RENAL NCLEX QUESTIONS

Renal NCLEX Questions ScienceMedicineNursing lilnurseangel Save NCLEX Questions for Renal Disorder...40 terms mdunlap5920Preview

RENAL NCLEX QUESTIONS

45 terms kidniki77Preview Maternity Nclex questions 68 terms crystalrose_rivera Preview Med-S 159 term AE2 A client with glomerulonephritis is at risk of developing acute renal failure. The nurse monitors the client for which sign of this complication?

• bradycardia
• hypertension
• decreased cardiac output
• decreased central venous pressure

B

• Acute renal failure caused by glomerulonephritis is classified as intrinsic or intrarenal failure. This form of acute renal failure is commonly

manifested by hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload. Acute renal failure from prerenal causes is characterized by decreased blood pressure or a recent history of the same, tachycardia, and decreased cardiac output and central venous pressure. Bradycardia is not part of the clinical picture for renal failure.A nurse provides home care instructions to a client hospitalized for a transurethral resection of the prostate (TURP). Which statement by the client indicates a need for further instructions?

a) I need to avoid strenuous activity for 4 to 6 weeks

b) I need to maintain a daily intake of 6 to 8 glasses of water daily

c) I need to avoid lifting items greater than 30 pounds

d) I need to include prune juice in my diet

C

• The client needs to be advised to avoid strenuous activity for 4 to 6 weeks and to avoid lifting items weighing greater than 20 pounds. The

client needs to consume an intake of at least 6 to 8 glasses daily of nonalcoholic fluids to minimize clot formation. Straining during defecation for at least 6 weeks after surgery is avoided to prevent bleeding. Prune juice is a satisfactory bowel stimulant.

A nurse is caring for a client who has just returned to the nursing unit after an intravenous pyelogram (IVP). The nurse determines that which of the following is important in the postprocedure care of this client?

• encouraging increased intake of oral fluids
• ambulating the client in the hallway
• encouraging the client to try to avoid frequently
• maintaining the client on bedrest

A

• Following an IVP, the client should take in increased fluids to aid in the clearance of the dye used for the procedure. It is unnecessary to void

frequently after the procedure. The client is usually allowed activity as tolerated without any specific activity guidelines.A nurse has collected nutritional data from a client with a diagnosis of cystitis. The nurse determines that which beverage needs to be eliminated from the client's diet to minimize the recurrence of cystitis?

• fruit juice
• tea
• water
• lemonade

B

• Caffeine and alcohol can irritate the bladder. Therefore, alcohol and caffeine-containing beverages such as coffee, tea, and cocoa are avoided

to minimize the risk. Water helps flush bacteria out of the bladder, and an intake of six to eight glasses per day is encouraged. Lemonade and fruit juice are acceptable items to drink.A client with pyelonephritis is being discharged from the hospital, and the nurse provides instructions to the client to prevent recurrence. The nurse determines that the cleint understands the information that was given if hte client states an intention to:

• increase fluids for 2 days if signs and symptoms of a urinary tract infection develop
• take the prescribed antibiotics until all symptoms subside
• return to the physician's office for scheduled follow-up urine cultures
• decrease fluid intake if frequent urination occurs

C

• The client with pyelonephritis should take the full course of antibiotic therapy that has been prescribed and return to the physician's office for

follow-up urine cultures if so instructed. The client should learn the signs and symptoms of a urinary tract infection, and report them immediately if they occur. The client should also drink 3 L of fluid per day.A nurse is giving a client with polycystic kidney disease instructions in replacing elements lost in the urine as a result of impaired kidney function.The nurse instructs the client to increase intake of which of the following in the client?

• sodium and potassium
• sodium and water
• water and phosphorus
• calcium and phosphorus

B

• Clients with polycystic kidney disease waste sodium rather than retain it and therefore need an increase in sodium and water in the diet.

Potassium, calcium, and phosphorus do not need to be increased in this condition.

A nurse has provided instructions to a female client with cystitis about measures to prevent recurrence. The nurse determines that the client

needs further instruction if the client verbalizes to:

• take bubble baths for more effective hygiene
• wear underwater made of cotton or with cotton panels
• drink a glass of water and void after intercourse
• avoid wearing pantyhose while wearing socks

A

• Measures to prevent cystitis include increasing fluid intake to 3 L per day; consuming an acid-ash diet; wiping front to back after urination;

using showers instead of tub baths; drinking water and voiding after intercourse; avoiding bubble baths, feminine hygiene sprays, or perfumed toilet tissue or sanitary pads; and wearing clothes that "breathe" (cotton pants, no tight jeans, no pantyhose under slacks). Other measures include teaching pregnant women to void every 2 hours, and teaching menopausal women to use estrogen vaginal creams to restore vaginal pH.A nurse has provided instructions to a client with a nephrotostomy tube regarding home care after hospital discharge. The nurse determines that the client understands the instructions if the client verbalizes to drink approximately how many 8-ounce glasses of water per day?

• 2
• 8
• 16
• 20

B

• The client with a nephrostomy tube needs to have adequate fluid intake to dilute urinary particles that could cause calculus and to provide

mechanical flushing of the kidney and tube. The nurse encourages the client to take in 2000 mL of fluid per day, which is roughly equivalent to eight 8-ounce glasses of water. Option A identifies a fluid intake volume that is too low and would not provide mechanical flushing of the kidney and tube. Options C and D identify very large volumes of fluid intake; these volumes are unnecessary and could possibly place undo distention on the renal pelvis.A client with nephrolithiasis arrives at a clinic for a follow-up visit. The laboratory analysis of the stone that the client passed 1 week ago indicates that the stone is composed of calcium oxalate. The nurse tells the client to avoid consuming which food item?

• lentils
• strawberries
• lettuce
• pasta

B

• Foods that raise urinary oxalate excretion include spinach, rhubarb, strawberries, chocolate, wheat bran, nuts, beets, and tea. Of the options

provided, the client will be instructed to avoid strawberries.

A client diagnosed with cancer of the bladder has a nursing diagnosis of fear related to the uncertain outcome of upcoming cystectomy and urinary diversion. The nurse determines that this diagnosis is appropriate if the client makes which statement?

a) I'm so afraid I won't live through all this

• what if I have no help at home after going through this awful surgery

c) I'll never feel like myself once I can't go to the bathroom normally

d) I wish I'd never gone to the doctor at all

A

• In order for fear to be an actual diagnosis, the client must be able to identify the object of fear. In this question, the client is expressing a fear of

the outcome related to surgery. The statement in option B relates to a nursing diagnosis of impaired home maintenance. Option C relates to a nursing diagnosis of disturbed body image. Option D is vague and nonspecific, and further assessment is needed to associate this statement with a nursing diagnosis.A nurse is developing a plan of care for a client with nephrotic syndrome. The nurse documents that which important parameter needs to be assessed on a daily basis?

• total protein levels
• weight
• blood urea nitrogen (BUN)
• activity tolerance

B The client with nephrotic syndrome typically presents with edema, hypoalbuminemia, and proteinuria. The nurse carefully assesses the fluid balance of the client, which includes daily monitoring of weight, intake and output, edema, and girth measurements. Albumin levels are monitored as they are ordered, as are the BUN and creatinine levels. The client's activity level is adjusted according to the amount of edema and water retention. As edema increases, the client's activity level should be restricted.A client with renal malignancy is admitted to the hospital for a diagnostic workup and probable surgery. During the admission assessment the nurse inquires about the presence of which common symptom related to this problem?

• flank pain and intermittent hematuria
• suprapubic pain and constant slight hematuria
• flank pain and foul-smelling urine
• abdominal pain and decreased urine output

A

• Renal cancer is commonly manifested by hematuria and flank pain (not abdominal or suprapubic), and a palpable mass may be palpated on

physical examination. Because the hematuria is gross but intermittent, the client may delay seeking medical treatment. Foul-smelling urine could indicate infection. Decreased urine output could indicate renal insufficiency.A client has undergone urinary diversion after cystectomy for bladder cancer. The nurse assesses the urostomy stoma to ensure that it is:

• pale and pink
• pink and dry
• red and moist
• dusky to beefy colored

C

• Following urostomy, the stoma should be red and moist. It may be edematous, but this will decrease after the first few days. A dusky or

cyanotic color indicates insufficient circulation with impending necrosis and warrants notification of the surgeon immediately.