RENAL NCLEX QUESTIONS
The nurse instructs a client with renal failure who is receiving hemodialysis about dietary modifications. The nurse determines that the client understands these dietary modifications if the client selects which items from the dietary menu? a) cream of wheat, blueberries, coffee b) sausage and eggs, banana, orange juice c) bacon, cantaloupe melon, tomato juice d) cured pork, strawberries, orange juice
A
The physician orders a combination of Sulfamethoxazole and Phenazopyridine hydrochloride (Azogantrisol) for a patient. Which therapeutic effect should this combination drug have: a) plain relief and a decreased WBC count b) equal fluid intake and output c) polyuria with reddish stain d) increased complaints of bladder spasm after 20 minutes
A
Which of the following client responses shows a correct understanding of continuous ambulatory peritoneal dialysis (CAPD)? a) I am expected to perform the procedure at home b) the procedure lasts for one hour c) I have to sit and raise my legs during the procedure d) I have to go to the hospital for this procedure
A
Which of the following is an expected finding in the client with chronic renal failure? a) anemia b) polyuria c) increased creatinine clearance d) increased serum calcium levels
A
Which of the following problems is expected in a client who is in end-stage renal failure? a) anemia b) thalassemia c) renal calculi d) hypotension
A
Which of the following should be considered in the diet of the client with end-stage-renal-disease (ESRD)? a) limit fluid intake during anuric phase b) limit phosphorus and vitamin D-rich food c) limit calcium-rich food d) limit carbohydrates
A
The client with chronic renal failure has an indwelling abdominal catheter for peritoneal dialysis. The client spills water on the catheter dressing while bathing. The nurse should immediately: a) change the dressing b) reinforce the dressing c) flush the peritoneal dialysis catheter d) scrub the catheter with povidine-iodine
A
The client with continuous ambulatory peritoneal dialysis (CAPD) has cloudy dialysate. Which of the following is the best initial nursing action? a) send fluid to the laboratory for culture b) administer antibiotic c) do nothing, this is expected d) stop drainage of fluid
A
A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell (RBC) production? a) iron supplement b) zinc supplement c) calcium supplement d) magnesium supplement
A
A nurse is assigned to care for a client with nephrotic syndrome. The nurse assesses which important parameter on a daily basis? a) weight b) albumin levels c) activity tolerance d) blood urea nitrogen (BUN) level
A
The client has been diagnosed to have glomerulonephritis. What should the nurse observe in the urine? a) blood b) pus c) white blood cells d) glucose
A
The client has end-stage renal disease. He had undergone kidney transplant 5 days ago. Which of the following is the most important intervention for the client to prevent infection? a) observe asepsis b) increase fluid intake c) avoid clients with flu d) avoid crowded places
A
The client hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale and anxious. The nurse suspects air embolism. The priority action for the nurse is to: a) discontinue dialysis and notify the physician b) monitor vital signs every 15 minutes for the next hour c) continue dialysis at a slower rate after checking the lines for air d) bolus the client with 500 ml of normal saline to break up the air embolus
A
Which of the following should the nurse include in the nursing care plan of the client who is diagnosed to have renal failure, whose BUN is 32 mg/dl, serum creatinine is 4 mg/dl, hematocrit is 38%. He is complaining of fatigue and edema. a) low protein diet and fluid restriction b) high protein diet and fluid restriction c) low protein diet and increase in fiber d) high protein diet and potassium restriction
A
The client with chronic renal failure is on chronic hemodialysis. Which of the following indicate improvement of the client's condition due to hemodialysis? Select all that apply a) the client's BP is 130/90 b) the client's serum potassium is 4.8 mEq/L c) the client's hemoglobin level is 10 g/dL d) the client's serum calcium is 7.7 mg/dL e) the client's serum sodium is 140 mEg/L f) the client's serum magnesium is 4 mEq/L g) the client's weight has increased from 60 kg to 63 kg
A, B, E
A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen level drops to: a) 3 mg/dL b) 15 mg/dL c) 29 mg/dL d) 35 mg/dL
B
The client had been diagnosed to have chronic renal failure. He had undergone hemodialysis for the first time. What signs and symptoms when experienced by the client suggest that he is experiencing disequilibrium syndrome? a) restlessness, hypotension, headache b) nausea and vomiting, hypertension, dizziness c) lethargy, hypotension, dizziness d) thachycardia, hypotension, headache
B
The client is in end-stage renal failure (ESRD). Which of the following foods may be allowed for the client? a) banana b) apple c) carrot cake d) cantaloupe
B
The client who has a history of gout also is diagnosed with urolithisis and the stones are determined to be of uric acid type. The nurse gives the client instructions in which foods to limit, including: a) milk b) liver c) apples d) carrots
B
The client with acute renal failure has a serum potassium of 6.0 mEq/L. The nurse would plan which of the following as a priority action? a) check the sodium level b) place the client on a cardiac monitor c) encourage increased vegetables in the diet d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration
B
The client with chronic renal failure is undergoing peritoneal dialysis. He asks why the nurse monitors his blood glucose levels. Which of the following will be the most appropriate response by the nurse? a) I have to check if you have diabetes mellitus b) the dialysate contains glucose c) the procedure may lower your blood glucose levels d) it is a routine procedure for every client who undergoes the treatment
B
Three year old Carlo has been admitted to the pediatric unit with a tentative diagnosis of nephrotic syndrome Prednisone is prescribed for Carlo. The nurse evaluate its effectiveness by a) checking his BP every 4 hours b) checking his urine for protein c) weighing him each morning before breakfast d) observing him for behavioral changes
B
Three year old Carlo has been admitted to the pediatric unit with a tentative diagnosis of nephrotic syndrome: At Carlo's last check-up when he was 2 1/2 years old, his BP was 95/60, PR was 110/min and weight was 15 kg. Which unexpected assessment today would the nurse report to help the diagnosis? a) BP: 95/60 b) weight: 20 kg c) PR: 110 d) temp: 37 C
B
A adult client has had laboratory work done as part of a routine physical examination. The nurse interprets that the client may have a mild degree of renal insufficiency if which of the following serum creatinine levels is noted? a) 0.2 mg/dlL b) 0.5 mg/dL c) 1.9 mg/dL d) 3.5 mg/dL
C
A client has been diagnosed to have chronic renal failure. Sodium polysterene sulfonate (exchange resin kayexalate) is prescribed. The action of the medication is that it releases a) bicarbonate in exchange for primarily sodium ions b) sodium ions in exchange for primarily bicarbonate ions c) sodium ions in exchange for primarily potassium ions d) potassium ions in exchange for primarily sodium ions
C
A client who has a renal mass asks the nurse why an ultrasound has been scheduled, as opposed to other diagnostic tests that may be ordered. The nurse formulates a response based on the understanding that: a) all other tests are more invasive than an ultrasound b) all other tests require more elaborate postprocedure care c) an ultrasound can differentiate a solid mass from a fluid-filled cyst d) an ultrasound is much more cost effective than other diagnostic tests
C
A nurse is assessing a client who is diagnosed with cystitis. Which assessment finding is inconsistent with the typical clinical manifestations noted in this disorder? a) hematuria b) low back pain c) urinary retention d) burning on urination
C
Diagnosis of acute pyelonephritis has been established your nursing intervention includes the following except: a) provide health teaching and discharge planning b) administer antibiotic c) measure I and O d) provide adequate comfort and rest
C
Situation: Three year old Carlo has been admitted to the pediatric unit with a tentative diagnosis of nephrotic syndrome. The diagnosis of Idiopathic Nephrotic Syndrome has been confirmed. Which unexpected finding would the nurse report? a) proteinuria b) distended abdomen c) blood in the urine d) elevated serum lipid levels
C
The client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of: a) pyelonephritis b) glomerulonephritis c) trauma to the bladder or abdomen d) renal cancer in the client's family
C
The client in end-stage of renal failure had undergone kidney transplant. Which of the following assessment findings indicate kidney transplant rejection? a) increased urinary output, BUN = 15 mg/dL b) HCT = 50%, Hgb = 17 g/dl c) decreased urinary output, sudden weight gain d) decreased urinary output, sudden weight loss
C
The home care nurse is making follow-up visits to a client following renal transplant. The nurse assesses the client for which signs of acute graft rejection? a) hypotension, graft tenderness, and anemia b) hypertension, oliguria, thirst, and hypothermia c) fever, hypertension, graft tenderness, and malaise d) fever, vomiting, hypotension, and copious amounts of dilute urine
C
The nurse has completed client teaching with the hemodialysis client about self-monitoring between hemodialysis treatments. The nurse determines that the best understands the information if the client states to record daily the: a) amount of activity b) pulse and respiratory rate c) intake and output and weight d) blood urea nitrogen and creatinine levels
C
Three year old Carlo has been admitted to the pediatric unit with a tentative diagnosis of nephrotic syndrome. Carlo's potential for impairment of skin integrity is related to: a) joint inflammation b) drug therapy c) edema d) generalized body rash
C
Which of the following complaints is common in a client with pyelonephritis? a) right upper quadrant pain b) left upper quadrant pain c) pain at the costovertebral region d) pain at the suprapubic region
C
A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safely? a) take blood pressures only on the right arm to ensure accuracy b) use the fistula for all venipunctures and intravenous infusions c) ensure that small clamps are attached to the AV fistula dressing d) assess the fistula for the presence of a bruit and thrill every 4 hours
D
A client has been admitted to the hospital with a diagnosis of acute glomerulonephritis. During history-taking the nurse first asks the client about a recent history of: a) bleeding ulcer b) deep vein thrombosis c) myocardial infarction d) streptococcal infection
D
A client is being admitted to the hospital with a diagnosis of urolithiasis and ureteral colic. The nurse assesses the client for pain that is: a) dull and aching in the costovetebal area b) aching and camplike thoughout the abdomen c) sharp and radiating posteriorly to the spinal column d) excruciating, wavelike, and radiating toward the genitalia
D
A client is scheduled for computed tomography (CT) of the kidneys to rule out renal disease. As an essential preprocedure component of the nursing assessment, the nurse plans to ask the client about a history of: a) familial renal disease b) frequent antibiotic use c) long-term diuretic therapy d) allergy to shellfish or iodine
D
In the oliguric phase of renal failure, what is the most appropriate nursing diagnosis? a) fluid volume deficit b) activity intolerance c) ineffective breathing pattern d) fluid volume excess
D
The client with an external arteriovenous shunt in place for hemodialysis is at risk for bleeding. The priority nurse action would be to: a) check the shunt for the presence of bruit and thrill b) observe the site once as time permits during the shift c) check the results of the prothrombin time as they are determined d) ensure that small clamps are attached to the arteriovenous shunt dressing
D
The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication: a) during dialysis b) just before dialysis c) the day after dialysis d) on return form dialysis
D
The nurse develops a post-procedure plan of care for a client who had a renal biopsy. The nurse avoids documenting which intervention in the plan? a) administering analgesics as needed b) encouraging fluids to at least 3L in the first 24 hours c) testing serial urine samples with dipstick for occult blood d) ambulating the client in the room and hall for short distances
D
Which of the following anti-hypertensive medications is contraindicated for clients with renal insufficiency? a) beta-adrenergic blockers b) calcium-channel blockers c) direct-acting vasodilators d) angiotensin-converting enzyme inhibitors
D
Which of the following may be included in the diet of the client with chronic renal failure? a) orange slices b) watermelon slices c) cantaloupe slices d) apple slices
D
