A nurse is caring for four clients on the urology unit. Which of the following clients should the nurse plan to teach about kidney stone prevention?
The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting.
The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass.
The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria.
The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure.
The Correct Answer is A
A. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting: These are hallmark signs of a current or recent episode of kidney stones. Once the acute symptoms are managed, this client would benefit the most from kidney stone prevention education, including dietary modifications and increased fluid intake, to reduce recurrence risk.
B. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass: These signs suggest a chronic kidney condition such as polycystic kidney disease or another form of kidney pathology rather than nephrolithiasis. Kidney stone prevention is not the primary teaching focus for this client.
C. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria: These symptoms are more consistent with a lower urinary tract condition such as benign prostatic hyperplasia (BPH) or a urinary tract infection, rather than kidney stones. Prevention teaching should be focused on the underlying cause.
D. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure: These symptoms point to nephrotic syndrome or glomerulonephritis, which involve protein loss and renal inflammation. The pathophysiology here differs from that of kidney stone formation, and stone prevention would not be the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Notify the rapid response team due to the client’s clinical signs of a tension pneumothorax: The client presents with acute right-sided chest pain, dyspnea, hypotension, unilateral decreased breath sounds, hyperresonance, and agitation—classic signs of a tension pneumothorax, a life-threatening emergency requiring immediate intervention. Rapid response activation ensures rapid access to advanced airway and chest decompression support.
B. Reassure the client and administer prescribed analgesics for pain relief: The pain is a symptom of a serious underlying condition—possibly a collapsed lung. Administering pain medication could delay life-saving intervention.
C. Encourage the client to take deep breaths and use incentive spirometry: This intervention is appropriate for postoperative atelectasis, but it is contraindicated in tension pneumothorax. Increasing intrathoracic pressure through deep breaths may worsen the pneumothorax.
D. Elevate the head of the bed and increase oxygen to 4 L/min via nasal cannula: While increasing oxygen and elevating the head can help improve oxygenation, they do not treat the underlying cause. These supportive measures may be used after emergency intervention has been initiated.
E. Document the findings and re-evaluate in 15 minutes: Delaying intervention in this situation is unsafe. A tension pneumothorax can rapidly lead to cardiovascular collapse, so waiting even a few minutes may result in deterioration or death.
Correct Answer is C
Explanation
A. A client who has an autoimmune disorder: While autoimmune disorders can affect the body's ability to regulate blood sugar, they do not directly cause type 2 diabetes mellitus (T2DM). T2DM is primarily related to insulin resistance and other metabolic factors such as obesity, genetics, and lifestyle.
B. A 40-year-old client with hypoglycemia: Hypoglycemia is typically associated with insulin-treated diabetes or other endocrine issues, but it is not a risk factor for developing type 2 diabetes mellitus. In fact, hypoglycemia may indicate an issue with insulin or glucose regulation rather than insulin resistance.
C. A client who does not get much sleep: Chronic sleep deprivation is a well-established risk factor for developing type 2 diabetes mellitus. Lack of sleep disrupts metabolic processes, increases stress hormone levels (like cortisol), and can lead to insulin resistance, making this client the most at risk.
D. A 26-year-old female client who has never been pregnant: Pregnancy is not a risk factor for developing type 2 diabetes mellitus; however, gestational diabetes (a form of diabetes during pregnancy) does increase the future risk of developing T2DM. A client who has never been pregnant is not at a higher risk compared to other factors like obesity, age, or family history of diabetes.
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