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 A
Explanation
Rationale:
A. Wheezing occurs when airflow passes through narrowed or obstructed airways, as seen in conditions like asthma, chronic bronchitis, or bronchiolitis. The turbulence created by bronchospasm, inflammation, or mucus accumulation produces a characteristic high-pitched, musical sound, typically heard during expiration, although severe obstruction can produce wheezing during both inspiration and expiration.
B. Crackles (rales) are intermittent, popping sounds caused by the sudden opening of small, fluid-filled airways in conditions such as pulmonary edema, pneumonia, or interstitial lung disease. They are not associated with airway narrowing from bronchospasm.
C. This description corresponds to rhonchi, which are caused by airflow through larger airways obstructed with thick secretions. Rhonchi are different from wheezing, which is high-pitched and usually occurs in smaller bronchioles.
D. Silent breathing indicates severe airway obstruction or near-complete airway closure, which is a medical emergency. While it may occur in extreme cases of asthma, it is not a characteristic feature of wheezing in narrowed airways.
Correct Answer is B
Explanation
Rationale:
A. Very low-density lipoprotein (VLDL) is incorrect. VLDL is considered a “bad” lipoprotein because it carries triglycerides from the liver to peripheral tissues and can contribute to plaque formation in arteries. Elevated VLDL levels increase the risk of atherosclerosis and cardiovascular disease.
B. High-density lipoproteins (HDL) is correct. HDL is referred to as “good cholesterol” because it transports excess cholesterol from peripheral tissues back to the liver for excretion or recycling. High levels of HDL are associated with reduced risk of atherosclerosis and cardiovascular events. HDL also has anti-inflammatory and antioxidant properties, providing additional protection to blood vessels.
C. Intermediate-density lipoproteins (IDL) is incorrect. IDL is a transitional lipoprotein formed during the metabolism of VLDL to LDL. It is considered atherogenic, meaning it can contribute to plaque buildup, and is not classified as “good cholesterol.”
D. Low-density lipoproteins (LDL) is incorrect. LDL is commonly referred to as “bad cholesterol” because it transports cholesterol from the liver to peripheral tissues, where it can deposit in the arterial walls and lead to atherosclerosis, heart attacks, and strokes.
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