A 78-year-old male client presents to the emergency department complaining of a history of urinary frequency and a weak urinary stream. Today he complains of extreme pain in the pelvic area. The client urinates 50 mL, and an immediate bladder scan shows a post-void residual urine measurement of 600 mL. The nurse recognizes these symptoms are most likely related to which condition?

Benign prostatic hyperplasia (BPH)

End stage renal disease (ESRD)

Pre-renal acute kidney injury (AKI)

Polycystic kidney disease (PKD)

Answer and Explanation

The Correct Answer is A

A.   BPH is a common condition in older men that causes the prostate gland to enlarge, obstructing the urethra and leading to difficulty urinating, urinary retention, and pelvic pain. The symptoms described, including urinary frequency, weak urinary stream, severe pelvic pain, and a significantly elevated post- void residual urine volume, are consistent with BPH.
B.   ESRD can cause urinary symptoms. However, the presentation in this case is more consistent with a urinary obstruction, not a kidney failure issue. ESRD typically involves more systemic symptoms like fatigue, edema, and electrolyte imbalances.
C.   This is unlikely given the patient's age and lack of significant comorbidities. Additionally, the primary issue appears to be urinary obstruction, not a decrease in renal perfusion.
D.   This is a chronic condition that typically presents with flank pain, and it does not usually cause acute urinary retention.

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Correct Answer is B

Explanation

A. Calcium gluconate is used to treat or prevent calcium deficiencies and to manage conditions related to calcium imbalances, such as hypocalcemia. It is not typically used to prevent struvite stones.
B. Antibiotics are the most appropriate choice for preventing the recurrence of struvite stones. Since struvite stones are associated with urinary tract infections caused by urease-producing bacteria, antibiotic therapy is aimed at eliminating these infections. By treating or preventing UTIs, the conditions that lead to struvite stone formation are addressed, reducing the likelihood of recurrence.
C. Tamsulosin is an alpha-blocker used to relax the muscles in the prostate and bladder neck to improve urine flow in conditions like benign prostatic hyperplasia (BPH). It is not specifically used for preventing struvite stones.
D. Phosphate binders are used to reduce phosphate levels in the blood, which is important in managing conditions such as chronic kidney disease (CKD) where phosphate levels can be elevated.

A. Milk B. Liver C. Spinach D. Chocolate

Correct Answer is B

Explanation

A. Milk is low in purines and is not associated with an increase in uric acid levels or the formation of uric acid stones. In fact, dairy products like milk can be beneficial in a diet for managing kidney stones because they are low in purines and provide calcium, which may help prevent stone formation.

B. Liver is very high in purines. High-purine foods increase the levels of uric acid in the body, which can lead to the formation of uric acid stones in the kidneys. Therefore, clients with recurrent kidney stones due to excessive purine intake should avoid liver and other organ meats.
C. Spinach is considered to have a moderate level of purines. While it is not as high in purines as organ meats, it still contains a notable amount. However, in comparison to foods like liver, it is less of a concern for individuals who need to strictly limit purine intake.
D. Chocolate contains a moderate amount of purines, but it is not as high in purines as organ meats like liver. While it’s not completely free from purines, its purine content is generally lower compared to foods such as liver.

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Naxlex Comprehensive Predictor Exams

A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?

Correct Answer is B

Explanation

A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

Correct Answer is B

Explanation

A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

A patient who performs dialysis at home using a catheter placed through the abdominal wall reports nausea, vomiting, diarrhea, and fluid discharge from the catheter site. The laboratory reports reveal an increased white blood cell count (WBC). Which condition does the nurse suspect in the patient?

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following are high-potassium foods which the client should avoid? (Select all that apply.)

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

A nurse is admitting a client who has been diagnosed with acute glomerulonephritis. Considering the most common cause of this condition, which test should the nurse anticipate will be performed?

During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?