Nclex-Rn Practice Questions-Care of Adults Renal and Urinary Management
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Question 1 |
The nurse is planning care for the client, who is scheduled for an IVP. Which intervention should the nurse plan to implement?
A | Teach that a warm, flushing sensation may occur as the dye is injected. |
B | Prepare the client for urinary catheterization before the procedure. |
C | Keep the client NPO after the procedure until test results are obtained. |
D | Ambulate the client in the hall to promote excretion of the dye. |
Question 2 |
The nurse is caring for a group of clients on a hospital unit with the assistance of the LPN. Which aspect of client care would be most appropriate for the nurse to delegate to the LPN?
A | Completing the admission for the client who has flank pain |
B | Preparing the client for a newly prescribed renal biopsy |
C | Administering sevelamer hydrochloride to the cheat with CRF |
D | Observing the cheat self-cathcterizc a continent ileal reservoir |
Question 3 |
The cheat who had a kidney transplant has newly prescribed medications. Which prescribed medication should the nurse administer for BP control?
A | Digoxin |
B | Tacrolimus |
C | Aralodipine |
D | Epoctin alfa |
Question 4 |
The nurse is assessing the client receiving peritoneal dialysis. Which finding suggests that the client may be developing peritonitis?
A | Abdominal numbness |
B | Cloudy dialysis output |
C | Radiating sternal pain |
D | Decreased WBC count |
Question 5 |
After determining that the client with CRF has no signs of an infection, the nurse initiates the first peritoneal dialysis treatment for the client. During the infusion of the dialysate, the client reports abdominal pain. How should the nurse best respond to the situation?
A | Raise the bed to a high Fowler’s position. |
B | Stop the infusion rate until the pain goes away. |
C | Ask when the client last had a bowel movement. |
D | Explain that the pain will subside after a few exchanges. |
Question 6 |
A nursing home resident returns to the facility after receiving a hemodialysis treatment. Which symptom observed by the charge nurse suggests that the client has developed disequilibrium syndrome?
A | Shortness of breath with a nonproductive cough |
B | Pitting edema in both of the hands and feet |
C | Inability to palpate a thrill in the arteriovenous (AV) fistula |
D | Headache with a decreased level of consciousness |
Question 7 |
The NA reports to the nurse that the client with CRF has “white crystals” and dry, itchy skin. Based on this information, which instruction should the nurse give to the NA?
A | Apply the prescribed antipruritic cream. |
B | Offer the client a glass of warm milk. |
C | Prepare a tepid-water bath for the client. |
D | Assess the skin for areas of breakdown. |
Question 8 |
The client diagnosed with ESRD states to the nurse, “I don‘t think I want to be on dialysis anymore; it's just too painful for me.” What is the most appropriate response by the nurse?
A | “Why do you think staying on dialysis is so painful for you?” |
B | “You feel that dialysis is painful for you. Tell me more about that.” |
C | “It really isn’t hard to stay on dialysis. You can sleep during these.” |
D | “You should stay on dialysis so you won’t get worse or even die.” |
Question 9 |
After a diagnosis of CRF, the client was started on epoetin alfa. Which finding indicates that the medication has been effective?
A | Decrease in serum creatinine levels |
B | Increase in white blood cells |
C | Increase in serum hematocrit |
D | Decrease in blood pressure |
Question 10 |
The experienced nurse is orienting the new nurse to the care of clients with CRF. Which statement made by the new nurse should the experienced nurse correct?
A | “The client with CRF is starting on peritoneal dialysis and should have a high-protein diet." |
B | “The amount of outflow from peritoneal dialysis should equal the amount that was instilled.” |
C | “I should hold the client’s dose of lisinopril because the client is going for hemodialysis now.” |
D | “I will ensure that the client with CRF has more carbohydrates because protein is restricted.” |
Question 11 |
The nurse is planning meals for the client on hemodialysis and fluid restriction secondary to ARF. Which afternoon snack should the nurse include?
A | Large banana |
B | Glass of milk |
C | Ham sandwich |
D | A small apple |
Question 12 |
The nurse is caring for four clients. Which client requires further nursing assessment due to risk of prerenal failure?
A | The client diagnosed with renal calculi |
B | The client undergoing an IV pyelograrn |
C | The client who has congestive heart failure |
D | The client who had a transfirsion reaction |
Question 13 |
The NA reports to the nurse that urine in the client’s urostomy bag is dark amber colored with a large amount of thick mucus. Which should be the nurse’s instruction to the NA?
A | Obtain a urine specimen for culture. |
B | Change the client’s urostomy bag. |
C | Offer the client fluids more often. |
D | Ambulate the client in the hall. |
Question 14 |
The female nurse is preparing to empty the urostomy bag of a female client who is Muslim. Which statement would be most respectful of the client?
A | “Do you want your spouse in the room when I empty the urine from this bag?" |
B | “You need to increase your fluid intake. What beverages do you like to drink?” |
C | “I need to move the covers to the side in order to empty the bag. Can I do this now?” |
D | “You didn’t eat any lunch, and you need protein for healing. What foods can you eat?” |
Question 15 |
The client is scheduled for .a cystectomy with an ileal conduit for urinary diversion. Which explanation should the nurse provide when the client asks about postsurgery urination?
A | “The normal urinary flow is maintained with this type of surgery.” |
B | “Doing kegel exercises may help you achieve urinary continence.” |
C | “Bladder retraining will be taught later during your recovery.” |
D | “A urine collection bag is placed over the stoma that will be created.” |
Question 16 |
The nurse is providing teaching to the client with a noncontinent urostomy created during urinary diversion. Which information should the nurse include?
A | Wear clothing that is tight-fitting. |
B | Intermittently catheterize the stoma. |
C | The stoma will be red and protruding. |
D | Push on the stoma daily to keep it flat. |
Question 17 |
The nurse is assessing the client with polycystic kidney disease (PKD). The nurse should consider that a cyst may have ruptured when collecting which client information?
A | Reports a decrease in pain |
B | Voids cola-colored urine |
C | Passes stools that are bloody |
D | Has a decreased serum creatinine level |
Question 18 |
The nurse is assessing the client’s right groin puncture site after a renal angiogram finds a saturated, bloody dressing and blood pooling on the sheets. What should be the nurse’s priority?
A | Remove the dressing to further assess the puncture site. |
B | Reinforce the dressing with a compression dressing. |
C | Glove and apply firm pressure directly over the dressing. |
D | Have the client flex the right leg to control the bleeding. |
Question 19 |
The nurse notes bright red blood and clots in the client’s urine after a cystoscopy. Which is the most appropriate initial action by the nurse?
A | Irrigate the client’s bladder. |
B | Notify the health care provider. |
C | Apply heat over the client’s bladder. |
D | Give the prescribed antispasmodic agent. |
Question 20 |
The nurse is caring for the client experiencing a possible hospital-acquired bladder infection. Which nursing action should the nurse perform first?
A | Obtain a urine specimen for culture and sensitivity. |
B | Administer the prescribed antibiotic medication. |
C | Teach the client to wipe the perineum front to back. |
D | Prepare the client for removal of the urinary catheter. |
Question 21 |
The nurse is caring for the female client experiencing recurrent UTIs. Which statement would best help the client reduce her risk for another UTI?
A | “Eliminate caffeine and tea from your diet.” |
B | “Take tub baths rather than showering.” |
C | “Wear good-quality synthetic underwear.” |
D | “Abstain from having sexual intercourse.” |
Question 22 |
The client with acute pyelonephritis of the left kidney is hospitalized. The nurse should monitor for which most frequently occurring symptom?
A | Low-grade fever |
B | Bradycardia |
C | Left-sided flank pain |
D | Right quadrant rebound tenderness |
Question 23 |
The nurse is caring for the client who was newly diagnosed with renal cell carcinoma. The nurse should assess for which specific symptoms?
A | Hematuria and nocturia |
B | Abdominal pain and dysuria |
C | Flank pain and hematuria |
D | Suprapubic pain and foul-smelling urine |
Question 24 |
The nurse is completing an admission assessment of the client with a possible obstructing struvite calculus of the right ureter. Which is the best question for the nurse to ask?
A | “Are you experiencing any pain in your left flank?” |
B | “Do you like to drink cranberry, prune, or tomato juice?” |
C | “Have you had a history of chronic urinary tract infections?” |
D | “How often do you eat organ meats, poultry, fish, and sardines?” |
Question 25 |
Laboratory analysis reveals that the client passed a calcium oxalate stone. To prevent the formation of future stones, the nurse should instruct the client to avoid consuming which food?
A | Cheese |
B | Lettuce |
C | Chocolate |
D | Beans |
Question 26 |
The client has xerostomia secondary to oxybutynin use for treating urge incontinence. Which interventions should the nurse implement to relieve xerostomia?
A | Have the client bathe in tepid water. |
B | Offer sugar-free candy or gumdrops. |
C | Massage the client’s skin with lotion. |
D | Place a fan by the client at a low setting. |
Question 27 |
The nurse is admitting a hospitalized client who has a renal calculi. Which should be the nurse’s priority?
A | Encourage the client to increase the amount of oral fluids. |
B | Obtain necessary supplies to measure and strain all urine. |
C | Assess the location and the severity of the client’s pain. |
D | Obtain consent for extracorporeal shock wave lithotripsy (ESWL). |
Question 28 |
Three weeks after developing ARF following trauma, the hospitalized client has a significantly increased urinary output. Which assessment finding should the nurse report to the HCP immediately?
A | Absence of adventitious breath sounds |
B | A drop in BP and increase in pulse rate |
C | A 3-pound weight loss over 24 hours |
D | A serum potassium level of 3.7 mEq/L |
Question 29 |
The nurse is caring for the client with CRF. Which statement should the nurse document as an appropriate outcome in the plan of care?
A | Eats three large meals daily without nausea |
B | Daily weight gain of no more than 3 pounds |
C | Reduced serum albumin levels within 1 week |
D | No evidence of bleeding |
Question 30 |
The client is hospitalized with nephrotic syndrome and has 3+ pitting edema in all extremities. Which laboratory test result should the nurse associate with this condition?
A | Elevated protein in the urine |
B | Elevated serum albumin |
C | Low serum lipid levels |
D | Multiple cysts in the kidneys |
Question 31 |
The nurse is caring for four cheats. For which cheat should the nurse anticipate treatment with continuous renal replacement therapy (CRRT)?
A | The cheat who has an increased serum creatinine level after receiving vancomyein IV to treat a wound infection |
B | The client who is in stage 4 chronic kidney disease (CKD) as a complication of type 1 diabetes mellitus |
C | The client who had an acute MI during coronary artery bypass graft (CABG) surgery and develops ARF |
D | The client who can no longer have peritoneal dialysis (PD) due to thickening of the peritoneal membrane |
Question 32 |
The nurse is caring for the client who had continent urinary diversion surgery with creation of a Kock pouch. Which intervention should the nurse include in the care?
A | Insert a catheter in the pouch every 4 to 6 hours to drain the urine. |
B | Cleanse the skin around the stoma with alcohol and water every day. |
C | Encourage sleeping on the side of the stoma for good urine drainage. |
D | Apply the stoma pouch so that it fits snugly to avoid urine leakage. |
Question 33 |
The client has been on hemodialysis for the past 5 years. The client’s spouse calls the clinic because the client has stopped eating, is taking long naps, and refuses to talk. Which conclusion made by the nurse about the client’s behavior is most accurate?
A | The client may be feeling depressed. |
B | The client is expressing displacement. |
C | The client has become noncompliant. |
D | The client now has activity intolerance. |
Question 34 |
The nurse is assessing the client following a kidney transplant from a live donor. The nurse should notify the HCP to report a possible complication of urine leakage when which findings are noted?
A | Urine output 15 mL/hour; serum creatinine 3.4 mg/dL; lower abdominal discomfort |
B | Urine output 200 mL/hour; serum creatinine 1.2 mg/dL; incisional discomfort |
C | Urine output 20 mL/hour; elevated temperature; tenderness over the transplanted kidney |
D | Urine output 0 mL for one hour, then 300 mL/hour; erratic output; incisional discomfort |
Question 35 |
The nurse is caring for the client diagnosed with obstructing left ureterolithiasis. The nurse evaluates that the client may have passed the calculi in the urine when which outcome has been achieved?
A | Voiding clear amber urine greater than 30 mL per hour |
B | No evidence of hematemesis or urinary tract infection |
C | Absence of epigastric pain, nausea, and vomiting |
D | Absence of colicky pain in the left lateral flank and groin |
Question 36 |
The female client, being treated for stress incontinence with vaginal cone therapy, calls a clinic to report that she is experiencing burning on urination, chills, and fever. Which is the best instruction by the nurse?
A | “Take acetaminophen to relieve the pain and reduce your fever.” |
B | “Come to the clinic. We need to complete a urine culture and sensitivity.” |
C | “Discontinue the use of the vaginal weights to see if the symptoms subside.” |
D | “Drink cranberry juice and increase your fluid intake for the next 48 hours.” |
Question 37 |
The nurse assesses that the client with ARF has a serum potassium level of 6.8 mEq/L. Which medications, if prescribed, should the nurse plan to administer now? Select all that apply.
A | Erytlrropoietin |
B | Regular insulin |
C | 0.45% saline bolus |
D | Calcium gluconate |
E | Sodium polystyrene sulfonate |
Question 38 |
The 75-year-old client is hospitalized with ESRD. Which finding in the client’s medical record should the nurse associate with the diagnosis of ESRD?
A | A urinary output of less than 100 mL in 24 hours |
B | A glomcrular filtration rate less than 15 mIJmin/ 1.73 m2 |
C | A serum creatinine level greater than 12.0 mg/dL |
D | A serum blood urea nitrogen greater than 100 mg/dL |
Question 39 |
The client is concerned about having brown-colored urine after starting nitrofurantoin for treating a UTI. Which response by the nurse is most appropriate?
A | “Your urine is too concentrated. Take only one- half the dose of nitrofurantoin.” |
B | “Stop taking nitrofurantoin and make an appointment to have a urine culture.” |
C | “Nitrofurantoin normally does discolor urine; continue taking it as prescribed.” |
D | “Drink at least 500 mL of fluid every 3 hours to lighten the color of your urine.” |
Question 40 |
The HCP writes orders for the newly hospitalized client who has polycystic kidney disease (PKD) and dull flank pain, nocturia, and low urine specific gravity dilute urine. Which admission order should the nurse clarify with the HCP?
A | Fluid intake of at least 2000 mL daily |
B | Restrict sodium intake to 500 mg daily |
C | Initiate referral for genetic counseling |
D | Metoprolol 12.5 mg (oral) bid |
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