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 ["A","D","E"]

Explanation

Choice A rationale
Hemoglobin released from hemolyzed red blood cells (RBCs) can cause intrarenal acute kidney injury by obstructing the renal tubules and damaging the nephrons.

Choice B rationale
Benign prostatic hyperplasia is a cause of postrenal, not intrarenal, acute kidney injury as it can obstruct the flow of urine out of the bladder.

Choice C rationale
Prostate cancer, similar to benign prostatic hyperplasia, typically leads to postrenal acute kidney injury due to urinary obstruction.

Choice D rationale
Myoglobin released from necrotic muscle cells, as seen in conditions like rhabdomyolysis, can cause intrarenal acute kidney injury by precipitating in the renal tubules.

Choice E rationale
Nephrotoxins, such as certain medications, chemicals, or toxins, can directly damage the kidney tissue, leading to intrarenal acute kidney injury.

A. Place the patient on a cardiac monitor. B. Insert a urinary retention catheter. C. Give the prescribed spironolactone. D. Administer epoetin alfa (Epogen).

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.

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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

Which of the following are causes of intrarenal acute kidney injury? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

Correct Answer is A

Explanation

Which finding in the patient's history increases the risk for acute pancreatitis?

A nurse is providing discharge education to a client diagnosed with fluid volume excess (FVE) due to liver failure. Which of the following meal options should the nurse recommend for the client?

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