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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Respiratory acidosis: Clients with COPD have chronic difficulty exhaling carbon dioxide due to airflow obstruction, leading to CO₂ retention. This accumulation of carbon dioxide causes a drop in blood pH, resulting in respiratory acidosis, a common acid-base imbalance in COPD patients.
B. Metabolic acidosis: Metabolic acidosis results from increased acid production or loss of bicarbonate through the kidneys or gastrointestinal tract, such as in diabetic ketoacidosis or severe diarrhea. It is not typically associated with impaired ventilation or chronic lung disease like COPD.
C. Respiratory alkalosis: Respiratory alkalosis occurs when there is excessive loss of carbon dioxide due to hyperventilation. Clients with COPD generally hypoventilate rather than hyperventilate, making this acid-base imbalance unlikely in this case.
D. Metabolic alkalosis: Metabolic alkalosis is typically caused by loss of hydrogen ions through vomiting or diuretic use, or excessive bicarbonate intake. It is unrelated to the impaired gas exchange and CO₂ retention seen in clients with COPD.
Correct Answer is B
Explanation
A. The SA node sends an electrical signal greater than 100/min: A fast SA node firing rate may indicate sinus tachycardia, not atrial fibrillation. In atrial fibrillation, the SA node is not the primary pacemaker because disorganized signals originate from multiple ectopic foci in the atria, leading to ineffective atrial contractions.
B. The heart's electrical signals are rapid, chaotic, and irregular: In atrial fibrillation, the atria experience disorganized and chaotic electrical impulses, causing an irregular and often rapid heart rhythm. This results in decreased cardiac output, leading to symptoms like dizziness and palpitations due to poor perfusion.
C. An early electrical signal occurs before the expected sinoatrial (SA) node signal: This describes a premature atrial contraction (PAC), not atrial fibrillation. PACs are isolated early beats and do not typically result in sustained irregular rhythms or significant hemodynamic symptoms like those seen in atrial fibrillation.
D. The heart's electrical transmission through the atrioventricular (AV) node is unusually slow:
Delayed conduction through the AV node is associated with AV blocks, not atrial fibrillation. While AV conduction may be variable in atrial fibrillation, the root problem lies in the atria, not in slowed AV nodal transmission.
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