A client with renal calculi is experiencing hematuria and reports severe flank pain.
Which intervention should the nurse implement first?
Obtain a urine specimen for analysis.
Administer a prescribed opioid analgesic.
Strain the urine for the presence of stones.
Prepare the client for a prescribed computed tomography (CT) scan.
Prepare the client for a prescribed computed tomography (CT) scan.
The Correct Answer is B
Choice A rationale:
Obtaining a urine specimen for analysis is an important step in the assessment of the client with renal calculi. However, it is not the most immediate intervention when the client is experiencing severe flank pain and hematuria. Pain management should take precedence.
Choice B rationale:
This is the correct answer. Severe flank pain in a client with renal calculi is indicative of renal colic, which is typically excruciating. Administering a prescribed opioid analgesic is the priority to relieve the client's pain and distress.
Choice C rationale:
Straining the urine for the presence of stones is an essential nursing intervention to identify and collect any passed stones. However, it is not the most immediate action when the client is in severe pain. Pain management is the priority.
Choice D rationale:
Preparing the client for a prescribed computed tomography (CT) scan is an important diagnostic step to assess the location and size of the renal calculi. However, it is not the most immediate intervention when the client is in severe pain and distress. Pain management should come first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Assessment of tobacco use geared toward adolescents. Rationale: While assessing tobacco use is essential for promoting health in adolescents, the question is about developing a class about mental health and addressing the increase in suicides in the community. Assessing tobacco use is not directly related to this topic. Stress self-management techniques are more relevant.
Choice B rationale:
Exploration of stress self-management techniques. Rationale: This is the correct answer. Addressing stress and teaching adolescents self-management techniques is crucial in the context of mental health promotion and suicide prevention. Adolescents often face stressors, and providing them with effective strategies to manage stress can contribute to their overall well-being.
Choice C rationale:
Video with statistics showing trends in suicide rates. Rationale: While providing statistics about suicide rates can be informative, it may not be the most engaging or effective method for teaching adolescents about mental health and stress management. Interactive activities and skill-building exercises are often more beneficial.
Choice D rationale:
Handouts for local substance abuse treatment centers. Rationale: Providing handouts for substance abuse treatment centers
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}
Explanation
Choice B rationale:
Stroke is a condition that occurs when the blood supply to a part of the brain is interrupted, causing brain tissue damage. Facial drooping and garbled speech are common signs of stroke, especially if they occur suddenly and on one side of the face.Stroke is a medical emergency that requires immediate treatment to prevent further brain damage and complications
Choice C rationale:
An allergic reaction could cause various symptoms, but it typically does not result in facial drooping or garbled speech. Common signs of an allergic reaction include hives, itching, redness, and swelling of the skin, as well as difficulty breathing in severe cases (anaphylaxis). There is no mention of these symptoms in the client’s presentation.
Choice D rationale:
Malignant hypertension is a possibility given the client’s extremely high blood pressure reading. This condition refers to severe hypertension that can quickly lead to organ damage. However, while it can cause neurological symptoms if it leads to a hypertensive crisis, the specific symptoms of facial drooping and garbled speech are more indicative of a stroke. In conclusion, based on the collected data, the nurse recognizes that the client is most likely exhibiting signs of a stroke as evidenced by neurological defects (facial drooping and garbled speech). The client’s high blood pressure and reported alcohol consumption are both risk factors for stroke. Immediate medical intervention is crucial to minimize brain damage and potential complications.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
