Which client report should prompt the nurse to suspect a kidney stone?
Burning during urination
Dark, frothy urine with strong odor
Dull flank pain relieved by rest
Sudden sharp pain radiating to groin
The Correct Answer is D
Rationale:
A. Burning during urination is most commonly associated with urinary tract infections (UTIs) or irritation of the urethra, not kidney stones. While stones can cause some urinary discomfort, dysuria alone is not the hallmark symptom for nephrolithiasis.
B. Dark, frothy urine with strong odor suggests proteinuria, hematuria, or a possible infection. These findings are more consistent with conditions like glomerulonephritis or urinary tract infections rather than kidney stones. Kidney stones do not typically produce frothy urine unless there is secondary infection or concurrent renal disease.
C. Dull flank pain relieved by rest is characteristic of musculoskeletal issues or chronic renal conditions but is not typical for kidney stones. Pain from kidney stones is usually acute and severe rather than dull and alleviated by rest.
D. Sudden sharp pain radiating to the groin is the classic symptom of a kidney stone (renal colic). The pain results from obstruction of the ureter by a stone, causing spasm of smooth muscle in the ureter and increased hydrostatic pressure in the kidney. The pain often begins in the flank or lower back and may radiate toward the abdomen, groin, or genital area. It is typically severe, colicky, and intermittent as the stone moves. Associated symptoms can include nausea, vomiting, hematuria, and urinary urgency. The acute, radiating nature of the pain makes this the hallmark presentation prompting suspicion of a kidney stone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Neprilysin is an enzyme that breaks down natriuretic peptides and other vasoactive substances but does not convert angiotensin I to angiotensin II. Its role in the RAAS is indirect and involves modulation of vasodilation rather than the direct formation of angiotensin II.
B. ACE is a key enzyme in the renin-angiotensin-aldosterone system (RAAS). It converts angiotensin I, an inactive decapeptide, into angiotensin II, a potent vasoconstrictor. Angiotensin II increases blood pressure by causing vasoconstriction, stimulating aldosterone release from the adrenal cortex, and promoting sodium and water reabsorption in the kidneys. This conversion is central to regulating blood pressure and fluid balance.
C. Aldosterone is a hormone released by the adrenal cortex in response to angiotensin II. It promotes sodium and water reabsorption in the distal tubules and collecting ducts, increasing blood volume and pressure, but it does not catalyze the conversion of angiotensin I to angiotensin II.
D. Renin is an enzyme secreted by the juxtaglomerular cells of the kidney in response to low blood pressure or sympathetic stimulation. It cleaves angiotensinogen into angiotensin I, the inactive precursor, but it does not convert angiotensin I to angiotensin II.
Correct Answer is D
Explanation
Rationale:
A. Decreased blood flow to the kidneys is not related to stress incontinence. While renal perfusion affects urine production, it does not cause leakage of urine due to increased pressure or pelvic floor weakness.
B. Involuntary detrusor muscle spasms are associated with urge incontinence, not stress incontinence. In urge incontinence, sudden, strong contractions of the detrusor muscle lead to an urgent need to void, often resulting in leakage if the person cannot reach a bathroom in time.
C. Lack of bladder sensation can contribute to functional incontinence or overflow incontinence but is not the primary mechanism in stress incontinence. Functional incontinence occurs when the person is unable to respond to normal bladder signals due to cognitive or physical impairments.
D. Increased intra-abdominal pressure is the primary cause of stress incontinence in women. Stress incontinence occurs when physical activities such as coughing, sneezing, laughing, or exercising increase pressure within the abdomen, and the weakened pelvic floor muscles or urethral sphincter are unable to maintain closure. This results in involuntary leakage of urine. Factors such as pregnancy, childbirth, aging, and hormonal changes can weaken pelvic floor support, making stress incontinence more common in women.
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