Nokea
A client diagnosed with nephrolithiasis arrives at the clinic for a follow-up visit. The laboratory analysis of the stone that the client passed 1 week ago indicates that the stone is composed of calcium oxalate. On the basis of this analysis, the nurse should tell the client that it is best to avoid which food to minimize the risk of recurrence?
- A. Pasta
- B. Lentils
- C. Lettuce
- D. Spinach
Correct Answer: D
Rationale: Many kidney stones are composed of calcium oxalate. Foods that raise urinary oxalate excretion and predispose to stone formation include spinach, rhubarb, strawberries, chocolate, wheat bran, nuts, beets, almonds, cashews, rhubarb, and tea. Pasta, lentils, and lettuce are not high in oxalates and are generally safe for clients with calcium oxalate stones.
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Which of the following conditions may warrant a serum creatinine level?
- A. Rhabdomyolysis
- B. Digitalis toxicity
- C. Glomerulonephritis
- D. All answers are correct
Correct Answer: D
Rationale: A serum creatinine level may be warranted in conditions that can affect renal function or cause muscle breakdown. Rhabdomyolysis, characterized by muscle injury and breakdown, can lead to elevated creatinine levels due to the release of creatinine from muscles. Digitalis toxicity can impair renal function, leading to a need for monitoring creatinine levels. Glomerulonephritis, an inflammatory condition affecting the kidney's filtering units, can also impact renal function and require assessment of creatinine levels. Therefore, all the provided conditions may warrant a serum creatinine level to assess renal function and muscle breakdown.
A child is seen in the health care clinic, and testing for human immunodeficiency virus (HIV) is performed because of the child's exposure to HIV infection. Which home care instruction should the nurse provide to the parents of the child?
- A. Avoid sharing toothbrushes.
- B. Avoid all immunizations until the diagnosis is established.
- C. Wipe up any blood spills with a rag, and allow them to air-dry.
- D. Wash your hands with half-strength bleach if they come in contact with the child's blood.
Correct Answer: A
Rationale: Parents should avoid sharing toothbrushes to prevent potential HIV transmission through blood or bodily fluids. Immunizations should be kept up to date to protect the child. Blood spills should be cleaned with a paper towel, followed by soap and water, then a bleach solution, not just a rag and air-drying. Washing hands with soap and water is sufficient; bleach is too caustic for skin.
The nurse is teaching a client the proper technique for using a cane. Which statements should the nurse include in the teaching? Select all that apply.
- A. Hold the cane on the affected side.
- B. Hold the cane on the unaffected side.
- C. Move the cane at the same time as the affected leg.
- D. Move the cane at the same time as the unaffected leg.
- E. Hold the cane 8 to 10 inches from the side of the foot.
Correct Answer: B,C
Rationale: The cane is held on the unaffected side and moved with the affected leg to provide support. The cane is held closer to the body, not 8-10 inches away.
The nurse is performing an assessment on a 3-year-old child with chickenpox. The child's mother tells the nurse that the child keeps scratching at night, and the nurse teaches the mother about measures that will prevent an alteration in skin integrity. Which statement by the mother indicates that teaching was effective?
- A. I need to place white gloves on my child's hands at night.
- B. I will apply generous amounts of a cortisone cream to prevent itching.
- C. I will give my child a glass of warm milk at bedtime to help my child sleep.
- D. I need to keep my child in a warm room at night so that the covers will not cause my child to scratch.
Correct Answer: A
Rationale: Placing white gloves on the child's hands at night prevents scratching during sleep, which helps maintain skin integrity and reduces the risk of secondary infections. Applying cortisone cream is not recommended without a prescription, as it may not be appropriate for chickenpox and could increase the risk of complications. Warm milk may help with sleep but does not directly address scratching or skin integrity. Keeping the child in a warm room does not prevent scratching and may increase discomfort, as cooler environments are often better for reducing itching.
The nurse has given instructions to the client diagnosed with chronic kidney disease about reducing pruritus from uremia. The nurse determines that the client needs further teaching if the client states the intention to use which item for skin care?
- A. Mild soap
- B. Oil in the bath water
- C. Lanolin-based lotion
- D. Alcohol cleansing pads
Correct Answer: D
Rationale: Alcohol cleansing pads increase skin dryness and pruritus in chronic kidney disease clients with uremia. Mild soap, bath oils, and lanolin-based lotions help reduce dryness and irritation without exacerbating symptoms.