A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram.

Which instruction should the nurse include in the client’s discharge instructions?

Use an incentive spirometer.

Monitor the urinary stream for decreased output.

Restrict physical activities.

Report when hematuria becomes pink-tinged.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Using an incentive spirometer is generally recommended for respiratory conditions to improve lung function, not specifically for a client with hydronephrosis and a history of renal calculi.
Choice B rationale
Monitoring the urinary stream for decreased output is crucial for a client with hydronephrosis and a history of renal calculi. Hydronephrosis is a condition characterized by urine accumulation in the kidney, which can lead to decreased urine output. Therefore, monitoring urinary output can help detect any potential complications or worsening of the condition.
Choice C rationale
Restricting physical activities is not typically necessary for a client with hydronephrosis and a history of renal calculi unless specified by the healthcare provider. It’s more important to focus on maintaining overall health and well-being.
Choice D rationale
Reporting when hematuria becomes pink-tinged is not the most relevant instruction for a client with hydronephrosis and a history of renal calculi. While it’s important to report any changes in urine color, monitoring urinary output (Choice B) is more directly related to the client’s condition.

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Correct Answer is A

Explanation

Choice A rationale
Maintaining the prescribed fluid restriction is crucial in the management of SIADH. Fluid restriction helps to prevent further dilution of sodium in the blood, which can exacerbate the symptoms of SIADH34.
Choice B rationale
Withholding the next scheduled dose of treatment is not necessarily the appropriate intervention based on the increase in serum sodium level. The treatment plan should be adjusted based on the patient’s overall clinical picture and in consultation with the healthcare provider.
Choice C rationale
Increasing neurologic checks to every 2 hours is not directly related to the increase in serum sodium level. While neurologic checks are important in monitoring the overall health status of the patient, they are not specifically indicated based on the serum sodium level alone.
Choice D rationale
Assessing for increasing fluid volume overload is not the appropriate intervention based on the increase in serum sodium level. SIADH is characterized by water retention, not fluid volume overload.

A. Start an intravenous infusion for antiviral drug to be administered for positive COVID-19 test results. B. Move the patient to a private room, keep the door closed, and initiate droplet precautions. C. Notify the charge nurse that the patient will need assignment to the COVID-19 specified area of the facility. D. Explain to the patient to inform others that they may have been potentially exposed in the last 14 days.

Correct Answer is B

Explanation

Choice A rationale
Starting an intravenous infusion for antiviral drug administration is premature at this stage. The patient’s COVID-19 test results are not yet available, and antiviral drugs should not be administered without a confirmed positive test.
Choice B rationale
Moving the patient to a private room, keeping the door closed, and initiating droplet precautions is the most important action. Given the patient’s symptoms and the significant other’s COVID-19 status, these measures will help prevent potential spread of the virus.
Choice C rationale
Notifying the charge nurse for assignment to the COVID-19 specified area of the facility is important, but it is not the immediate priority. The first step should be to initiate droplet precautions to minimize the risk of transmission.
Choice D rationale
While it is important to inform the patient about potential exposure, the immediate priority is to prevent the spread of the virus within the healthcare facility.

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A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram. Which instruction should the nurse include in the client’s discharge instructions?

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Naxlex Comprehensive Predictor Exams

A patient with small cell carcinoma of the lung is admitted with syndrome of inappropriate antidiuretic hormone (SIADH). The patient’s serum sodium level increases from 120 mEq/L to 125 mEq/L as they respond to treatment. Based on this finding, what intervention should the nurse implement?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram.

Which instruction should the nurse include in the client’s discharge instructions?