Urinary NCLEX QUESTIONS AND ANSWERS

Urinary NCLEX QUESTIONS AND ANSWERS

Fever, chills, and costovertebral pain are symptoms of a urinary tract infection (acute pyelonephritis), which requires a urine culture first to confirm the diagnosis. - The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first? 1

1.A midstream urine for culture.

2.A sonogram of the kidney.

3.An intravenous pyelogram for renal calculi.

4.A CT scan of the kidneys.

4

Coffee, tea, cola, and alcoholic beverages are urinary tract irritants. - The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI?

1.Clean the perineum from back to front after a bowel movement.

2.Take warm tub baths instead of hot showers daily.

3.Void immediately preceding sexual intercourse.

4.Avoid coffee, tea, colas, and alcoholic beverages.

3

The client should be taught to take all the prescribed medication anytime a prescription is written for antibiotics. - The nurse is discharging a client with a health-care facility acquired urinary tract infection. Which information should the nurse include in the discharge teaching?

1.Limit fluid intake so the urinary tract can heal.

2.Collect a routine urine specimen for culture.

3.Take all the antibiotics as prescribed.

4.Tell the client to void every five (5) to six (6) hours.

3

A long-term complication of glomerulonephritis is it can become chronic if unresponsive to treatment,and this can lead to end-stage renal disease. Maintaining renal function is an appropriate long-term goal. - The nurse is preparing a plan of care for the client diagnosed with acute glomerulonephritis. Which statement is an appropriate long-term goal?

1.The client will have a blood pressure within normal limits.

2.The client will show no protein in the urine.

3.The client will maintain normal renal function.

4.The client will have clear lung sounds.

3

Glomerular filtration rate (GFR) is approximately 120 mL/min. If the GFR is decreased to 40 mL/min, the kidneys are functioning at about one-third filtration capacity. - The elderly client is diagnosed with chronic glomerulonephritis. Which laboratory value indicates to the nurse the condition has become worse?

1.The blood urea nitrogen is 15 mg/dL.

2.The creatinine level is 1.2 mg/dL.

3.The glomerular filtration rate is 40 mL/min.

4.The 24-hour creatinine clearance is 100 mL/min.

1.

Blood urea nitrogen (BUN) levels reflect the balance between the production and excretion of urea from the kidneys. Creatinine is a by-product of the metabolism of the muscles and is excreted by the kidneys. Creatinine is the ideal sub-stance for determining renal clearance because it is relatively constant in the body and is the laboratory value most significant in diagnosing renal failure. - The nurse is caring for a client diagnosed with ARF. Which laboratory values are most significant for diagnosing ARF?

1.BUN and creatinine.

2.WBC and hemoglobin.

3.Potassium and sodium.

4.Bilirubin and ammonia level.

2.

Hypotension, which causes a decreased blood supply to the kidney, is one of the most common causes of pre-renal failure(before the kidney). - The nurse is caring for a client diagnosed with rule-out ARF. Which condition predisposes the client to developing prerenal failure?

1.Diabetes mellitus.

2.Hypotension.

3.Aminoglycosides.

4.Benign prostatic hypertrophy

4.

Normal potassium level is 3.5 to5.5 mEq/L. A level of 6.8 mEq/L is life threatening and could lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to decrease the potassium level quickly. This requires a health-careprovider order, so it is a collaborative intervention. - The client diagnosed with ARF has a serum potassium level of 6.8 mEq/L. Which collaborative treatment should the nurse anticipate for the client?

1.Administer a phosphate binder.

2.Type and crossmatch for whole blood.

3.Assess the client for leg cramps.

4.Prepare the client for dialysis.

3.

Carbohydrates are increased to provide for the client's caloric intake and protein is restricted to minimize protein breakdown and to prevent accumulation of toxic waste products. - The client diagnosed with ARF is admitted to the intensive care unit and placed on a therapeutic diet.Which diet is most appropriate for the client?

1.A high-potassium and low-calcium diet.

2.A low-fat and low-cholesterol diet.

3.A high-carbohydrate and restricted-protein diet.

4.A regular diet with six (6) small feedings a day.

2.

Bed rest reduces exertion and the metabolic rate, thereby reducing catabolism and subsequent release of potassium and accumulation of endogenous waste products (urea and creatinine). - The client diagnosed with ARF is placed on bed rest. The client asks the nurse, "Why do I have to stay in bed? I don't feel bad." Which scientific rationale supports the nurse's response?

1.Bed rest helps increase the blood return to the renal circulation.

2.Bed rest reduces the metabolic rate during the acute stage.

3.Bed rest decreases the workload of the left side of the heart.

4.Bed rest aids in reduction of peripheral and sacral edema.