The nurse is preparing a client for discharge who underwent a percutaneous nephrolithotomy with nephrostomy tube placement. Which instruction should the nurse include in the client's postoperative discharge teaching?

Report when hematuria becomes pink tinged.

Restrict all physical activities.

Use the incentive spirometer.

Monitor urinary stream for decreased output.

Answer and Explanation

The Correct Answer is D

A.   Pink-tinged hematuria is expected after the procedure, but reporting should be directed at increased bleeding or other signs of complications.
B.   While some activity restrictions are necessary, a complete restriction of all physical activities is generally not advised and can lead to other complications like blood clots or decreased mobility.
C.   An incentive spirometer is typically used to prevent respiratory complications post-surgery, but it is not specifically related to nephrolithotomy procedures.
D.   Monitoring the urinary output is crucial because decreased output can indicate a blockage or other complications related to the nephrostomy tube.

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Correct Answer is B

Explanation

A. Level of consciousness is not directly related to the risk of OSAS.

B. Body mass index (BMI) is a significant risk factor for OSAS, as higher BMI is strongly associated with increased risk of sleep apnea.

C. Self-description of pain does not relate to the risk factors for OSAS.

D. Breath sounds might be relevant in assessing respiratory status but do not directly indicate the risk for OSAS.

A. Serum electrolytes. B. Platelet count. C. Complete blood count. D. Liver enzymes.

Correct Answer is C

Explanation

A. Serum electrolytes are important to monitor in chronic kidney disease but do not directly relate to the effects of epoetin alfa.

B. Platelet count is not typically affected by epoetin alfa and does not directly address the client’s symptoms of tiredness.
C. Complete blood count (CBC) is crucial to monitor, especially hemoglobin and hematocrit levels, as epoetin alfa is used to treat anemia in chronic kidney disease, which can cause fatigue.
D. Liver enzymes are not directly related to the effects of epoetin alfa and the symptoms described.

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The nurse is preparing a client for discharge who underwent a percutaneous nephrolithotomy with nephrostomy tube placement. Which instruction should the nurse include in the client's postoperative discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which information is most important for the nurse to obtain when determining a client's risk for obstructive sleep apnea syndrome (OSAS)?

Correct Answer is B

Explanation

A client with chronic kidney disease reports to the nurse of feeling increasingly tired. The client receives injections for epoetin alfa three times a week. Which laboratory value should the nurse review?

Correct Answer is C

Explanation

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