A nurse is caring for four clients on the urology unit. Which of the following clients should the nurse plan to teach about kidney stone prevention?

The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting.

The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass.

The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria.

The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure.

Answer and Explanation

The Correct Answer is A

A. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting: These are hallmark signs of a current or recent episode of kidney stones. Once the acute symptoms are managed, this client would benefit the most from kidney stone prevention education, including dietary modifications and increased fluid intake, to reduce recurrence risk.
B. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass: These signs suggest a chronic kidney condition such as polycystic kidney disease or another form of kidney pathology rather than nephrolithiasis. Kidney stone prevention is not the primary teaching focus for this client.
C. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria: These symptoms are more consistent with a lower urinary tract condition such as benign prostatic hyperplasia (BPH) or a urinary tract infection, rather than kidney stones. Prevention teaching should be focused on the underlying cause.
D. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure: These symptoms point to nephrotic syndrome or glomerulonephritis, which involve protein loss and renal inflammation. The pathophysiology here differs from that of kidney stone formation, and stone prevention would not be the priority.

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Correct Answer is D

Explanation

A. Decreased urinary sodium: In SIADH, urinary sodium is typically not decreased. The kidneys continue to excrete sodium even in the presence of low serum sodium, due to the inappropriate retention of water. This results in normal or elevated urinary sodium levels, making decreased urinary sodium inconsistent with SIADH.
B. Increased serum sodium: SIADH is characterized by the retention of free water, which leads to dilutional hyponatremia, not hypernatremia. The excess water dilutes sodium concentration in the blood, resulting in decreased rather than increased serum sodium. Elevated serum sodium would suggest dehydration or another endocrine issue.
C. Decreased urine osmolality: In SIADH, the kidneys respond to the high levels of antidiuretic hormone by concentrating the urine. As a result, urine osmolality is typically elevated, not decreased. Dilute urine would be more consistent with diabetes insipidus rather than SIADH.
D. Decreased serum osmolality: This is a key diagnostic feature of SIADH. The excessive release of ADH causes the body to retain water, which dilutes the blood and lowers serum osmolality. This dilutional effect also contributes to hyponatremia and associated neurological symptoms.

A. Fatigue B. Pain C. Confusion D. Slurred speech

Correct Answer is A

Explanation

A. Fatigue: Fatigue is a hallmark symptom of iron deficiency anemia due to decreased oxygen delivery to tissues. With insufficient iron, the production of hemoglobin is impaired, leading to a reduced oxygen-carrying capacity of red blood cells, which results in fatigue and weakness.
B. Pain: While pain is not directly associated with iron deficiency anemia, individuals with severe anemia may experience discomfort or cramping due to poor oxygenation of tissues, but this is not a primary or expected symptom of the condition.
C. Confusion: Confusion can occur in severe cases of anemia due to insufficient oxygen supply to the brain, but it is not a common or early finding in iron deficiency anemia. It is more likely to appear if anemia becomes more severe or chronic.
D. Slurred speech: Slurred speech is not a typical symptom of iron deficiency anemia. If present, slurred speech could indicate other neurological issues or a more severe condition, such as a stroke or a neurological disorder.

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A nurse is caring for four clients on the urology unit. Which of the following clients should the nurse plan to teach about kidney stone prevention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following physiological alterations is consistent with a diagnosis of SIADH?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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