A client with recurrent kidney stones is prescribed thiazide diuretics. The nurse should recognize that these medications help prevent stone formation by:

A. Citrus fruits are generally not a concern for calcium oxalate stones. They are a good source of citrate, which may actually help prevent stone formation.

B. Dairy products are not specifically associated with calcium oxalate stones. However, high-calcium supplements might increase the risk, not dietary calcium from dairy products.

C. Red meat is not a significant concern for calcium oxalate stones. It is more associated with uric acid stones.

D. This is the correct answer. Leafy green vegetables are high in oxalates, which can contribute to calcium oxalate stone formation. Clients with calcium oxalate stones should limit their intake of these vegetables.

A. Fever and chills are more commonly associated with a urinary tract infection, which can sometimes be a complication of kidney stones. However, the severe pain described is more likely related to the presence of the stone itself.

B. This is the correct answer. Blood in the urine, also known as hematuria, is a common symptom of kidney stones. As the stone moves through the urinary tract, it may cause irritation and small blood vessels may be damaged, resulting in blood in the urine.

C. Difficulty starting the urine stream is not a specific symptom of kidney stones. It may be seen in other urinary conditions but is not typically associated with stones.

D. The frequent urge to urinate may be experienced if the stone causes irritation in the bladder, but it is not the most common symptom associated with kidney stones.