A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

The client states that they consume a high calcium diet and have had high calcium in their blood.

The client reports that they took a lot of ibuprofen for arthritis for many years.

The client reports that they had two urinary tract infections (UTIs) in the past 10 months.

The client states that they remember their mother saying their grandmother had this same genetic disease.

Answer and Explanation

The Correct Answer is C

Choice A rationale
A high calcium diet and hypercalcemia are not directly associated with pyelonephritis. While dietary habits and blood calcium levels can impact overall health, they do not typically contribute to the development of pyelonephritis.

Choice B rationale
Long-term use of ibuprofen can lead to kidney damage, which may increase the risk of pyelonephritis, especially if there is pre-existing kidney impairment. However, it is not as directly related to pyelonephritis as a history of UTIs.

Choice C rationale
A history of UTIs is relevant to pyelonephritis, as the infection can ascend from the lower urinary tract to the kidneys. Recurrent UTIs are a risk factor for pyelonephritis, making this the most likely report from the client.

Choice D rationale
Genetic diseases can have various impacts on health, but there is no common genetic disease that directly causes pyelonephritis. This choice is less likely to be relevant to the client's current condition.

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Correct Answer is A

Explanation

Choice A rationale
In the case of hyperkalemia, which can cause fatal cardiac arrhythmias, the most immediate nursing action is to place the patient on a cardiac monitor. This allows for continuous monitoring of the heart's rhythm and immediate detection of any life-threatening changes, which is crucial for timely intervention.

Choice B rationale
Inserting a urinary retention catheter may be necessary for managing oliguria, but it is not the most urgent action when compared to the potential cardiac risks associated with hyperkalemia.

Choice C rationale
Administering spironolactone, a potassium-sparing diuretic, could be part of the treatment for hyperkalemia, but it is not the first action to take. Spironolactone works more slowly and does not address the immediate risk of cardiac arrhythmias.

Choice D rationale
Epoetin alfa (Epogen) is used to treat anemia, particularly in chronic kidney disease, to increase red blood cell production. However, it does not have an immediate effect and is not the priority in the presence of hyperkalemia and potential cardiac complications.

A. Diarrhea stools B. Lesions that penetrate the intestine C. Strictures are common D. Restricted to rectum

Correct Answer is A

Explanation

Choice A rationale
Diarrhea is a common symptom in both ulcerative colitis (UC) and Crohn's disease, often presenting with urgency and frequency.

Choice B rationale
Lesions that penetrate the intestine are more characteristic of Crohn's disease, which can affect any layer of the intestinal wall and any part of the gastrointestinal tract.

Choice C rationale
Strictures are more common in Crohn's disease due to its transmural inflammatory nature, which can lead to fibrosis and narrowing of the intestines¹.

Choice D rationale
UC is restricted to the colon and often involves the rectum, but Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus and is not restricted to the rectum¹.

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A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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