A client with renal calculi is experiencing hematuria and reports severe flank pain.
Which intervention should the nurse implement first?
Obtain a urine specimen for analysis.
Administer a prescribed opioid analgesic.
Strain the urine for the presence of stones.
Prepare the client for a prescribed computed tomography (CT) scan.
Prepare the client for a prescribed computed tomography (CT) scan.
The Correct Answer is B
Choice A rationale:
Obtaining a urine specimen for analysis is an important step in the assessment of the client with renal calculi. However, it is not the most immediate intervention when the client is experiencing severe flank pain and hematuria. Pain management should take precedence.
Choice B rationale:
This is the correct answer. Severe flank pain in a client with renal calculi is indicative of renal colic, which is typically excruciating. Administering a prescribed opioid analgesic is the priority to relieve the client's pain and distress.
Choice C rationale:
Straining the urine for the presence of stones is an essential nursing intervention to identify and collect any passed stones. However, it is not the most immediate action when the client is in severe pain. Pain management is the priority.
Choice D rationale:
Preparing the client for a prescribed computed tomography (CT) scan is an important diagnostic step to assess the location and size of the renal calculi. However, it is not the most immediate intervention when the client is in severe pain and distress. Pain management should come first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choiced. Notify your healthcare provider if you start having abdominal pain.
Choice A rationale:
Exenatide does not act in the same way as insulin. It is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, suppresses glucagon secretion, and slows gastric emptying.
Choice B rationale:
Exenatide should be injected within 60 minutes before the morning and evening meals, not within 30 minutes before or after a meal.
Choice C rationale:
There are precautions about taking exenatide with other medications. It can affect the absorption of oral medications, so timing and interactions need to be considered.
Choice D rationale:
Abdominal pain can be a sign of pancreatitis, a serious side effect of exenatide.It is important to notify the healthcare provider if this symptom occurs.
Correct Answer is A
Explanation
Choice A rationale:
Encouraging the client to face their fear gradually is an appropriate nursing intervention for a client with a phobia. This approach is consistent with exposure therapy, which is a widely recognized and effective treatment for phobias. Exposure therapy involves gradually exposing the client to the feared object or situation in a controlled and supportive environment. By doing so, the client can learn to confront and manage their fear over time. This approach is evidence-based and helps the client build resilience and reduce anxiety.
Choice B rationale:
Administering benzodiazepines as needed for acute anxiety (Choice B) is not the first-line treatment for phobias. While benzodiazepines can provide temporary relief from anxiety symptoms, they do not address the underlying phobia and can lead to dependence and tolerance with prolonged use. Moreover, they are generally reserved for acute anxiety episodes and not considered a primary treatment for phobias.
Choice C rationale:
Providing psychoeducation about the causes and effects of phobias (Choice C) is a valuable component of treatment, but it alone may not be sufficient. Psychoeducation can help clients understand the nature of their phobia and reduce stigma, but it should be combined with evidence-based therapies like exposure therapy for comprehensive care.
Choice D rationale:
Teaching the client relaxation techniques to manage anxiety (Choice D) can be a helpful adjunct to treatment, but it is not the primary intervention for phobias. Relaxation techniques can be part of a broader strategy to reduce anxiety, but the client also needs exposure therapy or cognitive-behavioral therapy to address the phobia directly.
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