NCLEX Renal, Urinary and reproductive systems

A client with end-stage renal disease is hospitalized. For which complications should the nurse monitor the client? Select all that apply. A. Anemia B. Dyspnea C. Jaundice D. Hyperexcitability E. Hypophosphatemia

A. Anemia B. Dyspnea

A nurse is caring for a client with chronic kidney failure. What should the nurse teach the client to limit the intake of to help control uremia associated with end-stage renal disease (ESRD)? A. Fluid B. Protein C. Sodium D. Potassium

B. Protein

A client with acute glomerulonephritis reports thirst. Which is the most appropriate choice that the nurse can offer to relieve the client's thirst? A. Ginger ale B. Milkshake C. Hard candy D. Cup of broth

C. Hard candy

As the nurse, you know that it is important to implement a low sodium diet for a patient with nephrotic syndrome. However, it is important to implement what other type of diet due to another complication associated with this syndrome? A. Low-phosphate B. Low-fat C. High-carbohydrate D. Low-potassium

B. Low-fat

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? Select all that apply. A. Polyuria B. Lethargy C. Hypotension D. Muscle twitching E. Respiratory acidosis

B. Lethargy D. Muscle twitching

The nurse instructs a client suspected of bladder cancer to discard the morning first-voided urine and to collect a fresh urine specimen. The nurse also sends the specimen to the laboratory within 1 hour of collection. Which diagnostic procedure requires this intervention? A. Residual urine B. Concentration test C. Urine cytologic study D. Protein determination

C. Urine cytologic study

The urinalysis results of a female client shows the 17-ketosteroids value as 25 mg/24 hr. Which condition should the nurse monitor for in this client? A. Addison disease B. Ovarian neoplasms C. Ovarian dysfunction D. Cushing syndrome

D. Cushing syndrome

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for which complication? A. Peritonitis B. Hepatitis B C. Renal calculi D. Bladder infection

B. Hepatitis B

A nurse is caring for a client with end-stage renal disease. For which clinical indicator should the nurse monitor the client? A. Polyuria B. Jaundice C. Azotemia D. Hypotension

C. Azotemia

The mother of a child, who was recently diagnosed with nephrotic syndrome, asks how she can identify early signs that her child is experiencing a relapse with the condition. You would tell her to monitor the child for the following: Select-all-that-apply: A. Weight loss B. Protein in the urine using an over-the-counter kit C. Tea-colored urine D. Swelling in the legs, hands, face, or abdomen

B. Protein in the urine using an over-the-counter kit D. Swelling in the legs, hands, face, or abdomen

A client complains of nocturia, bladder pain, urinary frequency, urgency, and dribbling at the end of urination. On physical examination, the nurse finds a smooth, firm, and enlarged prostate. The digital rectal examination report indicates enlargement of prostate tissue surrounding the urethra. Which condition does the nurse suspect in the client? A. Prostatitis B. Paraphimosis C. Prostate cancer D. Benign prostatic hyperplasia (BPH)

D. Benign prostatic hyperplasia (BPH)

The nurse is explaining the physiologic reasons for taking vitamin D and calcium supplements to a client with renal failure. Which statement made by the nurse is appropriate? A. "There will be a decrease in the inactive forms of vitamin D in your body." B. "There will be a decrease in the active metabolite of vitamin D in your body." C. "There will be an increase in the conversion of skin cholesterol into vitamin D." D. "There will be an increase in the vitamin D associated intestinal absorption of calcium."

B. "There will be a decrease in the active metabolite of vitamin D in your body."

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The nurse estimates that the urine output for the last 12 hours is about 200 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. What does the nurse conclude about the amount of fluid prescribed? A. It equals the expected urinary output for the next 24 hours. B. It will prevent the development of pneumonia and a high fever. C. It will compensate for both insensible and expected output over the next 24 hours. D. It will reduce hyperkalemia, which can lead to life-threatening cardiac dysrhythmias.

C. It will compensate for both insensible and expected output over the next 24 hours.

A client's urine specific gravity is being measured. For which condition should the nurse conduct a focused assessment when a client's specific gravity is increased? A. Polyuria B. Fluid overload C. Low-grade fever D. Diabetes insipidus

C. Low-grade fever

A client with a history of excessive alcohol use develops hepatic portal hypertension and an elevated serum aldosterone level. For which complications should the nurse assess this client? A. Chloride depletion and hypovolemia B. Potassium retention and dysrhythmias C. Sodium retention and fluid accumulation D. Calcium depletion and pathologic fractures

C. Sodium retention and fluid accumulation

After reviewing the urinalysis reports of a client with a renal disorder, the nurse concludes that the client may have a urinary tract infection. Which urinary laboratory findings enabled the nurse to make this conclusion? Select all that apply. A. pH: 8.5 B. Specific gravity: 1.010 C. Red blood cells: 3/hpf D. Osmolality: 1500 mOsm/kg (1500 mmol/kg) E. White blood cells: 6/hpf

A. pH: 8.5 E. White blood cells: 6/hpf

A nurse is caring for a client who just had surgery to repair an inguinal hernia. To limit a common complication associated with this surgery, which action should the nurse take? A. Apply an abdominal binder. B. Place a support under the scrotum. C. Teach the client to cough several times an hour. D. Encourage the client to eat a high-carbohydrate diet.

B. Place a support under the scrotum.

A client with acute kidney failure is fatigued and becomes lethargic. Upon reviewing the client's medical record, which finding does the nurse determine is the most likely cause of this change in symptoms? A. Hyperkalemia B. Hypernatremia C. A limited fluid intake D. An increased blood urea nitrogen level

D. An increased blood urea nitrogen level

A nurse is caring for a client with acute kidney injury. Which findings should the nurse anticipate when reviewing the laboratory report of the client's blood level of calcium, potassium, and creatinine? Select all that apply. A. Calcium: 7.6 mg/dL (1.9 mmol/L) B. Calcium: 10.5 mg/dL (2.6 mmol/L) C. Potassium 6.0 mEq/L (6.0 mmol/L) D. Potassium 3.5 mEq/L (3.5 mmol/L) E. Creatinine: 3.2 mg/dL (194 mcmol/L) F. Creatinine: 1.1 mg/dL (90 mcmol/L)

A. Calcium: 7.6 mg/dL (1.9 mmol/L) C. Potassium 6.0 mEq/L (6.0 mmol/L) E. Creatinine: 3.2 mg/dL (194 mcmol/L)

A client with an invasive carcinoma of the bladder is receiving radiation to the lower abdomen in an attempt to shrink the tumor before surgery. What should the nurse do considering the side effects of radiation? A. Observe the feces for the presence of blood. B. Monitor the blood pressure for hypertension. C. Administer enemas to remove sloughing tissue. D. Provide a high-bulk diet to prevent constipation.

A. Observe the feces for the presence of blood.

A 6 year old male is diagnosed with nephrotic syndrome. In your nursing care plan you will include which of the following as a nursing diagnosis for this patient? A. Risk for infection B. Deficient fluid volume C. Constipation D. Overflow urinary incontinence

A. Risk for infection

A client who has had a transurethral resection of the prostate (TURP) experiences dribbling after the indwelling catheter is removed. Which is an appropriate nursing response? A. "I know you're worried, but it will go away in a few days." B. "Increase your fluid intake and urinate at regular intervals." C. "Limit your fluid intake and urinate when you first feel the urge." D. "The catheter will have to be reinserted until your bladder regains its tone."

B. "Increase your fluid intake and urinate at regular intervals."

While providing care to a pediatric patient with acute glomerulonephritis, you note the urine output to be 10 mL/hr. The patient weighs 30 lbs. As the nurse, you will want to limit what type of foods from the patient's diet? A. Calcium-rich foods B. Potassium-rich foods C. Purine -rich foods D. None of the above because the patient's urinary output is normal based on the patient's weight.

B. Potassium-rich foods

A client comes to the emergency department because of minimal urinary output despite drinking adequate fluid. The client's blood pressure is 190/94 mm Hg. For what additional clinical manifestation associated with this data should the nurse assess the client? A. Thirst B. Weight gain C. Urinary retention D. Urinary hesitancy

B. Weight gain

An ambulatory client with benign prostatic hyperplasia tells the nurse on morning rounds that he has not been able to void. The nurse assesses the client and determines that the bladder is distended. What should the nurse do? A. Ask him to use a urinal. B. Encourage increased fluids. C. Assist him into a warm shower. D. Exert pressure over the pubic area.

C. Assist him into a warm shower.

A nurse is teaching an adult health and wellness class about bladder cancer. Which activities should the nurse include in the teaching session that increase risk? Select all that apply. A. Jogging 3 miles (4.8 km) a day B. Drinking three cans of cola a day C. Smoking two packs of cigarettes a day D. Working with dyes used in rubber every day E. Using a jackhammer and chainsaw every day

C. Smoking two packs of cigarettes a day D. Working with dyes used in rubber every day

A client reports urinary frequency and burning. To determine whether there is tenderness that indicates the presence of an ascending urinary tract infection, the nurse should palpate which area? A. Tail of Spence B. Suprapubic area C. McBurney point D. Costovertebral angle

D. Costovertebral angle

What is an acute, life-threatening complication for which a nurse should assess a client in the early postoperative period after a radical nephrectomy? A. Sepsis B. Hemorrhage C. Renal failure D. Paralytic ileus

B. Hemorrhage

A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening the client's urinary output is much less than the intake. When it is confirmed that the bladder is not distended, what should the nurse suspect developed? A. Oliguria B. Hydroureter C. Renal shutdown D. Urethral obstruction

B. Hydroureter

A client is admitted to the hospital with a diagnosis of severe chronic kidney disease. Which assessment findings should the nurse expect the client to exhibit? Select all that apply. A. Polyuria B. Paresthesias C. Hypertension D. Metabolic alkalosis E. Widening pulse pressure

B. Paresthesias C. Hypertension

After reviewing the laboratory reports, the nurse anticipates that the client has renal impairment. Which test reports support the nurse's concern? Select all that apply. A. Serum albumin: 4.7 g/dL(6.815 µmol/L) B. Serum creatinine: 2.0 mg/dL (176.8 µmol/L) C. Serum potassium: 5.9 mEq/L (5.9 mmol/L) D. Serum cholesterol: 120 mg/dL (3.108 mmol/L) E. Blood urea nitrogen: 32 mg/dL (11.424 mmol/L)

B. Serum creatinine: 2.0 mg/dL (176.8 µmol/L) C. Serum potassium: 5.9 mEq/L (5.9 mmol/L) E. Blood urea nitrogen: 32 mg/dL (11.424 mmol/L)

The nurse is providing care to a client who has had a transurethral resection of the prostate (TURP). Which goal is the priority? A. Maintain patency of the cystostomy tube. B. Prevent wound hemorrhage and infection. C. Maintain patency of the indwelling catheter. D. Prevent the abdominal dressing from draining.

C. Maintain patency of the indwelling catheter.

After reviewing the 24-hour urine collection reports of a client with kidney dysfunction, the nurse suspects diabetes mellitus. Which finding supports this suspicion? A. Calcium level: 500 mg/24 hr B. Sodium level: 300 mEq/24 hr C. Urea nitrogen level: 30 g/24 hr D. Creatinine level: 40 mg/kg/24 hr

D. Creatinine level: 40 mg/kg/24 hr

The nurse is developing a postprocedure plan of care for a client with a continuous bladder irrigation after a transurethral vaporization of the prostate. What should the nurse include in the plan? A. Measure the output hourly. B. Monitor the specific gravity of the urine. C. Irrigate the catheter with saline three times daily. D. Exclude the amount of irrigant instilled from the output.

D. Exclude the amount of irrigant instilled from the output.

The nurse assesses a male client with a preliminary diagnosis of cancer of the urinary bladder. Which clinical manifestation will indicate to the nurse the cancer is in the early stage? A. Dysuria B. Retention C. Hesitancy D. Hematuria

D. Hematuria

You're providing education to a group of nursing students about nephrotic syndrome. A student describes the signs and symptoms of this condition. Which signs and symptoms verbalized by the student require you to re-educate the student about this topic? Select-all-that-apply: A. Slight proteinuria B. Hypoalbuminemia C. Edema D. Hyperlipidemia E. Tea-colored urine F. Hypertension

A. Slight proteinuria E. Tea-colored urine F. Hypertension

A patient who is experiencing poststreptococcal glomerulonephritis has edema mainly in the face and around the eyes. As the nurse, you know to expect the edema to be more prominent during the? A. Evening B. Afternoon C. Morning D. Bedtime

C. Morning

Which patient below is NOT at risk for developing nephrotic syndrome? A. An 8 year old male with diabetes mellitus. B. A 5 year old female diagnosed with minimal change disease. C. A 10 year old male with Lupus. D. A 7 year old male recently diagnosed with Goodpasture's Syndrome.

D. A 7 year old male recently diagnosed with Goodpasture's Syndrome.

The 1-day urine sample results of a client reveal that the calcium level is 800 mg/24 hr. What does the finding indicate? A. The client has nephritis. B. The client has nephrosis. C. The client has hypocalcemia. D. The client has hyperparathyroidism.

D. The client has hyperparathyroidism.

A rubella vaccination is ordered for a client. Which statement made by the client is cause for concern? A. " I have been trying to conceive a baby for a few months." B. "I have plans to have a baby by next year." C. "I have no history of rubella in childhood." D. "I have plans to get married by the next year."

A. " I have been trying to conceive a baby for a few months."

A client is scheduled for a kidney ultrasound. Which instructions given by the nurse to the client would be most beneficial? Select all that apply. A. "Drink plenty of fluids." B. "Eat foods rich in fiber." C. "Do not urinate prior to the exam." D. "Lie flat and perfectly still during the test." E. "A urinary catheter may be needed temporarily for the test."

A. "Drink plenty of fluids." C. "Do not urinate prior to the exam." D. "Lie flat and perfectly still during the test."

A client with end-stage kidney disease says to the nurse, "I heard that it is inevitable that I will need a kidney transplant. If so, which one of my kidneys will be removed?" Which is the best response by the nurse? A. "Neither of your kidneys will be removed unless they are infected." B. "The kidney that is the most diseased is removed and replaced with a new one." C. "It is up to the primary healthcare provider as to which kidney is replaced with a new one." D. "Your right kidney will be removed, because it has a longer renal vein, making transplantation easier."

A. "Neither of your kidneys will be removed unless they are infected."

A client who has been receiving hemodialysis for several years is to receive a kidney transplant. What should the nurse share in the client's preoperative teaching plan? Select all that apply A. "The kidney may not function immediately." B. "Precautions are needed to prevent infection." C. "A urinary catheter will be present postoperatively." D. "Immunosuppressive medications will be given preoperatively." E. "The arteriovenous fistula will be used for drawing blood specimens preoperatively."

A. "The kidney may not function immediately." B. "Precautions are needed to prevent infection." C. "A urinary catheter will be present postoperatively."

Which patient below is at MOST RISK for developing acute glomerulonephritis? A. A 3 year old male who has a positive ASO titer. B. A 5 year old male who is recovering from an appendectomy. C. An 18 year old male who is diagnosed with HIV. D. A 6 year old female newly diagnosed with measles.

A. A 3 year old male who has a positive ASO titer.

A client is admitted with renal calculi. Which clinical manifestations does a nurse expect the client to report? Select all that apply. A. Blood in the urine B. Irritability and twitching C. Dry, itchy skin and pyuria D. Frequency and urgency of urination E. Pain radiating from the kidney to a shoulder

A. Blood in the urine D. Frequency and urgency of urination

Which of the following are NOT a sign and symptom of acute glomerulonephritis (poststreptococcal)? SELECT-ALL-THAT-APPLY: A. Hypotension B. Increased Glomerular filtration rate C. Cola-colored urine D. Massive proteinuria E. Elevated BUN and creatinine F. Mild swelling in the face or eyes

A. Hypotension B. Increased Glomerular filtration rate D. Massive proteinuria

A nurse is assessing a client 8 hours after the creation of a colostomy. Which assessment finding should the nurse expect? A. Presence of hyperactive bowel sounds B. Absence of drainage from the colostomy C. Dusky-colored, edematous-appearing stoma D. Bright bloody drainage from the nasogastric tube

B. Absence of drainage from the colostomy

A client is admitted to the hospital for acute gastritis and ascites secondary to alcoholism and cirrhosis. For which condition is it most important for the nurse to assess this client? A. Nausea B. Blood in the stool C. Food intolerances D. Hourly urinary output

B. Blood in the stool

A 5 year old male is admitted with acute glomerulonephritis. On assessment, you note mild edema predominately in the face and tea-colored urine. The patient's blood pressure is 165/110, heart rate 95, oxygen saturation 98% on room air, and temperature 98.9 'F. In your nursing care plan, what nursing interventions will you include in this patient's plan of care? SELECT-ALL-THAT-APPLY: A. Initiate and maintain a high sodium diet daily. B. Monitor intake and output hourly. C. Encourage patient to ambulate every 2 hours while awake. D. Assess color of urine after every void. E. Weigh patient every daily on a standing scale. F. Encourage the patient to consume 4 L of fluid per day.

B. Monitor intake and output hourly. D. Assess color of urine after every void. E. Weigh patient every daily on a standing scale.

You're providing care to a 6 year old male patient who is receiving treatment for nephrotic syndrome. Which assessment finding below requires you to notify the physician immediately? A. Frothy, dark urine B. Redden area on the patient's left leg that is swollen and warm C. Elevated lipid level on morning labs D. Urine test results that shows proteinuria

B. Redden area on the patient's left leg that is swollen and warm

A sexually active client presents with a sore throat and a generalized rash. The client states that a chancre that had been present healed approximately 3 months ago. The physical assessment and the serologic test findings indicate a diagnosis of syphilis. Which stage should the nurse determine the client is in at this time? A. Primary B. Secondary C. Latent D. Tertiary

B. Secondary

A client is scheduled for a computed tomography (CT) scan of the chest with intravenous (IV) contrast. Which assessment is the priority before the test is performed? A. Breath sounds B. Serum creatinine level C. Any allergies to betadine D. History of claustrophobia

B. Serum creatinine level

An older adult male is discharged after treatment for urinary tract infection. The family members are instructed regarding age-related changes and care to be taken. In the follow-up visit, which statement made by the client's family indicates decreased risk of urinary retention in the client? A. "I ensure he sips water just before bed." Incorrect B. "I respond immediately when he indicates a need to void." C. "I provide privacy and assistance to him to void." D. "I encourage him to use the urinal at least every 2 hours."

C. "I provide privacy and assistance to him to void."

A nursing student counsels a 70-year-old female client about changes in the reproductive system caused by aging. Which statement made by the client indicates effective learning? A. "I should reduce my intake of dietary calcium." B. "I should limit my Kegel exercises." C. "I should undergo regular clinical breast examinations." D. "I should report to my primary healthcare practitioner if my nipples do not become erect."

C. "I should undergo regular clinical breast examinations."

After a transurethral vaporization of the prostate, the client returns to the unit with an indwelling urinary catheter and a continuous bladder irrigation. The client puts the call light on to report the need to urinate. What should the nurse do first? A. Obtain the client's vital signs. B. Review the client's intake and output. C. Assess that the tubing attached to the collection bag is patent. D. Explain that the balloon inflated in the bladder causes this feeling.

C. Assess that the tubing attached to the collection bag is patent.

A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-stage renal disease should the nurse expect? Select all that apply. A. Polyuria B. Jaundice C. Azotemia D. Hypertension E. Polycythemia

C. Azotemia D. Hypertension

You're collecting a urine sample on a patient who is experiencing proteinuria due to nephrotic syndrome. As the nurse, you know the urine will appear: A. Tea-colored B. Orange and frothy C. Dark and foamy D. Straw-colored

C. Dark and foamy

A client has end-stage kidney disease and is receiving hemodialysis. During dialysis the client reports nausea and a headache and appears confused. Operating on prescribed protocols, which action will the nurse take? A. Give an analgesic. B. Administer an antiemetic. C. Decrease the rate of exchange. D. Discontinue the procedure immediately.

C. Decrease the rate of exchange.

A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should the nurse include in the education? A. Weight loss B. Subnormal temperature C. Elevated blood pressure D. Increased urinary output

C. Elevated blood pressure

Which instructions will be most beneficial for a diabetic client with renal disease? Select all that apply. A. Recommend the client drink boiled water B. Suggest the client to go for a morning walk C. Instruct the client to check blood pressure regularly D. Contact the primary healthcare provider before taking ibuprofen E. Encourage the client to undergo a microalbuminuria test yearly

C. Instruct the client to check blood pressure regularly D. Contact the primary healthcare provider before taking ibuprofen E. Encourage the client to undergo a microalbuminuria test yearly

A client who has had a continent urostomy created reports postoperative pain. What should the nurse do first? A. Tell the client to take deep breaths. B. Measure the client's current vital signs. C. Interview the client to gather more information. D. Administer the prescribed analgesic to the client.

C. Interview the client to gather more information.

The nurse assists an elderly client in squirting warm water over the perineum. Which outcome indicates effective nursing care? A. The client will not have nocturia. B. The client will not have a bladder infection. C. The client will not have a tendency to retain urine. D. The client will not have urinary stress incontinence.

C. The client will not have a tendency to retain urine.

A clinic nurse is interviewing a client with syphilis. The nurse should ask the client about sexual contacts during which time period? A. The past 21 days B. The past 30 days C. The past 3 months D. The past 6 months

C. The past 3 months

A client who has ovarian cancer is to receive intravenous chemotherapy. Before the infusion, the nurse teaches the client how to use imagery to maximize the effects of the chemotherapy. Which statement specifically relates to this alternative therapy? A. "Rest the mind while remaining in the present." B. "Listen to soothing instrumental music during the infusion." C. "Light a candle with the scent of lavender during the infusion." D. "Focus on the droplets of chemotherapy attacking the cancer cells."

D. "Focus on the droplets of chemotherapy attacking the cancer cells."

Within the past month, the admission rate of patients with poststreptococcal glomerulonephritis has doubled on your unit. You are proving an in-service to your colleagues about this condition. Which statement is CORRECT about this condition? A. "This condition tends to present 6 months after a strep infection of the throat or skin." B. "It is important the patient consumes a diet rich in potassium based foods due to the risk of hypokalemia." C. "Patients are less likely to experience hematuria with this condition." D. "This condition is not caused by the streptococcal bacteria attacking the glomerulus, but by the immune system's response to the bacteria by creating an antigen-antibody complex which inflames the glomerulus."

D. "This condition is not caused by the streptococcal bacteria attacking the glomerulus, but by the immune system's response to the bacteria by creating an antigen-antibody complex which inflames the glomerulus."

A nurse reviews the history of a client who is hospitalized with a diagnosis of urinary calculi and identifies that which factor may have contributed to the development of the calculi? A. Increased fluid intake B. Urine specific gravity of 1.017 C. Jogging 3 miles (4.8 km) a day D. History of hyperparathyroidism

D. History of hyperparathyroidism

TRUE or FALSE: Poststreptococcal glomerulonephritis is a type of NEPHROTIC SYNDROME, which means there is the leakage of BOTH red blood cells and protein from the inflamed glomerulus into the filtrate.

False