Med Surg Exam Urinary Stones

Urinary Stones 1. The most common component of renal calculi is: a. Calcium b. Uric acid c. Cystine d. Struvite 2. You're providing discharge teaching to a patient who was hospitalized for the treatment of a kidney stone. The type of kidney stone the patient experienced was a uric acid type stone. What type of foods will you educate the patient to avoid? a. Cabbage, spinach, tomatoes, strawberries b. Ice cream, milk, pork, cheese c. Beans, potatoes, corn, peas d. Liver, scallops, anchovies, sardines, pork 3. Which patient below is at MOST risk for developing uric acid type kidney stones? a. A 53 year old female with recurrent urinary tract infections. b. A 6 year old male with cystinuria. c. A 63 year male with gout. d. A 25 year old female that follows a vegan diet and report eating high amounts of spinach and strawberries on a regular basis. 4. A patient with a kidney stone explains that the pain he is experiencing is intense, sharp, and wavelike that radiates to the scrotum. In addition, he explains it feels like he has to void but a small amount of urine is passed. Based on the patient's signs and symptoms, where may the kidney stone be located? a. Renal Calyx b. Renal Papilla c. Ureter d. Urethra 5. A patient is scheduled for an intravenous pyelogram (IVP) to assess for kidneys stones. Which finding below requires the nurse to contact the physician? a. Patient reports flank pain that radiates downward b. Patient has hematuria c. Patient is allergic to shellfish d. Patient has cloudy urine 6. A client is treated for renal calculi and suspected hydronephrosis. Therefore, the nurse should maintain a record of the kidney's function. Which measure can the nurse take to help achieve the objective? a. Note the nail beds and mobility of the fingers b. Monitor the patient's intake and output c. Palpate for a thrill over the vascular access d. Inspect the skin over the fistula or graft for signs of infection 7. Which of the following increases the risk for renal calculi? a. Running 5 miles b. Drinking 32 ounces of milk per day c. Sedentary lifestyle d. Dehydration 8. A client is complaining of severe flank and abdominal pain. A flat plate of the abdomen shows urolithiasis. Which of the following interventions is important? a. Strain all urine b. Limit fluid intake c. Enforce strict bed rest d. Encourage a high calcium diet 9. 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: a. Fluid and food will be withheld the morning of the examination. b. A tranquilizer will be given before the examination. c. An enema will be given before the examination. d. No special preparation is required for the examination. 10. When providing discharge teaching for a client with uric acid calculi, the nurse should an instruction to avoid which type of diet? a. Low-calcium b. Low-oxalate c. High-oxalate d. High-purine 11. The client with urolithiasis has a history of chronic urinary tract infections. The nurse concludes that this client most likely has which of the following types of urinary stones? a. Calcium oxalate b. Uric acid c. Struvite d. Cysteine 12. The client passes a urinary stone, and lab analysis of the stone indicates that it is composed of calcium oxalate. Based on this analysis, which of the following would the nurse specifically include in the dietary instructions? a. Increase intake of meat, fish, plums, and cranberries b. Avoid citrus fruits and citrus juices c. Avoid green, leafy vegetables such as spinach d. Increase intake of dairy products 13. A patient returns to the medical-surgical unit after having shock wave lithotripsy. What is a post-procedural care of this patient? a. Strain the urine to monitor the passage of stone fragments b. Report bruising that occurs on the flank of the affected side c. d. Continuously monitor electrocardiogram for dysrhythmia Apply a local anesthetic cream to the skin of the affected side