Nokea
Which information should the nurse include when explaining the management of the client's urolithiasis? Select all that apply.
- A. Increase fluid intake to 3 liters per day.
- B. Strain all urine to collect stones for analysis.
- C. Take prescribed analgesics for pain relief.
- D. Avoid all dairy products to prevent stone formation.
- E. Follow a low-sodium diet to reduce stone risk.
- F. Report fever or chills immediately.
Correct Answer: A,B,C,F
Rationale: Increasing fluid intake, straining urine, taking analgesics, and reporting fever or chills are key management strategies for urolithiasis to promote stone passage and prevent complications.
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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.
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 client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first?
- A. A midstream urine for culture.
- B. A sonogram of the kidney.
- C. An intravenous pyelogram for renal calculi.
- D. A CT scan of the kidneys.
Correct Answer: A
Rationale: Chills, fever, and costovertebral pain suggest pyelonephritis. A midstream urine culture is the first test to identify the causative organism. Imaging (sonogram, IVP, CT) is secondary to confirm complications or other diagnoses.
The client is admitted to a nursing unit from a long-term care facility with a hematocrit of 56% and a serum sodium level of 152 mEq/L. Which condition is a cause for these findings?
- A. Overhydration.
- B. Anemia.
- C. Dehydration.
- D. Renal failure.
Correct Answer: C
Rationale: Elevated hematocrit (56%) and hypernatremia (152 mEq/L) indicate dehydration, which concentrates blood components and sodium. Overhydration dilutes these values, anemia lowers hematocrit, and renal failure typically causes hyponatremia.
The nurse is caring for clients on a renal surgery unit. After the afternoon report, which client should the nurse assess first?
- A. The male client who just returned from a CT scan who states he left his glasses in the x-ray department.
- B. The client who is one (1) day postoperative and has a moderate amount of serous drainage on the dressing.
- C. The client who is scheduled for surgery in the morning and wants an explanation of the operative procedure before signing the permit.
- D. The client who had ileal conduit surgery this morning and has not had any drainage in the drainage bag.
Correct Answer: D
Rationale: No drainage in the ileal conduit bag post-surgery suggests obstruction or complications, risking urine backup and renal damage. This is critical. Lost glasses, serous drainage, and surgical education are less urgent.