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The laboratory data reveal a calcium phosphate renal stone for a client diagnosed with renal calculi. Which discharge teaching intervention should the nurse implement?
- A. Encourage the client to eat a low-purine diet and limit foods such as organ meats.
- B. Explain the importance of not drinking water two (2) hours before bedtime.
- C. Discuss the importance of limiting vitamin D-enriched foods.
- D. Prepare the client for extracorporeal shock wave lithotripsy (ESWL).
Correct Answer: C
Rationale: Calcium phosphate stones are linked to hypercalciuria. Limiting vitamin D-enriched foods reduces calcium absorption, preventing recurrence. Low-purine diets are for uric acid stones, water restriction is contraindicated, and ESWL is a treatment, not teaching.
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When administering the bladder instillation containing the chemotherapeutic drug, which safety precaution is most important for the nurse to take?
- A. Wear two pairs of latex gloves.
- B. As a mass syringe for the drug.
- C. Avoid wearing clothing with long sleeves.
- D. Limit contact time with the client.
Correct Answer: A
Rationale: Wearing two pairs of latex gloves protects the nurse from exposure to the chemotherapeutic drug during instillation.
The nurse is assessing a client diagnosed with urethral strictures. Which data support the diagnosis?
- A. Complaints of frequency and urgency.
- B. Clear yellow drainage from the urethra.
- C. Complaints of burning during urination.
- D. A diminished force and stream during voiding.
Correct Answer: D
Rationale: Urethral strictures obstruct urine flow, causing a diminished force and stream. Frequency, urgency, and burning suggest UTI, and clear drainage is unrelated.
Which statement by the client indicates a need for further teaching about the management of urolithiasis?
- A. I will drink at least 3 liters of water daily.
- B. I will strain all my urine to collect any stones.
- C. I will take my pain medication as prescribed.
- D. I will avoid drinking water to reduce urine output.
Correct Answer: D
Rationale: Avoiding water intake is incorrect, as increased fluid intake is essential to promote stone passage and prevent recurrence.
The client is admitted with a serum sodium level of 110 mEq/L. Which nursing intervention should be implemented?
- A. Encourage fluids orally.
- B. Administer 10% saline solution IVPB.
- C. Administer antidiuretic hormone intranasally.
- D. Place on seizure precautions.
Correct Answer: D
Rationale: Severe hyponatremia (110 mEq/L) increases seizure risk due to cerebral edema. Seizure precautions are the priority to ensure safety. Oral fluids or ADH may worsen hyponatremia, and 10% saline is not standard.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients on a medical floor. Which nursing task is most appropriate for the nurse to delegate?
- A. Collect a clean voided midstream urine specimen.
- B. Evaluate the client’s eight (8)-hour intake and output.
- C. Assist in checking a unit of blood prior to hanging.
- D. Administer a cation-exchange resin enema.
Correct Answer: A
Rationale: Collecting a clean voided midstream urine specimen is a task within the UAP’s scope, as it involves following a standard procedure. Evaluating intake/output, checking blood, or administering enemas require nursing judgment or specialized training, making them inappropriate for delegation.