A nurse is assessing a client with suspected kidney stones. The client reports experiencing severe pain in the back and lower abdomen, along with nausea and vomiting. On physical examination, the nurse notes costovertebral angle tenderness. Which type of kidney stones is most likely causing the client's symptoms?

Calcium oxalate stones

Struvite stones

Cystine stones

Answer and Explanation

The Correct Answer is C

A. Uric acid stones may cause pain, but they do not typically present with costovertebral angle tenderness. Uric acid stones are more likely to be associated with gout and hyperuricemia.

B. Calcium oxalate stones are common and can cause pain, but they do not typically cause costovertebral angle tenderness. They are more likely to cause localized pain in the back or side.

C. This is the correct answer. Struvite stones, also known as infection stones, can cause severe pain that radiates to the back and lower abdomen. They are often associated with urinary tract infections, and the presence of an infection can lead to costovertebral angle tenderness.

D. Cystine stones are rare and are more likely to cause chronic, dull pain rather than sudden and severe pain with tenderness.

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Correct Answer is C

Explanation

A. Extracorporeal shock wave lithotripsy (ESWL) does not typically require general anesthesia. It is usually done under sedation or with the use of local anesthesia.

B. The procedure does not involve the insertion of a scope into the urinary tract. ESWL is a non-invasive procedure that uses shock waves to break up the stone from outside the body.

C. This is the correct answer. ESWL involves the use of high-energy shock waves that are focused on the stone to break it up into smaller fragments. The fragments are then passed out of the body through the urine.

D. A urinary catheter is not typically required after ESWL. The client may be encouraged to drink plenty of fluids to help flush out the stone fragments, but a catheter is not usually needed.

Questions

A. Urinary retention B. Hyperkalemia C. Hypoglycemia D. Hypertension

Correct Answer is A

Explanation

A. This is the correct answer. After percutaneous nephrolithotomy (PCNL), the client may experience urinary retention due to swelling and irritation around the bladder or urethra from the procedure. The nurse should monitor the client for signs of urinary retention, such as difficulty urinating or a distended bladder, and take appropriate measures to relieve the obstruction.

B. Hyperkalemia is not directly related to PCNL. It may occur in certain medical conditions but is not a common complication of this procedure.

C. Hypoglycemia is not related to PCNL. It is a condition related to low blood sugar levels and is not a typical complication of kidney stone removal.

D. Hypertension is not directly related to PCNL. While some clients with hypertension may be at increased risk for kidney stones, hypertension is not a common complication of PCNL itself.

Questions

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Naxlex Comprehensive Predictor Exams

A client with renal calculus is scheduled for extracorporeal shock wave lithotripsy (ESWL). What information should the nurse provide to the client about this procedure?

Correct Answer is C

Explanation

A nurse is caring for a client who had a kidney stone removed through percutaneous nephrolithotomy (PCNL). The nurse should closely monitor the client for which potential complication?

Correct Answer is A

Explanation

A nurse is caring for a client who had a kidney stone removed through ureteroscopy. The nurse should closely monitor the client for which potential complication?

A client with a history of kidney stones is prescribed a thiazide diuretic. The nurse should monitor the client's laboratory values for which electrolyte imbalance?

A client asks the nurse, "What can I do to prevent kidney stones from forming again?" Which response by the nurse is most appropriate?

A nurse is teaching a client about dietary modifications to prevent the recurrence of calcium oxalate stones. Which instruction should the nurse include?

A client comes to the emergency room complaining of sudden, excruciating pain in the lower back and side. The nurse suspects renal calculus. Which term best describes this type of pain?

A client with a history of kidney stones is prescribed potassium citrate. Which statement by the client indicates understanding of the medication's purpose?

A nurse is teaching a client with a history of struvite stones about dietary modifications to prevent stone recurrence. Which instruction should the nurse include in the client's plan of care?

A nurse is providing education to a client who has a family history of kidney stones. The client asks, "Can I do anything to prevent getting kidney stones?" What is the nurse's best response?