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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. MS hug: The "MS hug" refers to a tight or squeezing sensation around the torso, often caused by muscle spasms or spasticity in multiple sclerosis (MS). This is a common symptom in MS and can feel like pressure or a tight band around the chest or abdomen.
B. Paroxysmal spasms: Paroxysmal spasms are sudden, short episodes of intense muscle contractions. While these spasms may occur in MS, the sensation described in the question is more specific to the MS hug, which involves a sensation of tightness rather than spasm.
C. Lhermitte's sign: Lhermitte's sign is a sudden, electric shock-like feeling that runs down the spine or limbs when the neck is flexed. This sign is common in individuals with multiple sclerosis but does not describe the tightening sensation around the torso.
D. Trigeminal neuralgia: Trigeminal neuralgia causes severe facial pain due to irritation of the trigeminal nerve, not a tightening sensation around the torso. It typically presents as sharp, stabbing pain along the facial nerve distribution.

A. Calcium level of 10.0 mg/dL (9.0 to 10.5 mg/dL) B. Serum sodium 138 mEq/L (136 to 145 mEq/L) C. Serum potassium 4.8 mEq/L (3.5 to 5.0 mEq/L) D. Serum glucose 58 mg/dL (74 to 106 mg/dL)

Correct Answer is D

Explanation

A. Calcium level of 10.0 mg/dL (9.0 to 10.5 mg/dL): The calcium level here is normal, and insulin therapy does not directly affect calcium levels. Therefore, this is not an adverse outcome related to insulin administration.

B. Serum sodium 138 mEq/L (136 to 145 mEq/L): The sodium level is within normal range. Insulin therapy does not typically cause major shifts in sodium, so this is not a concern.

C. Serum potassium 4.8 mEq/L (3.5 to 5.0 mEq/L): The potassium level here is also within normal range. Insulin therapy is often used to lower potassium levels, so this result does not suggest an adverse effect.

D. Serum glucose 58 mg/dL (74 to 106 mg/dL): This indicates hypoglycemia, which is a well-known adverse effect of insulin therapy. When insulin is administered, especially in the context of treating hyperkalemia, it can lower blood glucose levels to dangerously low levels, leading to hypoglycemia.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has multiple sclerosis and reports a tightening feeling around their torso. Which of the following conditions should the nurse recognize this finding indicates?

Correct Answer is A

Explanation

A nurse is caring for a client who has a hyperkalemia and is receiving insulin therapy. Which of the following should the nurse recognize as an adverse outcome?

Correct Answer is D

Explanation

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