A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram.

Which instruction should the nurse include in the client’s discharge instructions?

Use an incentive spirometer.

Monitor the urinary stream for decreased output.

Restrict physical activities.

Report when hematuria becomes pink-tinged.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Using an incentive spirometer is generally recommended for respiratory conditions to improve lung function, not specifically for a client with hydronephrosis and a history of renal calculi.
Choice B rationale
Monitoring the urinary stream for decreased output is crucial for a client with hydronephrosis and a history of renal calculi. Hydronephrosis is a condition characterized by urine accumulation in the kidney, which can lead to decreased urine output. Therefore, monitoring urinary output can help detect any potential complications or worsening of the condition.
Choice C rationale
Restricting physical activities is not typically necessary for a client with hydronephrosis and a history of renal calculi unless specified by the healthcare provider. It’s more important to focus on maintaining overall health and well-being.
Choice D rationale
Reporting when hematuria becomes pink-tinged is not the most relevant instruction for a client with hydronephrosis and a history of renal calculi. While it’s important to report any changes in urine color, monitoring urinary output (Choice B) is more directly related to the client’s condition.

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Correct Answer is A

Explanation

Choice A rationale
Maintaining the prescribed fluid restriction is crucial in the management of SIADH. Fluid restriction helps to prevent further dilution of sodium in the blood, which can exacerbate the symptoms of SIADH34.
Choice B rationale
Withholding the next scheduled dose of treatment is not necessarily the appropriate intervention based on the increase in serum sodium level. The treatment plan should be adjusted based on the patient’s overall clinical picture and in consultation with the healthcare provider.
Choice C rationale
Increasing neurologic checks to every 2 hours is not directly related to the increase in serum sodium level. While neurologic checks are important in monitoring the overall health status of the patient, they are not specifically indicated based on the serum sodium level alone.
Choice D rationale
Assessing for increasing fluid volume overload is not the appropriate intervention based on the increase in serum sodium level. SIADH is characterized by water retention, not fluid volume overload.

A. Obtain a sputum sample. B. Arrange transport for radiographic imaging. C. Move the patient into airborne isolation. D. Collect specimens for blood cultures.

Correct Answer is C

Explanation

Choice A rationale
Obtaining a sputum sample is important for diagnosing respiratory infections, but it is not the priority intervention in this case. The patient’s symptoms of intermittent fever, night sweats, and a productive cough with small amounts of blood are indicative of a possible airborne disease such as tuberculosis.
Choice B rationale
Arranging transport for radiographic imaging can be helpful in diagnosing the patient’s condition, but it is not the immediate priority. The primary concern should be to prevent the potential spread of an airborne disease.
Choice C rationale
Moving the patient into airborne isolation is the priority intervention. This action is taken to prevent the spread of potential airborne diseases to other patients and healthcare workers.
Choice D rationale
Collecting specimens for blood cultures can help identify the causative organism if the patient has a systemic infection. However, given the patient’s symptoms and the potential for an airborne disease, moving the patient into isolation is the priority.

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A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram. Which instruction should the nurse include in the client’s discharge instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram.

Which instruction should the nurse include in the client’s discharge instructions?