The Client with Renal Calculi

19.

A client has renal colic due to renal lithiasis.

What is the nurses fi rst priority in managing care
for this client?
1. Do not allow the client to ingest fl uids.
2. Encourage the client to drink at least 500 mL
of water each hour.
3. Request the central supply department to
send supplies for straining urine.
4. Administer an opioid analgesic as prescribed.

20.

A client is admitted to the hospital with a

diagnosis of renal calculi. The client is experiencing
severe fl ank 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.
3. Alleviation of pain.
4. Maintenance of fl uid and electrolyte balance.

21.

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.

22.

In addition to nausea and severe fl ank pain, a

female client with renal calculi has pain in the groin
and bladder. The nurse should assess the client further
for signs of:
1. Nephritis.
2. Referred pain.
3. Urine retention.
4. Additional stone formation.

23.

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 fl ank area.
2. Administering meperidine (Demerol).
3. Encouraging high fl uid intake.
4. Maintaining complete bed rest.

24.

A client who has been diagnosed with renal

calculi reports that the pain is intermittent and less
colicky. Which of the following nursing actions is
most important at this time?
1. Report hematuria to the physician.
2. Strain the urine carefully.
3. Administer meperidine (Demerol) every
3 hours.
4. Apply warm compresses to the fl ank area.

25.

The client is scheduled for an intravenous

pyelogram (IVP) to determine the location of the
renal calculi. Which of the following measures
would be most important for the nurse to include in
pretest preparation?
1. Ensuring adequate fl uid intake on the day of
the test.
2. Preparing the client for the possibility of bladder
spasms during the test.
3. Checking the clients history for allergy to
iodine.
4. Determining when the client last had a bowel
movement.

26.

After an intravenous pyelogram (IVP), the

nurse should anticipate incorporating which of the
following measures into the clients plan of care?
1. Maintaining bed rest.
2. Encouraging adequate fl uid intake.
3. Assessing for hematuria.
4. Administering a laxative.

27.

A client has a ureteral catheter in place after

renal surgery. A priority nursing action for care of
the ureteral catheter would be to:
1. Irrigate the catheter with 30 mL of normal
saline every 8 hours.
2. Ensure that the catheter is draining freely.
3. Clamp the catheter every 2 hours for 30 minutes.
4. Ensure that the catheter drains at least 30 mL/
hour.

28.

Which of the following interventions would

be the most appropriate for preventing the development
of a paralytic ileus in a client who has undergone
renal surgery?
1. Encourage the client to ambulate every 2 to 4
hours.
2. Offer 3 to 4 oz of a carbonated beverage periodically.
3. Encourage use of a stool softener.
4. Continue I.V. fl uid therapy.

29.

The nurse is conducting a postoperative

assessment of a client on the fi rst day after renal surgery.
Which of the following fi ndings would be most
important for the nurse to report to the physician?
1. Temperature, 99.8 F (37.7 C).
2. Urine output, 20 mL/hour.
3. Absence of bowel sounds.
4. A 2 2 area of serosanguineous drainage on
the fl ank dressing.

30.

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 clients discharge teaching plan?
1. Increase daily fl uid 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.

31.

Because a clients renal stone was found to

be composed of uric acid, a low-purine, alkaline-ash
diet was ordered. Incorporation of which of the following
food items into the home diet would indicate
that the client understands the necessary diet
modifi cations?
1. Milk, apples, tomatoes, and corn.
2. Eggs, spinach, dried peas, and gravy.
3. Salmon, chicken, caviar, and asparagus.
4. Grapes, corn, cereals, and liver.

32.

Allopurinol (Zyloprim), 200 mg/day, is

prescribed for the client with renal calculi to take
at home. The nurse should teach the client about
which of the following adverse effects of this medication?
1. Retinopathy.
2. Maculopapular rash.
3. Nasal congestion.
4. Dizziness.

33.

A client has been prescribed allopurinol

(Zyloprim) for renal calculi that are caused by high
uric acid levels. Which of the following indicate the
client is experiencing adverse effect(s) of this drug?
Select all that apply.
1. Nausea.
2. Rash.
3. Constipation.
4. Flushed skin.
5. Bone marrow depression.

34.

The nurse is reviewing laboratory reports for

a client who is taking allopurinol (Zyloprim). Which
of the following indicate that the drug has had a
therapeutic effect?
1. Decreased urine alkaline phosphatase level.
2. Increased urine calcium excretion.
3. Increased serum calcium level.
4. Decreased serum uric acid level.