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Exam (elaborations)

PN 140 Test 4 Practice Questions and Answers 2024/2025

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A client who has been diagnosed with calculi reports that the pain is intermittent and less colicky. Which of the following nursing actions is most important at this time? A. Report hematuria to the physician B. Strain the urine carefully C. Administer meperidine (Demerol) every 3 hours D. Ap...

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  • October 11, 2024
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  • 2024/2025
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  • PN 140
  • PN 140
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PN 140 Test 4 Practice Questions and
Answers 2024/2025
A client who has been diagnosed with calculi reports that the pain is intermittent and less

colicky. Which of the following nursing actions is most important at this time?




A. Report hematuria to the physician

B. Strain the urine carefully

C. Administer meperidine (Demerol) every 3 hours

D. Apply warm compresses to the flank area


 B. Strain the urine carefully


Intermittent pain that is less colicky indicates that the calculi may be moving along the urinary

tract. Fluids should be encouraged to promote movement, and the urine should be strained to

detect passage of the stone. Hematuria is to be expected from the irritation of the stone.

Analgesics should be administered when the client needs them, not routinely. Moist heat to the

flank area is helpful when renal colic occurs, but it is less necessary as pain is lessened.




A client is admitted to the hospital with a diagnosis of renal calculi. The client is experiencing

severe flank pain and nausea; the temperature is 100.6 ° F (38.1 ° C). Which of the following

would be a priority outcome for this client?




1. Prevention of urinary tract complications.

2. Alleviation of nausea.


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3. Alleviation of pain.

4. Maintenance of fluid and electrolyte balance.


 3.


The priority nursing goal for this client is to alleviate the pain, which can be excruciating.

Prevention of urinary tract complications and alleviation of nausea are appropriate

throughout the client's hospitalization, but relief of the severe pain is a priority. The client is at

little risk for fluid and electrolyte imbalance.




The client is scheduled to have a kidney, ureter, and bladder (KUB) radiograph. To prepare

the client for this procedure, the nurse should explain to the client that:




1. Fluid and food will be withheld the morning of the examination.

2. A tranquilizer will be given before the examination.

3. An enema will be given before the examination.

4. No special preparation is required for the examination.


 4.


A KUB radiographic examination ordinarily requires no preparation. It is usually done while

the client lies supine and does not involve the use of radiopaque substances.




In addition to nausea and severe flank pain, a female client with renal calculi has pain in the

groin and bladder. The nurse should assess the client further for signs of:


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1. Nephritis.

2. Referred pain.

3. Urine retention.

4. Additional stone formation.

 2.


The pain associated with renal colic due to calculi is commonly referred to the groin and

bladder in female clients and to the testicles in male clients. Nausea, vomiting, abdominal

cramping, and diarrhea may also be present. Nephritis or urine retention is an unlikely cause

of the referred pain. The type of pain described in this situation is unlikely to be caused by

additional stone formation.




Which of the following nursing interventions is likely to provide the most relief from the pain

associated with renal colic?




1. Applying moist heat to the flank area.

2. Administering meperidine (Demerol).

3. Encouraging high fluid intake.

4. Maintaining complete bed rest.


 2.




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During episodes of renal colic, the pain is excruciating. It is necessary to administer opioid

analgesics to control the pain. Application of heat, encouraging high fluid intake, and

limitation of activity are important interventions, but they will not relieve the renal colic pain.




A client with a history of renal calculi formation is being discharged after surgery to remove

the calculus. What instructions should the nurse include in the client's discharge teaching plan?




1. Increase daily fluid intake to at least 2 to 3 L.

2. Strain urine at home regularly.

3. Eliminate dairy products from the diet.

4. Follow measures to alkalinize the urine.


 1.


A high daily fluid intake is essential for all clients who are at risk for calculi formation because

it prevents urinary stasis and concentration, which can cause crystallization. Depending on the

composition of the stone, the client also may be instructed to institute specific dietary measures

aimed at preventing stone formation. Clients may need to limit purine, calcium, or oxalate.

Urine may need to be either alkaline or acid. There is no need to strain urine regularly.




During hemodialysis, the patient develops light-headedness and nausea. What should the

nurse do first?




a. Administer hypertonic saline.


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