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Quizzes > Health & Medicine

Urolithiasis Client Teaching: NCLEX Practice Quiz

Quick, free kidney stone nursing quiz to test your knowledge. Instant results.

Editorial: Review CompletedCreated By: Little MimikyuUpdated Aug 28, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration showing kidneys bladder test tubes water drop on coral background for urinary disorders quiz

This quiz helps you practice urolithiasis client teaching, from hydration and diet to pain control and prevention. Work through short patient scenarios and get quick feedback to check your understanding. For more practice, try the kidney stone vs uti quiz, review intake and output quiz skills, and build confidence with renal nclex questions.

What minimum daily fluid intake should clients with urolithiasis be encouraged to drink to prevent stone formation?
1000 mL
3000 mL
2000 mL
4000 mL
High fluid intake dilutes urinary solutes, reducing the risk of stone formation. Clinical guidelines recommend a urine output of at least 2.5 liters per day, which usually requires about 3 liters of fluid intake. Encouraging clients to aim for 3,000 mL daily promotes adequate dilution and decreases supersaturation of lithogenic substances.
Which beverage is recommended to increase urinary citrate and help prevent calcium stone formation?
Cola
Coffee
Orange juice
Tea
Citrate binds calcium in the urine, inhibiting stone formation. Orange juice is a natural source of citrate and can help maintain urinary citrate levels. Avoiding carbonated beverages like cola is advised due to their high phosphate content, which can promote stone formation.
To facilitate analysis and treatment planning, clients with urolithiasis should be instructed to:
Restrict fluid intake
Strain all urine
Avoid all dairy products
Measure and record urinary output only
Straining urine allows for collection of passed stones for laboratory analysis, which guides dietary and pharmacologic management. Knowing the stone composition helps tailor preventive strategies. It is a simple nursing intervention that provides critical data for the interprofessional team.
Clients with calcium oxalate stones should be encouraged to limit which of the following high-oxalate foods?
Apples
Bananas
Chicken
Spinach
Spinach is a high-oxalate food that can increase urinary oxalate levels and promote calcium oxalate stone formation. Limiting high-oxalate foods is part of dietary management for these stones. Adequate calcium intake with meals can help bind oxalate in the gut and reduce absorption.
Thiazide diuretics help prevent calcium stone formation by which mechanism?
Reducing urinary oxalate
Increasing calcium excretion
Decreasing calcium excretion
Alkalinizing the urine
Thiazide diuretics promote distal tubular calcium reabsorption, leading to decreased urinary calcium excretion. Lower urinary calcium reduces supersaturation and stone risk. They do not directly affect oxalate levels or urine pH significantly.
Which imaging study is considered the gold standard for initial evaluation of suspected urolithiasis?
Intravenous pyelogram
Renal ultrasound
MRI of the abdomen
Non-contrast helical CT scan
A non-contrast helical (spiral) CT scan is highly sensitive and specific for detecting urinary stones and provides information on stone size and location. It is the preferred initial imaging modality in adults with suspected urolithiasis. Ultrasound may be used in pregnancy or to avoid radiation exposure.
Which analgesic is often considered first-line for acute renal colic due to its ability to reduce ureteral smooth muscle spasm?
Acetaminophen
Ibuprofen
Ketorolac
Morphine
Ketorolac, an NSAID, is effective for renal colic pain and has antispasmodic effects on the ureter, which can facilitate stone passage. It is often preferred over opioids to avoid side effects like nausea and sedation. Dosage and renal function must be monitored.
Clients with uric acid stones should be instructed to modify their urine pH by:
Acidifying the urine
Alkalinizing the urine
Maintaining acidic urine (pH<5)
Avoiding pH changes
Uric acid stones form in acidic urine; alkalinizing the urine to a pH of 6.5 - 7.0 increases uric acid solubility and helps dissolve existing stones. Potassium citrate or sodium bicarbonate may be prescribed. Clients should monitor pH regularly.
Which diuretic is specifically prescribed to reduce hypercalciuria in clients with recurrent calcium kidney stones?
Hydrochlorothiazide
Mannitol
Spironolactone
Furosemide
Hydrochlorothiazide is a thiazide diuretic that decreases calcium excretion by enhancing distal tubular calcium reabsorption. It is commonly prescribed for patients with hypercalciuria to prevent calcium-based stones. Loop diuretics like furosemide increase calcium excretion and are avoided in this context.
Allopurinol is prescribed for clients who form uric acid stones. Its primary mechanism of action is:
Inhibiting xanthine oxidase
Increasing uric acid excretion
Blocking purine absorption
Alkalinizing the urine
Allopurinol inhibits xanthine oxidase, the enzyme responsible for converting xanthine to uric acid, thereby lowering serum and urinary uric acid levels. This reduces the risk of uric acid stone formation. It does not directly alkalinize urine or block purine absorption.
Acetohydroxamic acid is used in struvite stone management. It works by:
Reducing oxalate synthesis
Inhibiting urease activity
Alkalinizing the urine
Blocking calcium reabsorption
Struvite stones are composed of magnesium ammonium phosphate and form in alkaline urine due to bacterial urease. Acetohydroxamic acid inhibits bacterial urease, preventing ammonia formation and subsequent stone growth. It is used adjunctively with antibiotics and surgical removal.
Clients with cystine stones are instructed to maintain their urine pH at which level to reduce stone crystallization?
6.0 - 6.5
Above 7.5
7.0 - 7.2
Below 5.5
Cystine is less soluble in acidic to neutral urine but becomes more soluble at alkaline pH levels above 7.5. Maintaining a urine pH above 7.5 helps prevent cystine crystallization and stone formation. Potassium citrate or sodium bicarbonate may be used to achieve this target.
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Study Outcomes

  1. Encourage Adequate Hydration -

    Apply knowledge of clients with urolithiasis need to be encouraged to increase fluid intake to maintain urinary dilution and prevent stone formation.

  2. Assess Fluid Balance -

    Incorporate evidence-based urolithiasis nursing care guidelines to monitor intake and output and adjust IV or oral fluids according to patient needs.

  3. Teach Dietary Modifications -

    Use renal calculi patient teaching principles to develop dietary recommendations that limit oxalate, sodium, and purines to reduce stone risk.

  4. Analyze NCLEX Scenarios -

    Analyze urinary system disorders NCLEX quiz questions to select appropriate nursing actions for clients experiencing acute renal calculi episodes.

  5. Interpret Laboratory Data -

    Interpret urine pH, specific gravity, and serum electrolytes to identify risk factors and guide preventive measures in renal stone care.

  6. Master Exam-Style Practice -

    Demonstrate proficiency in NCLEX urinary disorders practice questions by prioritizing interventions and explaining clinical rationale under timed conditions.

Cheat Sheet

  1. Adequate Fluid Intake -

    Clients with urolithiasis need to be encouraged to maintain at least 2.5 - 3 L of fluid daily to dilute urine and reduce stone formation, a cornerstone of urolithiasis nursing care. Aiming for pale yellow urine serves as an easy self-monitoring tip endorsed by the National Kidney Foundation.

  2. Dietary Oxalate and Calcium Balance -

    Encourage pairing dietary calcium with moderate-oxalate foods - like dairy with spinach - so calcium binds oxalate in the gut, reducing stone precursors (Mayo Clinic). Use the mnemonic "CALCIUM = Corrects Absorption, Limits Crystal-formation" to reinforce renal calculi patient teaching.

  3. Medication Adherence and pH Control -

    Clients with urolithiasis need to be encouraged to take prescribed agents - such as thiazide diuretics for calcium stones or allopurinol for uric acid stones - consistently to maintain optimal urine pH. Monitoring urinary pH twice daily, per nephrology guidelines, helps prevent supersaturation and recurrence.

  4. Activity and Urine Straining -

    Regular ambulation supports calcium reabsorption in bone and lowers urinary excretion, a key element of urolithiasis nursing care. Straining all urine captures passed stones for analysis, enabling tailored prevention strategies based on stone composition.

  5. Lab Monitoring and Follow-Up -

    Encourage routine 24-hour urine collections and periodic serum electrolyte checks to identify metabolic risk factors, following university nephrology protocols. Emphasize the "24/7 Check" mantra - 24-hour urine, 7 labs - to boost retention and reinforce concepts for NCLEX urinary disorders practice questions.

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