NCLEX practice-Renal

2

A client has epididymitis as a complication of urinary tract infection. A nurse is giving the client instructions to prevent a recurrence. The nurse would evaluate that the client needs further instructions if the client states to: 1. Drink increased amounts of fluids 2. Continue to take antibiotics until all symptoms are gone 3. Limit the force of the stream during voiding 4. Use condoms to eliminate contracting chlamydia or gonorrhea

1

A client is admitted to an emergency department following a motor vehicle accident. The client was wearing a lap seat belt when the accident occurred. The client has hematuria and lower abdominal pain. To further determine whether the pain is due to bladder trauma, a nurse asks the client if the pain is referred to which of the following areas? 1. Shoulder 2. Umbilicus 3. Costovertebral angle 4. Hip

1

A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure (CRF). Which of the following would a nurse expect to note on assessment of the client? 1. Polyuria 2. Polydypsia 3. Oliguria 4. Anuria

3

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate(TURP) is performed. Four hours after surgery, a nurse takes the client's vital signs and empties the urinary drainage bag. Which of the following assessment findings would indicate the need to notify the physician? 1. Red bloody urine 2. Urinary output of 200 ml. greater than intake 3. Blood pressure of 100/50 mm Hg, pulse of 130 beats per min 4. Pain related to bladder spasms

1

A client is admitted with a suspicion of bladder cancer. A nurse assesses the client for which of the following earliest manifestations of the disease? 1. Hematuria with no pain 2. Painful urination and hematuria 3. Pyuria and palpable abdominal mass 4. Proteinuria and dysuria

1

A client is diagnosed with polycystic kidney disease. Which f the following would the nurse not expect to be a component of the treatment plan? 1. Sodium restriction 2. Antihypertensive medications 3. Increased water intake 4. Genetic counseling

3

A client is scheduled for an intravenous pyelogram (IVP). Before the test, the priority nursing action would be to: 1. Administer an oral preparation of radiopaque dye 2. Restrict fluids 3. Determine a history of allergies 4. Administer a sedative

4

A client newly diagnosed with chronic renal failure has recently begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, during a dialysis a nurse assesses the client for: 1. Hypertension, tachycardia, and fever 2. Hypotension, bradycardia, and hypothermia 3. Restlessness, irritability, and generalized weakness 4. Headache, deteriorating level of consciousness, and twitching

3

A client newly diagnosed with renal failure will be receiving peritoneal dialysis. During the infusion of the dialysate the client complains of abdominal pain. Which action by the nurse is most appropriate? 1. Slow the infusion 2. Decrease the amount to be infused 3. Explain that the pain will subside after the first few exchanges 4. Stop the dialysis

3

A client passes a urinary stone, and laboratory analysis of the stone indicates that it is composed of calcium oxalate. On the basis of this analysis, which of the following would the nurse include in the dietary instructions? 1. Increase intake of meat, fish, plums, and cranberries 2. Avoid citrus fruits and citrus juices 3. Avoid green leafy vegetables such as spinach 4. Increase intake of dairy products

2

A client returns to the nursing unit following a pyelolithotomy for removal of a kidney stone. A Penrose drain is in place. Which of the following would a nurse include in the client's postoperative plan of care? 1. Sterile irrigation of the Penrose drain 2. Frequent dressing changes around the Penrose drain 3. Weighing dressings 4. Maintaining the client's position on the affected side

4

A client who has a cold is seen in the emergency room with inability to void. Since the client has a history of benign prostatic hyperplasia (BPH), a nurse determines that the client should be questioned about the use of which of the following medications? 1. Diuretics 2. Antibiotics 3. Antitussives 4. Decongestants

4

A client with prostatitis secondary to kidney infection has received instructions on management of the condition at home and prevention of recurrence. A nurse evaluates that the client understood the instructions if the client verbalized the intention to: 1. Keep fluid intake to a minimum to decrease the need to void 2. Exercise as much as possible to stimulate circulation 3. Stop antibiotic therapy when pain subsides 4. Use warm sitz baths and analgesics to increase comfort

3

A client with urolithiasis has a history of chronic urinary tract infections (UTIs). A nurse concludes that this client most likely has which of the following types of urinary stones? 1. Calcium oxalate 2. Uric acid 3. Struvite 4. Cystine1

4

A female client is admitted to an emergency department following a fall from a horse. A physician orders insertion of a Foley catheter. A nurse notes blood at the urinary meatus while preparing for the procedure. The nurse should: 1. Use extra povidone-iodine solution in cleansing the meatus 2. Use a smaller size catheter 3. Administer pain medication before inserting the catheter 4. Notify the physician

2

A hemodialysis client with a left arm fistula is at risk for steal syndrome. A nurse assesses this client for which of the following manifestations? 1. Warmth, redness, and pain in the left hand 2. Pallor, diminished pulse, and pain in the left hand 3. Edema and purplish discoloration of the left hand 4. Aching pain, pallor, and edema of the left arm

4

A male client has a tentative diagnosis of urethritis. A nurse assesses the client for which of the following manifestations of the disorder? 1. Hematuria and penile discharge 2. Hematuria and pyuria 3. Dysuria and proteinuria 4. Dysuria and penile discharge

2

A nurse has completed client teaching with a hemodialysis client about self-monitoring between hemodialysis treatments. The nurse evaluates that the client best understands the information given if the client states to record on a daily basis: 1. Pulse, respiratory rate 2. Intake and output, weight 3. Blood urea nitrogen and creatine levels 4. Activity log

1

A nurse has given a client with polycystic kidney disease information about management of the disorder, and prevention and recognition of complications. The nurse determines that the client understands the instructions if the client states that there is no reason to be concerned about: 1. A lowered blood pressure 2. Onset of shortness of breath 3. A fever 4. Burning on urination

2

A nurse is assessing a client with epididymitis. The nurse anticipates which of the following findings on physical examination? 1. Fever, diarrhea, groin pain, and ecchymosis 2. Fever, nausea and vomiting, and painful scrotal edema 3. Diarrhea, groin pain, and scrotal edema 4. Nausea and vomiting, and scrotal edema with ecchymosis

3

A nurse is assisting a client on a low-potassium diet to select food items from the menu. Ehich of the following food items, if selected by the client, would indicate an understanding of this dietary restriction? 1. Cantaloupe 2. Spinach 3. Lima beans 4. Strawberries

2

A nurse is caring for a client following a kidney transplant. The client develops oliguria. Which of the following would the nurse anticipate to be prescribed as the treatment for the oliguria? 1. Forcing fluids 2. Administration of diuretics 3. Irrigation of the Foley catheter 4. Restricting fluids

4

A nurse is caring for a client who has had a renal biopsy. Which of the following interventions would the nurse avoid in the care of the client after this procedure? 1. Forcing fluids to at least 3 liters in the first 24 hours 2. Administering PRN narcotics 3. Testing serial samples with dipsticks for occult blood 4. Ambulating the client in the room and hall for short distances

4

A nurse is caring for a client who has undergone renal angiography using the left femoral artery for access. The nurse evaluates that the client is experiencing a complication of the procedure if which of the following observations is made? 1. Urine output of 50 ml/hr 2. Absence of hematoma in the left groin 3. Blood pressure of 110/74 mm Hg 4. Pallor and coolness of the left leg

3

A nurse is caring for an 88-year old woman suspected of having a urinary tract infection (UTI). Which of the following if noted in the client, would alert the nurse to the possibility of the presence of a UTI? 1. Fever 2. Frequency 3. Confusion 4. Urgency

2

A nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the dwell time for the dialysis at the prescribed time because of the risk of: 1. Infection 2. Hyperglycemia 3. Fluid overload 4. Disequilibrium syndrome

1

A nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action? 1. Notify the physician 2. Monitor the client 3. Elevate the head of the bed 4. Medicate the client for nausea

1

A nurse is planning a teaching session with a female client diagnosed with urethritis resulting from infection and chlamydia. The nurse would plan to include which of the following points in the teaching session? 1. The most serious complication of this infection is sterility 2. The infection can be prevented by using spermicide to alter the pH in the perineal area 3. Medication therapy should be continued for 2 weeks without interruption 4. Sexual partners during the last 12 months should be notified and treated

4

A nurse is preparing to care for a client after a renal scan. Which of the following would the nurse include in the plan of care? 1. Place the client on radiation precautions for 18 hours 2. Save all urine in a radiation-safe container for 18 hours 3. Limit contact with the client to 20 minutes per hour 4. No special precautions except to wear gloves if in contact with the client' urine

2

A nurse is preparing to care for a client receiving peritoneal dialysis. Which of the following would be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis? 1. Monitor the client's level of consciousness 2. Maintain strict aseptic technique 3. Add heparin to the dialysate solution 4. Change the catheter site dressing daily

4

A client with chronic renal failure has completed a hemodialysis treatment. A nurse would use which of the following standard indicators to evaluate the client's status after dialysis? 1. Potassium level and weight 2. Blood urea nitrogen (BUN) and creatinine levels 3. Vital signs and BUN 4. Vital signs and weight

3

A client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). A nurse should plan to administer this medication: 1. Just prior to dialysis 2. During dialysis 3. Upon return from dialysis 4. The day after dialysis

3

A nurse is receiving in transfer from the post anesthesia care unit a client who has had percutaneous ultrasonic lithotripsy for calculi in the renal pelvis. The nurse anticipates that the client's care will involve monitoring which of the following 1. Suprapubic tube 2. Ureteral stent 3. Nephrostomy tube 4. Jackson-Pratt drain

1

A client who has a history of gout is also diagnosed with urolithiasis. The stones are determined to be of uric acid type. A nurse gives the client instructions in food to limit, which include: 1. Liver 2. Apples 3. Carrots 4. Milk

2

A client with a crush injury to the right lower leg develops acute renal failure (ARF). A nurse interprets that this type of renal failure is due to: 1. Prerenal causes 2. Renal causes 3. Postrenal causes 4. Extrarenal causes

3

A client with acute renal failure has a serum potassium (K) level of 5.8 mEq/L. A nurse would plan which of the following as a priority action? 1. Allow an extra 500 mL fluid intake to dilute the electrolyte concentration 2. Encourage increased vegetables in the diet 3. Place the client on a cardiac monitor 4. Check the sodium level

4

A client with an arteriovenous (AV) shunt in place for hemodialysis is at risk for bleeding. A nurse would do which of the following as a priority action to prevent this complication from occurring? 1. Check the results of the prothrombin time as they are ordered 2. Observe the site once per shift 3. Check the shunt for presence of bruit and thrill 4. Ensure that small clamps are attached to the AV shunt dressing

1

A nurse is reviewing a client's record and notes that the physician has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following? 1. Elevated blood urea nitrogen (BUN) 2. Decreased hemoglobin 3. Decreased red blood cell (RBC) count 4. Decreased white blood cell (WBC) count

1

A client with benign prostatic hyperplasia (BPH) undergoes a transurethral resection of the prostate (TURP). Postoperatively, the client is receiving continuous bladder irrigations. A nurse assesses the client for signs of transurethral resection (TUR) syndrome. Which of the following assessment data would indicate the onset of this syndrome? 1. Bradycardia and confusion 2. Tachycardia and diarrhea 3. Decreased urinary output and bladder spasms 4. Increased urinary output and anemia

4

A client with chlamydial infection has received instructions on self-care and prevention of further infection. A nurse evaluates that the client needs further reinforcement if the client states to: 1. Reduce the chance of infection by limiting the number of sexual partners 2. Use latex condoms to prevent disease transmission 3. Return to the clinic as requested for follow-up culture in one week 4. Use doxycycline prophylactically to prevent symptoms of chlamydia

2

A client with chronic renal failure (CRF) is at risk for developing dementia related to excessive absorption of aluminum. A nurse teaches the client that this is the reason that the client is being prescribed which of the following phosphate-binding agents? 1. Alu-Cap 2. Tums 3. Amphojel 4. Basalijel

4

A client with chronic renal failure (CRF) returns to the nursing unit following a hemodialysis treatment. On assessment, a nurse notes that the client's temperature is 100.2 degree F. Which of the following is the most appropriate nursing action? 1. Encourage fluids 2. Notify the physician 3. Monitor the site of the shunt for infection 4. Continue to monitor vital signs

2

A client with chronic renal failure has an indwelling catheter for peritoneal dialysis in the abdomen. The client spills water on the dressing while bathing. A nurse should plan to immediately: 1. Reinforce the dressing 2. Change the dressing 3. Flush the peritoneal dialysis catheter 4. Scrub the catheter with povidone -iodine

2

A client arrives at an emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. A nurse next assesses the client to determine a history of : 1. Renal cancer in the client's family 2. Blow or trauma to the bladder or abdomen 3. Glomerulonephritis 4. Pyelonephritis

2

A client being hemodialyzed becomes suddenly short of breath and complains of chest pain. The client is tachycardic, pale, and anxious. A nurse suspects air embolism. The nurse should: 1. Continue dialysis at a slower rate after checking the lines for air 2. Discontinue dialysis and notify the physician 3. Monitor vital signs every 15 minutes for the next hour 4. Bolus the client with 500 ml normal saline to break up the air embolus

1

A client complains of fever, perineal pain, urinary urgency and frequency, and dysuria. To assess whether the client's problem is related to prostatitis, the nurse would look at the results of the prostate examination, which should reveal that the prostate gland is: 1. Tender, indurated, and warm to the touch 2. Boggy, swollen, and warm to the touch 3. Tender and edematous with ecchymosis 4. Reddened, swollen , and boggy

4

A nurse is reviewing the list of components of the peritoneal dialysis solution with a client. The client asks the nurse about the purpose of the glucose contained in the solution. The nurse bases the response on the knowledge that glucose: 1. Prevents excess glucose from being removed from the client 2. Decreases the risk for peritonitis 3. Prevents disequilibrium syndrome 4. Increases osmotic pressure to produce ultra-filtration

3

A nurse is taking the history of a client who has had benign prostatic hyperplasia (BPH) in the past. To determine if the client is currently experiencing difficulty, the nurse asks the client about the presence of which of the following early symptoms? 1. Urge incontinence 2. Nocturia 3. Decreased force in the stream of urine 4. Urinary retention

1

A week after kidney transplantation, a client develops a fever of 100 degrees F, the blood pressure is elevated, and the kidney is tender. The x-ray results indicate that the transplanted kidney is enlarged. On the basis of these assessment findings a nurse would suspect which of the following? 1. Acute rejection 2. Chronic rejection 3. Kidney infection 4. Kidney obstruction

1

Following a renal biopsy, a client complains of pain at the biopsy site that radiates to the front of the abdomen. A nurse interprets this complaint and further assesses the client for: 1. bleeding 2. infection 3. renal colic 4. a normal expected pain