The nurse is performing an admission assessment for a client with pyelonephritis who has urgency and burning while urinating. Which finding indicates an expected response when the nurse percusses the costovertebral angle?

Choice A rationale An audible thud without pain is a normal finding when percussing the costovertebral angle (CVA) in a healthy individual. This indicates that there is no inflammation or infection in the kidneys or surrounding tissues. Choice B rationale Sharp, severe pain upon percussion of the CVA is a classic sign of pyelonephritis. This pain is due to the inflammation and infection of the kidney, which causes tenderness in the area. Choice C rationale Rebound tenderness is typically associated with peritoneal irritation, such as in cases of appendicitis or peritonitis. It is not a common finding in pyelonephritis. Choice D rationale Rigidity and firmness are more indicative of muscle spasms or guarding, which can occur in conditions like peritonitis or severe abdominal pain, but not specifically in pyelonephritis.