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 C
Explanation
A. Client D ran out of diuretics yesterday. The client's blood pressure is 136/84, heart rate is 88/min, respiratory rate is 18/min, and pulse oximetry is 95%: This client is stable with normal vital signs and does not show evidence of immediate life-threatening conditions. Although running out of diuretics may require prompt attention, it does not qualify as ESI Level 1.
B. Client B is obese and has right lower leg pain and swelling. The client's heart rate is 76/min and regular, blood pressure is 126/78, respiratory rate is 18/min, and pulse oximetry is 96%: This presentation could indicate a deep vein thrombosis, which is serious but not immediately life-threatening. The client is hemodynamically stable and does not meet the criteria for ESI Level 1.
C. Client A reports dizziness and confusion. The client's heart rate is 120/min and irregular, blood pressure is 88/52, respiratory rate is 26/min, and pulse oximetry is 82%: This client shows signs of hemodynamic instability, including hypotension, hypoxia, altered mental status, and an irregular, rapid heart rate. These findings indicate a critical condition requiring immediate life-saving interventions, qualifying the client for ESI Level 1.
D. Client C reports a urinary tract infection (UTI). The client's heart rate is 72/min, blood pressure is 110/70, respiratory rate is 15/min, and pulse oximetry is 98%: This client is stable with no signs of systemic or life-threatening complications. UTI symptoms can be uncomfortable but are not immediately life-threatening if vital signs are normal.
Correct Answer is ["A","B","C","D"]
Explanation
A. Thoracentesis: Thoracentesis may be ordered if there is suspected pleural effusion or hemothorax following thoracic trauma. It allows for both diagnostic and therapeutic removal of fluid or blood from the pleural space and helps assess the extent of internal injury.
B. Ultrasound: Ultrasound is a non-invasive tool used to quickly assess thoracic structures such as the pleura and pericardium. It helps detect hemothorax, pneumothorax, or pericardial effusion, and is commonly used in emergency settings for rapid diagnosis.
C. Focused assessment with sonography in trauma (FAST): FAST is a rapid bedside ultrasound exam used to detect free fluid (blood) in the thoracic or abdominal cavity. In trauma cases, it helps quickly identify life-threatening internal bleeding or organ injury, making it a critical diagnostic tool.
D. Chest x-ray: A chest x-ray is a standard imaging technique used to evaluate thoracic injuries. It can reveal fractures, pneumothorax, hemothorax, and other abnormalities in the chest cavity, providing a clear view of the extent of injury.
E. Pleural cavity decompression via needle aspiration: Needle aspiration is a therapeutic procedure rather than a diagnostic tool. It is used in emergencies to relieve a tension pneumothorax, not to assess or diagnose thoracic injury. Therefore, it is not anticipated as a diagnostic measure.
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