How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?

Percuss between the iliac crest and ribs at the midaxillary line.

Push fingers upward into the two lowest intercostal spaces.

Palpate along both sides of the lumbar vertebral column.

Strike a flat hand covering the costovertebral angle (CVA).

Answer and Explanation

The Correct Answer is D

Choice A rationale
Percussion between the iliac crest and ribs at the midaxillary line is not the standard method for assessing flank tenderness associated with pyelonephritis. This technique may not elicit the characteristic pain of kidney inflammation.

Choice B rationale
Pushing fingers upward into the two lowest intercostal spaces is not a specific test for flank tenderness and may not accurately assess for pyelonephritis. This action is more related to assessing the integrity of the rib cage and intercostal muscles.

Choice C rationale
Palpating along both sides of the lumbar vertebral column is not the correct method for assessing flank tenderness due to pyelonephritis. This approach is more suited for assessing the musculoskeletal structure rather than the kidneys.

Choice D rationale
Striking a flat hand over the costovertebral angle is the correct method for assessing flank tenderness in cases of suspected pyelonephritis. This technique, known as costovertebral angle tenderness, elicits pain when the kidneys are inflamed, which is a common sign of pyelonephritis.

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Correct Answer is C

Explanation

Choice A rationale
Elevated blood pressure is a common finding in cardiovascular conditions but is not specifically indicated by the presence of crackles, dyspnea on exertion, or an S3 gallop.

Choice B rationale
A decreased respiratory rate is not typically associated with the presence of crackles and dyspnea; these symptoms are more indicative of increased work of breathing and potential fluid overload.

Choice C rationale
Pitting edema is a classic sign of fluid retention, which can be associated with heart failure. The presence of crackles, dyspnea on exertion, and an S3 gallop are clinical indicators that suggest heart failure, making pitting edema a likely finding.

Choice D rationale
An irregular pulse may be found in various cardiac conditions but is not directly suggested by the symptoms described. The presence of an S3 gallop is more indicative of heart failure, which is commonly associated with fluid overload signs such as pitting edema.

A. Restricting airplane travel B. Driving restrictions C. Time constraints D. Limiting social activities to twice a week E. Restricting foods high in potassium, sodium, and phosphorus F. Restricting fluid intake

Correct Answer is ["C","E","F"]

Explanation

Choice A rationale
Restricting airplane travel is not typically necessary for patients on hemodialysis unless there are specific medical concerns or complications related to their condition.

Choice B rationale
Driving restrictions are not a standard restriction for patients with end-stage kidney disease unless there are other underlying conditions that impair the ability to drive safely.

Choice C rationale
Time constraints are a significant factor for patients on hemodialysis due to the frequent and lengthy treatment sessions, which can limit their availability for other activities.

Choice D rationale
Limiting social activities to twice a week is not a standard recommendation; social interactions are important for mental health and should be encouraged as much as the patient's health allows.

Choice E rationale
Restricting foods high in potassium, sodium, and phosphorus is crucial for patients with end-stage kidney disease to help manage electrolyte levels and prevent complications.

Choice F rationale

Restricting fluid intake is essential for patients on hemodialysis to prevent fluid overload, which can lead to heart failure and other serious health issues.

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How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the outpatient cardiologist's office. The client is alert and oriented. Lung sounds with crackles are heard bilaterally. Dyspnea is observed on exertion, and heart sounds reveal an S3 gallop. Which of the following findings is the nurse most likely to expect?

Correct Answer is C

Explanation

A nurse is caring for a client who has end-stage kidney disease and will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact their quality of life? (Select all that apply.)

Correct Answer is ["C","E","F"]

Explanation

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