The nurse is caring for an older client who is on complete bed rest. The nurse notes hematuria when the client suddenly reports excruciating pain that radiates from the back to the groin. Which pathological process has contributed to the client's clinical presentation of a possible renal calculi?

Excessive urine output.

Excessive fluid intake.

Increased calcium reabsorption.

Increased serum alkalinity.

Answer and Explanation

The Correct Answer is C

Renal calculi, also known as kidney stones, are solid masses made up of crystals that form in the kidneys due to various factors, including supersaturation of urine with stone-forming substances, inadequate urine volume, and conditions that promote crystal precipitation and retention in the urinary tract. Here's the breakdown of the pathological process contributing to the client's clinical presentation:

A) Excessive urine output:

Excessive urine output (polyuria) is not typically associated with the formation of renal calculi. In fact, low urine output (oliguria) or concentrated urine may increase the risk of stone formation by reducing the volume of urine available to dilute stone-forming substances.

B) Excessive fluid intake:

Excessive fluid intake is generally beneficial in preventing kidney stone formation by increasing urine volume and diluting stone-forming substances. Therefore, it is not likely to contribute to the development of renal calculi in this scenario.

C) Increased calcium reabsorption:

Correct. Increased calcium reabsorption in the renal tubules can lead to hypercalcemia and hypercalciuria, which are risk factors for the formation of calcium-containing kidney stones (calcium oxalate or calcium phosphate stones). Excessive calcium reabsorption may occur due to various factors, including hormonal imbalances (e.g., hyperparathyroidism) or medications that affect calcium metabolism.

D) Increased serum alkalinity:

Increased serum alkalinity (alkalosis) is not typically associated with the formation of renal calculi. Urinary pH may influence the formation of certain types of kidney stones (e.g., uric acid stones are more likely to form in acidic urine), but alkalosis alone is not a primary factor in stone formation.

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Correct Answer is A

Explanation

A) The usual types of reactions are mediated by antibodies:

Correct. Types I, II, and III hypersensitivity reactions are mediated by antibodies (IgE, IgG, or IgM) that bind to antigens and trigger immune responses. In contrast, Type IV hypersensitivity reactions are T-cell mediated and do not involve antibodies.

B) B-lymphocytes produce the offending substances:

This statement is incorrect. B-lymphocytes are involved in antibody-mediated immune responses (types I, II, and III hypersensitivity reactions), not Type IV hypersensitivity reactions, which are primarily mediated by T-lymphocytes.

C) They typically occur with the first exposure to an antigen:

This statement is incorrect. Type IV hypersensitivity reactions usually require sensitization upon initial exposure to an antigen, and subsequent exposures elicit the delayed hypersensitivity response. This is similar to types I, II, and III hypersensitivity reactions, which also involve sensitization upon initial exposure.

D) Delayed reactions are characterized by cytokine release:

This statement is partially correct. Type IV hypersensitivity reactions are characterized by a delayed onset (typically 24 to 72 hours after exposure) and involve the release of cytokines from activated T-lymphocytes, leading to inflammation and tissue damage. However, other types of hypersensitivity reactions may also involve cytokine release, so this feature alone does not differentiate Type IV from other types of reactions.

A. Provide pressure over the biopsy site. B. Keep the client from aspirating. C. Lessen the amount of post procedure pain D. Facilitate pulmonary expansion

Correct Answer is A

Explanation

A. Provide pressure over the biopsy site:

Positioning the client on the right side after a liver biopsy is aimed at providing pressure over the biopsy site. This pressure helps in promoting hemostasis by compressing the blood vessels at the biopsy site, thus reducing the risk of bleeding or hematoma formation. The liver is located on the right side of the body, so positioning the client on the right side applies pressure directly over the liver, aiding in the prevention of bleeding complications.

B. Keep the client from aspirating:

Positioning the client on the right side after a liver biopsy is not primarily aimed at preventing aspiration. Aspiration precautions are typically implemented during procedures where there is a risk of regurgitation or vomiting, such as during anesthesia induction or recovery, rather than specifically after a liver biopsy.

C. Lessen the amount of post-procedure pain:

While positioning can play a role in managing post-procedure pain, the primary reason for positioning the client on the right side after a liver biopsy is to provide pressure over the biopsy site to promote hemostasis. Pain management strategies such as administering analgesics may be utilized to address any discomfort experienced by the client post-procedure.

D. Facilitate pulmonary expansion:

Positioning the client on the right side after a liver biopsy does not directly facilitate pulmonary expansion. Facilitating pulmonary expansion is typically achieved through interventions such as deep breathing exercises, incentive spirometry, and early ambulation rather than positioning alone.

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The nurse is caring for an older client who is on complete bed rest. The nurse notes hematuria when the client suddenly reports excruciating pain that radiates from the back to the groin. Which pathological process has contributed to the client's clinical presentation of a possible renal calculi?

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Naxlex Comprehensive Predictor Exams

How are Type IV hypersensitivity reactions different from all other types (I, II, or III) of hypersentivity reactions?

Correct Answer is A

Explanation

A client received midazolam 2 mg and morphine sulfate 4 mg for a liver biopsy. After the procedure, the nurse positions the client on the right side and monitors the vital signs. Which is the physiological reason for the nurse's intervention?

Correct Answer is A

Explanation

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