A nurse is caring for a client who has an admitted diagnosis of renal calculi and medical history of hypertension and gout. The client works 6 days of the week outside in temperatures between 32.2° C to 37.8° C (90° F to 100° F). Which of the following should the nurse tell the client to prevent a reoccurrence of renal calculi?

Eat a diet high in calcium oxalate-rich foods.

Drink plenty of fluids during the day.

Eat a diet high in purine-rich foods.

Continue to take your prescribed gout medication.

Answer and Explanation

The Correct Answer is B

A. Eat a diet high in calcium oxalate-rich foods: This is incorrect. A diet high in oxalate can promote stone formation, so it should be avoided.

B. Drink plenty of fluids during the day. Adequate hydration is the most important strategy to prevent the formation of renal calculi, especially in hot climates where fluid loss through sweat increases the risk.

C. Eat a diet high in purine-rich foods: This is incorrect. Purine-rich foods can increase uric acid levels and contribute to uric acid stone formation, especially in clients with gout.

D. Continue to take your prescribed gout medication: While this is important for managing gout, it does not directly prevent renal calculi, so it is not the most relevant intervention.

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Correct Answer is A

Explanation

A. Laxatives are contraindicated in clients who have a small bowel obstruction. Laxatives such as senna are contraindicated in bowel obstructions because they can increase peristalsis and exacerbate the blockage, leading to complications like bowel perforation or ischemia.

B. Bulk-forming laxatives such as psyllium should be substituted for this client: Bulk-forming laxatives like psyllium would not be appropriate either because they rely on bowel movement for efficacy. They could worsen the obstruction by adding bulk.

C. An osmotic laxative, such as magnesium citrate, should be substituted in this client: Osmotic laxatives, like magnesium citrate, are also contraindicated in bowel obstruction because they draw water into the bowel, which can worsen distension and pressure on the obstructed area.

D. The prescribed medication should be administered via NG route rather than the oral route for this client: While NG tubes may be used to decompress the bowel in cases of obstruction, administering a laxative through an NG tube would still be contraindicated, as laxatives increase the risk of further complications in bowel obstruction.

A. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues. B. Use a floss pick instead of the floss string to floss in between the teeth. C. Apply an ice pack over a bleeding wound. D. Only use a soft-bristle toothbrush.

Correct Answer is D

Explanation

A. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues: While wearing loose or visible clothing may allow skin issues to be seen, it does not directly prevent bleeding complications, and there are more effective measures to focus on.

B. Use a floss pick instead of the floss string to floss in between the teeth: Flossing in any form, especially using a floss pick, can still increase the risk of gum bleeding in thrombocytopenic clients. It is safer to avoid flossing altogether or consult a dentist.

C. Apply an ice pack over a bleeding wound: While applying an ice pack may reduce bleeding once it occurs, it does not prevent bleeding. The focus should be on avoiding activities that increase the risk of bleeding.

D. Only use a soft-bristle toothbrush: Using a soft-bristle toothbrush helps reduce the risk of bleeding from the gums, which is a common issue for clients with thrombocytopenia due to the reduced platelet count.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing medications for a client who has just been diagnosed with a small bowel obstruction. The nurse should withhold senna prescribed orally based on understanding of which of the following?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

Correct Answer is D

Explanation

A female patient recently underwent a partial gastrectomy and is now presenting with symptoms of weakness, dizziness, and sweating, particularly after meals. Based on these symptoms, what is the most likely diagnosis?

A nurse is providing education to a client who has recently been diagnosed with Crohn's disease. Which of the following explanations by the nurse best simplifies and explains the disorder in non-medical terms?

A male patient is being discharged after hospitalization for a bleeding peptic ulcer. The nurse is providing discharge teaching on how to monitor for signs of recurrent bleeding. Which of the following statements by the patient indicates a need for further teaching?

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