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NR 570 FINAL EXAM COMMON DIAGNOSIS AND
MANAGEMENT IN ACUTE CARE PRACTICUM EXAM
AND STUDY GUIDE LATEST 2024-2025 ALL 250
QUESTIONS AND CORRECT ANSWERS JUST
RELEASED
What is nephrolithiasis? - ANSWER-renal calculi (kidney stones)
QUESTION: How does Renal calculi form? - ANSWER-formed d/t elevated levels of minerals in
the body
QUESTION: What minerals in excess can cause renal calculi? - ANSWER-calcium oxalate (most
common),
phosphate
uric acid
struvite
cystine
QUESTION: Where is the stone located if the patient has pain in the groin region? - ANSWER-
pain that radiates downward into the groin indicates the stone has passed into the lower third
of the ureter
QUESTION: Vague flank pain or acute colicky pain with increasing intensity means the stone is
located where? - ANSWER-stones in renal pelvis
Ectopic pregnancy
Ovarian or testicular torsion
Appendicitis
Bowel obstruction
Diverticulitis
Rupture of aortic aneurysm
QUESTION: Right lower abdominal tenderness with a +Blumberg sign. What should be
suspected? - ANSWER-Blumberg sign: Rebound tenderness in the RLQ, caused by acute
peritonitis.
*Appendicitis
QUESTION: Urolithiasis - ANSWER-stone in the bladder
QUESTION: Ureterolithiasis - ANSWER-condition of stones in the ureter
QUESTION: Classic Kidney stone presentation - ANSWER-acute onset of severe, colicky flank
pain that wax and wane in intensity.
Severe pain is associated with the movement of the stone and can cause n/v.
pt may seem anxious and unable to sit still
QUESTION: history and physical for nephrolithiasis (kidney stones) - ANSWER-Irritative Bladder
symptoms -dysuria (painful or difficulty urinating), urgency, & frequency
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,Page 3 of 108
Vague flank pain or acute colicky pain with increasing intensity
Radiation of pain into the groin
Costovertebral angle (CVA) tenderness
Hematuria
Diaphoretic, tachycardic, appear extremely uncomfortable
QUESTION: CVA tenderness tell your the stone is located where? - ANSWER-caused by passing
of the stone through the ureter with obstruction & spasm
QUESTION: What labs do we run to diagnose a kidney stone? - ANSWER-UA dipstick, urine
microscopy and urine C&S
Serum blood urea nitrogen (BUN) and creatinine (Cr) to assess renal function.
QUESTION: What radiology methods are preferred for outpatient treatment and why -
ANSWER-inexpensive, easily accessible. in combo its more practical
-KUB xray
-Renal Ultrasound
QUESTION: What stones can be seen on a KUB?
What stone can you not see on a KUB - ANSWER-CAN see: Calcium oxalate - most common type
of stone
CANNOT see: uric acid stones (radio translucent)
QUESTION: What is a Renal Ultrasound used for when testing for kidney stones? - ANSWER-
good for assessing for hydronephrosis (excess fluid in the kidney d/t back up of urine that can
be caused by an obstruction). Bad for identifying a stone.
3
, Page 4 of 108
QUESTION: What is the GOLD STANDARD for diagnosing a kidney stone? - ANSWER-Non-
contrast CT scan.
QUESTION: Goal of renal calculi treatment - ANSWER-focused on symptomatic relief
pain medications -NSAID or narcs
antiemetics -n/v
facilitate stone passage-Thiazide diuretics, alpha-blockers or calcium channel blockers to help
facilitate the passage of a stone. Terazosin -alpha blockers used for BPH.
QUESTION: <5 mm renal calculi can - ANSWER-be passed through the urine. may only require
NSAIDs for management.
QUESTION: >5 mm renal calculi requires what? - ANSWER-urology consult.
this may cause an obstruction or kidney failure.
this type of stone may need surgical intervention to be removed.
QUESTION: when is a Urology Referral indicated? - ANSWER-stone > 5mm
recurrent stones
QUESTION: When is a hospital admission appropriates for a patient with nephrolithiasis? -
ANSWER-Hospital admission is indicated when:
-Inability to control pain
-Impaired renal function with an obstructing stone
-Infection (pyelonephritis or sepsis)
-Intractable n/v
QUESTION: What does a 24 hour urine collection analyze? - ANSWER--total volume
4
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