A nurse is emptying a client’s urinal when she notices the urine is dark amber, cloudy, and has an unpleasant odor. The nurse should identify that these findings are likely to be the result of which of the following?

Choice A rationale
Telling the client to expect a decrease in urine output is incorrect because it may indicate dehydration, obstruction, or infection. Clients with urolithiasis should be encouraged to maintain adequate urine output to help flush out stones and prevent new stone formation. Decreased urine output can lead to complications and should be addressed promptly.
Choice B rationale
Providing the client with a high protein diet is incorrect because it may increase uric acid and calcium excretion, which can promote stone formation. Clients with urolithiasis should follow a balanced diet that is low in substances that can contribute to stone formation, such as oxalates, purines, and excessive calcium.
Choice C rationale
Maintaining the client on bed rest is incorrect because it may decrease renal perfusion and increase urinary stasis. Clients with urolithiasis should be encouraged to stay active and mobile to promote better circulation and prevent complications. Bed rest is not typically recommended unless there are specific medical indications for it.
Choice D rationale
Encouraging the client to drink 3 L of fluids per day is correct because it helps to flush out stones, prevent new stone formation, and reduce urinary concentration. Adequate hydration is essential for clients with urolithiasis to maintain proper kidney function and reduce the risk of complications. Drinking plenty of fluids helps to dilute the urine and promote the passage of stones.

Choice A rationale
Freezing unopened insulin vials is incorrect. Insulin should be stored in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C) until it is opened. Freezing insulin can cause it to lose its potency and effectiveness. Once opened, insulin vials can be kept at room temperature for up to 28 days, but they should never be frozen.
Choice B rationale

Increasing insulin when exercising is incorrect. Exercise generally lowers blood glucose levels, so clients with type 1 diabetes may need to decrease their insulin dose or consume additional carbohydrates to prevent hypoglycemia during and after physical activity. It is important for clients to monitor their blood glucose levels closely and adjust their insulin and carbohydrate intake accordingly.
Choice C rationale
Injecting insulin into the abdominal area is correct. The abdominal area is one of the recommended sites for insulin injection because it has a large surface area and provides consistent absorption. Other recommended sites include the upper outer arms, thighs, and buttocks. Rotating injection sites within the same area helps prevent lipodystrophy and ensures better insulin absorption.
Choice D rationale
Shaking the insulin vial vigorously to mix is incorrect. Insulin vials should be gently rolled between the hands to mix the contents. Shaking the vial vigorously can cause air bubbles to form, which can lead to inaccurate dosing. Proper mixing ensures that the insulin is evenly distributed and effective.