(Renal) NCLEX-style review questions from Honan

Retention of which electrolyte is the most life-threatening effect of renal failure? a. sodium b. potassium c. phosphorous d. calcium

b. potassium

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? a. glomerulonephritis b. increased fluid intake c. diabetes insipidus d. decreased fluid intake

d. decreased fluid intake

a 30-year-old client presents to the clinic for an employment physical. The nurse notes protein in the client's urine. The nurse understands that transient proteinuria can be caused by which factor(s)? Select all that apply. a. prolonged standing b. fever c. diabetes mellitus d. NSAIDs e. strenuous exercise

a, b, e

What is the term for a concentration of urea and other nitrogenous wastes in the blood? a. azotemia b. proteinuria c. hematuria d. uremia

a. azotemia

Rejection of a transplanted kidney within 24 hours after transplant is termed a. chronic rejection b. acute rejection c. simple rejection d. hyperacute rejection

d. hyperacute rejection

The term used to describe total urine output less than 0.5 mL/kg/hr is a. nocturia b. dysuria c. anuria d. oliguria

d. oliguria

Approximately what percentage of blood passing through the glomeruli is filtered into the nephron? a. 40 b. 30 c. 10 d. 20

d. 20

What is a hallmark of the diagnosis of nephrotic syndrome? a. hypokalemia b. hypoalbuminemia c. hyponatremia d. proteinuria

d. proteinuria

What is used to decrease potassium level seen in acute renal failure? a. sorbitol b. IV dextrose 50% c. calcium supplements d. sodium polystyrene sulfonate

d. sodium polystyrene sulfonate

The nurse passes out medications while a client prepares for hemodialysis. The client is ordered to recieve numerous medications including antihypertensives. What is the best action for the nurse to take? a. hold the medications until after dialysis b. check with the dialysis nurse about medications c. ask if the client wants to take the medication d. administer the medication as ordered

a. hold the medications until after dialysis

Acute dialysis is indicated during which situation? a. impending pulmonary edema b. dehydration c. metabolic alkalosis d. hypokalemia

a. impending pulmonary edema

What is a characteristic of the intrarenal category of acute renal failure? a. increased BUN b. high specific gravity c. decreased creatinine d. decreased urine sodium

a. increased BUN

A client diagnosed with acute kidney injury (AKI) has developed congestive heart failure. The client has received 40 mg of intravenous push (IVP) Lasix and 2 hours later, the nurse notes that there are 50 mL of urine in the foley catheter bag. The client's vital signs are stable. Which health care order should the nurse anticipate? a. lasix 80 mg IVP b. chest x-ray c. mannitol 12.5 g IVP d. normal saline bolus of 500 mL

a. lasix 80 mg IVP

The nurse is caring for a client after a cystoscopic examination. Following the procedure, the nurse informs the client that which effect may occur? a. diarrhea b. nausea and emesis c. severe abdominal pain d. blood-tinged urine

d. blood-tinged urine

Which term describes painful or difficult urination? a. anuria b. oliguria c. nocturia d. dysuria

d. dysuria

The nurse is caring for a client who underwent a kidney transplant. The client appears anxious and tearful and states, "My body is going to reject the new kidney; I know I'm going to die." What is the best response by the nurse? a. "if your body rejects the kidney, you go back of dialysis; you are not going to die" b. "I understand your concerns, let's talk about them" c. "You've waited years for this transplant, you need to think positive" d. "don't think like that; I'm certain you will be fine"

b. "I understand your concerns, let's talk about them"

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? a. "have you had a recent urinary tract infection?" b. "do you take phenytoin daily?" c. "have you noticed any vaginal bleeding?" d. "do you take multiple vitamin preparations?"

d. "do you take multiple vitamin preparations?"

While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? a. "do you have a strong desire to void?" b. "does it burn when you urinate?" c. " is it painful when you urinate?" d. "do you urinate while sleeping?"

d. "do you urinate while sleeping?"

Which hormone causes the kidneys to reabsorb sodium? a. growth hormone b. prostaglandins c. antidiuretic hormone d. aldosterone

d. aldosterone Aldosterone is a hormone synthesized and released by the adrenal cortex. ADH is secreted by the posterior pituitary gland.

A change that occurs during chronic glomerulonephritis is termed a. hypophosphatemia b. metabolic alkalosis c. hypokalemia d. anemia

d. anemia

The nurse cares for a client diagnosed with chronic gomerulonephritis. The nurse will observe the client for the development of a. hypophosphatemia b. metabolic alkalosis c. hypokalemia d. anemia

d. anemia

During a routine assessment, the client states; "I wake up all night long to go to the bathroom." The nurse documents this finding as which condition? a. polyuria b. nocturia c. oliguria d. dysuria

b. nocturia

What is an effect of aging on upper and lower urinary tract function? a. acid-base balance b. more prone to develop hypernatremia c. increased glomerular filtration rate d. increased blood flow to the kidneys

b. more prone to develop hypernatremia

The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client? a. hemodialysis b. peritoneal dialysis c. continuous arteriovenous hemofiltration (CAVH) d. continuous venovenous hemofiltration (CVVH)

a. hemodialysis

The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI? a. oliguria b. recovery c. initiation d. diuresis

a. oliguria

Which is the correct term for the ability of the kidneys to clear solutes from the plasma? a. renal clearance b. specific gravity c. glomerular filtration rate d. tubular secretion

a. renal clearance

The nurse treats a client with end-stage kidney disease (ESKD). The nurse is concerned that the client is developing renal osteodystrophy. Upon review of the client's laboratory values, it is noted the client has had a calcium level of 11 mg/dL for the past 3 days and the phosphate level is 5.5 mg/dL. The nurse anticipates the administration of which medication? a. sevelamer hydrochloride b. calcium carbonate c. calcium acetate d. mylanta

a. sevelamer hydrochloride

The nurse performs acute intermitten peritoneal dialysis (PD) on a client who is experiencing uremic signs and symptoms. The peritoneal fluid is not draining as expected. What is the best response by the nurse? a. turn the client from side to side b. notify the health care provider c. push the catheter further into the abdomen d. lower the head of the bed

a. turn the client from side to side This facilities draining, you can also raise the head of the bed

The nurse instructs a client to perform continuous ambulatory peritoneal dialysis correctly at home. Which educational information should the nurse provide to the client? a. use an aseptic technique during the procedure b. clean the catheter insertion site daily with soap c. wear a mask while handling any dialysate solutions d. keep the catheter stabilized to the abdomen, below the belt line

a. use an aseptic technique during the procedure

Which value represents a normal BUN-to-creatinine ratio? a. 8:1 b. 10:1 c. 6:1 d. 4:1

b. 10:1

Renal function results may be within normal limits until the GFR is reduced to less than which percentage of normal? a. 40 b. 50 c. 30 d. 20

b. 50

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which disorder? a. nephrotic syndrome b. acute glomerulonephritis c. acute renal failure d. chronic renal failure

b. acute glomerulonephritis

The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder? a. proteinuria b. chronic kidney disease c. neurogenic bladder d. kidney stone formation

b. chronic kidney disease

Which value does the nurse recognize as the best clinical measure of renal function? a. volume of urine output b. creatinine clearance c. circulating ADH concentration d. urine-specific gravity

b. creatinine clearance

The nurse monitors the client for potential complications during dialysis but recognizes NOT to monitor for a. muscle cramping b. hypertension c. dysrhythmias d. air embolism

b. hypertension

The nurse cares for a client with right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated? a. placing the client's watch on the left wrist b. obtaining a blood pressure reading from the right arm c. palpating the fistula for a "thrill" d. obtaining blood samples from the left arm

b. obtaining a blood pressure reading from the right arm

Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys? a. diuresis b. oliguria c. recovery d. initiation

b. oliguria

The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with the disorder? a. pH 7.50, PaCO2 29, HCO3 22 b. pH 7.20, PaCO2 30, HCO3 14 c. pH 7.31, PaCO2 48, HCO3 24 d. pH 7.47, PaCO2 45, HCO3 33

b. pH 7.20, PaCO2 30, HCO3 14

A client undergoes renal angiography. The nurse prepares the client for the test and provides post procedure care. Which intervention should the nurse provide to the client after renal angiography? a. encourage the client to void b. palpate the pulses in the legs and feet c. monitor the client for signs and symptoms of pyelonephritis d. assess for signs of electrolyte and water imbalance

b. palpate the pulses in the legs and feet

A client presents to the ED reporting left flank pain and lower abdominal pain. The pain severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing: a. urethral infection b. ureteral stones c. pyelonephritis d. cystitis

b. ureteral stones

A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? a. blood urea nitrogenc b. osmolality c. creatinine d. hemoglobin

c. creatinine

The nurse recognizes which condition as an integumentary manifestation of chronic renal failure? a. asterixis b. seizures c. gray-bronze skin color d. tremors

c. gray-bronze skin color

To obtain information about the chief report and medical history of an older client, the nurse asks the client about any medication history. Why is obtaining a medication history important? a. it may indicate drugs that should not be prescribed to the client b. it may indicate the client's general health c. it may indicate multiple medications taken by the client d. it may reflect the client's childhood and family illnesses

c. it may indicate multiple medications taken by the client

The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration? a. phenytoin b. infection c. phenazopyridine hydrochloride d. metronidazole

c. phenazopyridine hydrochloride

A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering: a. calcium supplements b. sorbitol c. sodium polystyrene sulfonate (Kayexalate) d. IV dextrose 50%

c. sodium polystyrene sulfonate (Kayexalate)

The most accurate indicator of fluid loss or gain in an acutely ill patient is: a. blood pressure b. pulse rate c. weight d. edema

c. weight

When the bladder contains 400 to 500 mL of urine, this is referred to as a. anuria b. renal clearance c. specific gravity d. functional capacity

d. functional capacity