A nurse is caring for a client who has a new diagnosis of urolithiasis.
Which of the following should the nurse identify as an associated risk factor?
Family history.
BMI less than 25.
Hypocalcemia.
Diuretic use.
The Correct Answer is A
The correct answer is choice a. Family history.
Choice A rationale:
Family history is a well-known risk factor for urolithiasis. If a close relative has had kidney stones, the likelihood of developing them increases due to genetic predispositions.
Choice B rationale:
A BMI less than 25 is generally considered normal or healthy weight and is not typically associated with an increased risk of urolithiasis. In fact, obesity is more commonly linked to a higher risk of kidney stones.
Choice C rationale:
Hypocalcemia, or low calcium levels in the blood, is not a common risk factor for urolithiasis. High calcium levels in the urine (hypercalciuria) are more often associated with the formation of kidney stones.
Choice D rationale:
Diuretic use can sometimes be associated with kidney stones, but it depends on the type of diuretic. Thiazide diuretics, for example, are often used to prevent calcium stones by reducing calcium excretion in the urine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Condition Most Likely Experiencing:
Delirium
- Explanation: The client has acute confusion, disorganized thinking, restlessness, incoherent speech, and altered sleep-wake cycle—all classic signs of delirium. The sudden onset (starting the previous evening) and fever (38.6°C) suggest a potential underlying cause, such as infection or dehydration.
Actions to Take:
Monitor the client's fluid intake and output.
- Explanation: The client has severe fluid imbalance (250 mL intake vs. 2,500 mL output), leading to dehydration, which can contribute to delirium. Monitoring intake and output is critical for managing hydration status.
Encourage family members to stay with the client.
- Explanation: Familiar faces can help reorient the client and reduce agitation. Delirium often improves with familiar environmental cues and reassurance.
Parameters to Monitor:
Sleep-wake cycle.
- Explanation: Disrupted sleep patterns are a key symptom of delirium. Tracking sleep can help assess improvement or worsening of the condition.
Fall risk.
- Explanation: The client is attempting to get out of bed without assistance, which puts them at high risk for falls. Close monitoring is essential to prevent injury.
Incorrect Choices and Explanations:
Request a prescription for benzodiazepine.
- Why Incorrect? Benzodiazepines can worsen delirium, especially in older adults, by increasing confusion and fall risk.
Assist the client to identify coping skills.
- Why Incorrect? Delirium is an acute medical condition, not a psychological disorder. The focus should be on treating the underlying cause, not psychological coping strategies.
Encourage the client to exercise.
- Why Incorrect? The client is confused, weak, and at risk of falls. Exercise is not appropriate at this stage.
BUN level.
- Why Incorrect? While kidney function (BUN) could be affected by dehydration, monitoring fluid balance directly (intake/output) is more immediate and relevant.
Weight loss.
- Why Incorrect? While the client has refused to eat or drink, weight loss occurs over time, whereas the primary concern is acute dehydration and delirium.
Suicidal ideation.
- Why Incorrect? There is no indication of suicidal thoughts. The confusion and agitation are more likely due to delirium than depression.
Correct Answer is D
Explanation
Choice A rationale:
Cardiac enzymes do not identify the location of the MI, they are biomarkers that indicate heart muscle injury.
Choice B rationale:
Cardiac enzyme tests do not provide information about the heart’s structure or the mobility of the heart valves. That’s typically assessed using imaging studies like an echocardiogram.
Choice C rationale:
Cardiac enzymes do not assist in diagnosing the presence of pulmonary congestion. They are specific to heart muscle damage.
Choice D rationale:
Cardiac enzymes, such as troponin and creatine kinase, rise when there is damage to the heart muscle, such as in an MI. Therefore, these tests help determine the degree of damage to the heart tissues.
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