The nurse provides care for a client who has a history of renal calculi. Which type of renal calculi is most common in clients with gout?
Uric acid
Struvite
Cystine
Calcium oxalate
The Correct Answer is A
Choice A reason: Uric acid is the most common type of renal calculi in clients with gout because it is a condition where the blood has a high level of uric acid, which is a waste product that results from the breakdown of purines, which are substances found in some foods and drinks, such as meat, seafood, and beer. Uric acid can form crystals in the joints, causing inflammation and pain, which is known as gout. Uric acid can also form crystals in the urine, causing kidney stones, which are hard deposits of minerals and salts that can block the urinary tract and cause symptoms such as severe pain, blood in the urine, nausea, and fever.
Choice B reason: Struvite is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of ammonia, which is a chemical that results from the breakdown of urea, which is a waste product that is produced by the liver and excreted by the kidneys. Ammonia can form crystals in the urine, along with magnesium, phosphate, and carbonate, creating struvite stones, which are large and staghorn-shaped stones that can fill the entire kidney or the ureter. Struvite stones are usually associated with urinary tract infections, which are caused by bacteria that produce enzymes that increase the urine pH and the ammonia level.
Choice C reason: Cystine is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of cystine, which is an amino acid that is a building block of proteins. Cystine can form crystals in the urine, causing kidney stones, which are rare and hereditary. Cystine stones are caused by a genetic disorder that affects the transport of cystine and other amino acids in the kidneys, resulting in excessive excretion of cystine in the urine.
Choice D reason: Calcium oxalate is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of calcium and oxalate, which are substances that are normally present in the diet and the body. Calcium and oxalate can form crystals in the urine, causing kidney stones, which are the most common type of kidney stones in the general population, but not in clients with gout. Calcium oxalate stones can be caused by various factors, such as dehydration, high intake of animal protein, low intake of fluids, and certain medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: "My feet swell up during the evening." is not a specific statement for systolic heart failure, but a general sign of fluid retention. Fluid retention may occur in both systolic and diastolic heart failure, as well as other conditions such as kidney disease, liver disease, or venous insufficiency.
Choice B reason: "It's harder to breathe during hot and humid weather." is not a specific statement for systolic heart failure, but a common complaint of many people with respiratory problems. Hot and humid weather may increase the workload of the lungs and the heart, but it does not indicate a reduced ejection fraction, which is the hallmark of systolic heart failure.
Choice C reason: "I wake up at night being short of breath." is the best statement for systolic heart failure, as it indicates a condition called paroxysmal nocturnal dyspnea. Paroxysmal nocturnal dyspnea is a sudden onset of breathlessness that occurs during sleep, usually due to fluid accumulation in the lungs. It is a sign of left-sided systolic heart failure, which is a failure of the left ventricle to pump blood effectively to the body.
Choice D reason: "I have stomach pain that is worse after meals." is not a specific statement for systolic heart failure, but a possible symptom of gastrointestinal disorders. Stomach pain may be caused by gastritis, ulcers, gallstones, or pancreatitis, among other conditions. It does not reflect the cardiac function or output, which are impaired in systolic heart failure.
Correct Answer is B
Explanation
Choice A reason: Liver failure is not the most common cause of this type of pain because it is a condition where the liver loses its ability to perform its vital functions, such as detoxifying the blood, producing bile, and metabolizing nutrients. Liver failure can cause symptoms such as jaundice, ascites, or bleeding, but it does not usually cause burning pain in the feet.
Choice B reason: Diabetes mellitus is the most common cause of this type of pain because it is a condition where the blood glucose level is too high, either due to insufficient insulin production or reduced insulin sensitivity. Diabetes mellitus can cause damage to the nerves, especially in the peripheral areas, such as the feet, which is called diabetic neuropathy. Diabetic neuropathy can cause symptoms such as burning pain, numbness, or tingling in the feet, which can worsen at night or with pressure.
Choice C reason: Mercury toxicity is not the most common cause of this type of pain because it is a condition where the body is exposed to high levels of mercury, which is a toxic metal that can be found in some fish, dental fillings, or thermometers. Mercury toxicity can cause damage to the nervous system, causing symptoms such as tremors, memory loss, or mood changes, but it does not usually cause burning pain in the feet.
Choice D reason: Vitamin B12 deficiency is not the most common cause of this type of pain because it is a condition where the body does not have enough vitamin B12, which is a nutrient that is essential for the production of red blood cells and the maintenance of the nervous system. Vitamin B12 deficiency can cause symptoms such as anemia, fatigue, or weakness, but it does not usually cause burning pain in the feet.
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