely of the above to cause infertility in men. 

Explanation:

The male condom is the most effective when used correctly. However, if used incorrectly, carries a much higher risk of failure. The male condom is also the only method of the answer choices that also carries protection against sexually transmitted diseases. 

Explanation:

Medroxyprogesterone acetate injection is the most effective of the listed methods. Other methods of the above carry the risk for displacement or incorrect use. The nurse should inform the client that the medroxyprogesterone acetate injection is not effective against sexually transmitted diseases.

Explanation:

Never twist, jerk, or rip the tick when attempting to remove them from the skin. Wear gloves or use a paper towel if they are not available. Seal the tick within a plastic bag and keep it in the freezer. If illness occurs, the tick may be useful for further testing. 

Explanation:

Escherichia coli is a bacteria that lives in the normal flora of the intestines. However, it is also a frequent cause of urinary tract infections. Candida albicans is a fungus that frequently causes thrush and vaginitis. Mycobacterium leprae is responsible for leprosy or Hansen's disease. Treponema pallidum is a spirochete responsible for syphilis. Lastly, Clostridium botulinum is responsible for botulism as a result of it's secretion of a neurotoxin.