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 D
Explanation
A. Tachycardia: Tachycardia is a common early sign of pulmonary embolism caused by hypoxia and sympathetic stimulation. However, it is nonspecific and not a direct indicator of embolism size or mortality risk.
B. Pleural effusion: A small pleural effusion can occur with a pulmonary embolism due to inflammation or infarction, but its presence does not correlate with embolism severity or predict outcomes such as death.
C. Respiratory alkalosis: Respiratory alkalosis is a typical response to hyperventilation in early PE. While common, it does not indicate the extent of the embolism or the risk of mortality and can be seen in mild cases.
D. Increased troponin levels: Elevated troponin indicates right ventricular strain or injury due to a moderate to large pulmonary embolism. This cardiac biomarker is associated with a higher risk of complications and death, signaling hemodynamic stress from the embolic event..
Correct Answer is B
Explanation
A. "Damage to the brain is related to coup and contrecoup injuries. Coup and contrecoup injuries are associated with closed traumatic brain injuries, where the brain hits the skull from forceful movement, such as in a car accident. These do not apply to penetrating injuries, where an object physically enters the brain tissue.
B. "Damage to the brain is related to the size, route, and rate of speed of the object entering the brain." In penetrating traumatic brain injuries, the extent of damage depends largely on the characteristics of the penetrating object—how large it is, the path it takes through the brain tissue, and how fast it enters. These factors determine the depth, location, and severity of brain tissue destruction.
C. "Damage occurs from the penetrating object shattering the skull and causing an infection."
While skull fracture and subsequent infection are possible complications, they are not the primary mechanisms of damage in penetrating brain injuries. The direct trauma caused by the object itself as it disrupts neural tissue is the main source of injury.
D. "Damage occurs from the penetrating injury causing leakage of cerebrospinal fluid." Cerebrospinal fluid (CSF) leakage may occur as a result of a skull or dura mater breach, but this is more of a secondary complication rather than the central mechanism of brain injury. The main damage is from direct tissue penetration and destruction.
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