The nurse is triaging a client who presents to the urgent care clinic with symptoms of severe flank pain with spasms, nausea, vomiting, and oliguria
The client states that the pain was initially intermittent and radiated from the lower back to the lower quadrants of the abdomen. Which action by the nurse is the most appropriate?
A) Complete the physical assessment.
B) Refer the client to a urologist.
C) Instruct the client to increase fluids.
D) Obtain a urine specimen for culture.
Answer: B
Hydroureter is a complication that occurs when a renal calculus moves into the ureter and blocks and dilates the ureter. Symptoms include severe pain and spasms, nausea, vomiting, and diminished volume of urine. Hydroureter is a medical emergency that can lead to shock, infection, and subsequent impaired renal function; medical collaboration should be initiated immediately. All other options, while important to complete, would not be appropriate in an emergency situation.
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A nurse cares for a client who has type 1 diabetes mellitus. The client asks, "Is it okay for me to have an occasional glass of wine?" How should the nurse respond?
a. "Drinking any wine or alcohol will increase your insulin requirements." b. "Because of poor kidney function, people with diabetes should avoid alcohol." c. "You should not drink alcohol because it will make you hungry and overeat." d. "One glass of wine is okay with a meal and is counted as two fat exchanges."
Positive patient outcomes are the ultimate goal of nurse–patient interactions, regardless of the particular setting. Which of the following factors has the most direct influence on positive patient-care outcomes?
A) Patient's age B) Patient's ethnic heritage C) Health education D) Outcome evaluation
The primary caregiver of a 10-year-old child is becoming increasingly tired and stressed
Which statement would be most appropriate for the nurse to suggest to this caregiver as a possible course of action for himself and the child? A) "When Eddy is feeling well enough, you and Eddy should go on a short vacation." B) "You would probably benefit from some counseling from the hospital's clinical social worker." C) "It is important for you to take a break from caring for Eddy. I can give you information about the hospital's respite care program." D) "Going out with friends a few times a week might be beneficial in helping you cope with Eddy's condition."
A dying client may decide to receive comfort measures only. What does comfort care measures focus on?
1. Quality of life 2. Length of life 3. Comfort focus of care 4. Cure as an attainable goal A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4