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    Exam Review

    1. A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching?
      A)
      Renal function is reestablished.
      B)
      The glomerular filtration rate (GFR) recovers.
      C)
      Urine output is less than 400 ml per 24 hr.
      D)
      BUN and creatinine levels decrease.
    2. A nurse is caring for a male client who reports nausea and vomiting and is receiving IV fluid therapy. His blood urea nitrogen (BUN) is 32 mg/dL, creatinine 1.1 mg/dL, and hematocrit 50%. Which of the following nursing interventions is appropriate?
      A)
      Collect a urine specimen for culture and sensitivity.
      B)
      Continue routine care because the results are within the expected reference range.
      C)
      Decrease the IV fluid infusion rate and limit oral fluid intake
      D)
      Evaluate urine for amount and for specific gravity
    3. A nurse is caring for a client on a pediatric unit. Exhibits Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
      ✓Encourage fluid intake
      ✓Administer pain medication
      ✓Hydronephrosis
      ✓Urine output
      ✓Blood pressure
      Actions to Take Choices
      ✕Restrict salt in the diet
      ✓Encourage fluid intake
      ✕Elevate the legs
      ✓Administer pain medication
      ✕Monitor blood glucose levels
      Potential Conditions Choices
      ✕Renal calculi
      ✕Benign prostatic hyperplasia
      ✓Hydronephrosis
      ✕Chronic Glomerulonephritis
      Parameters to Monitor Choices
      ✕Skin condition
      ✓Urine output
      ✕Respiratory rate
      ✕Heart rate
      ✓Blood pressure
    4. A 68-yr-old patient admitted to the hospital with dehydration is confused and incontinent of urine. Which nursing action should be included in the plan of care?
      A)
      Apply absorbent adult incontinence diapers and pads over the bed linens.
      B)
      Assist the patient to the bathroom every 2 hours during the day
      C)
      Restrict fluids between meals and after the evening meal
      D)
      Insert an indwelling catheter until the symptoms have resolved.
    Page 1 of 17

    Exam Review

    1. A nurse assessing a client notes that the client has a constant leakage of small amounts of urine and a bladder that is distended and palpable. The nurse should associate these findings with which of the following types of urinary incontinence?
      A)
      Reflex incontinence
      B)
      Urge incontinence
      C)
      Stress incontinence
      D)
      Overflow incontinence
    2. A nurse is caring for a client on a medical unit. Exhibits Drag the words from the choices below to fill in each blank in the following sentence Essential infection control practices in peritoneal dialysis include▾ performing hand hygiene, ▾ assessing fluid intakeand▾ applying antibiotic ointment.
      Dropdown 1:
      Option 1: monitoring vital signs
      Option 2: checking blood glucose levels
      Option 3: performing hand hygiene
      Option 4: applying antibiotic ointment
      Option 5: assessing fluid intake
      Option 6: using sterile techniques
      Dropdown 2:
      Option 1: monitoring vital signs
      Option 2: checking blood glucose levels
      Option 3: performing hand hygiene
      Option 4: applying antibiotic ointment
      Option 5: assessing fluid intake
      Option 6: using sterile techniques
      Dropdown 3:
      Option 1: monitoring vital signs
      Option 2: checking blood glucose levels
      Option 3: performing hand hygiene
      Option 4: applying antibiotic ointment
      Option 5: assessing fluid intake
      Option 6: using sterile techniques
    3. A nurse is teaching a client who has acute kidney disease about fluid restrictions. Which of the following statements by the client should the nurse identify as understanding of the teaching?
      A)
      "I should consume most of the fluid during the evening”
      B)
      "I will put beverages in large containers to give the appearance of drinking a lot."
      C)
      "I will not add ice cream to the amount of fluid intake.”
      D)
      "I will make a list of my favorite beverages."
    4. An adult patient is admitted to the hospital with new-onset nephrotic syndrome. Which assessment data will the nurse expect?
      A)
      Decreased blood pressure
      B)
      Poor skin turgor
      C)
      Recent weight gain
      D)
      Elevated urine ketones
    Page 2 of 17

    Exam Review

    1. Which information from a patient's urinalysis requires that the nurse notify the health care provider?
      A)
      decreased pH
      B)
      Increased protein
      C)
      Increased WBC
      D)
      Increase specific gravity
    2. A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?
      A)
      BUN 23 mg/dL and creatinine 1.0 mg/dL
      B)
      BUN 45 mg/dL and creatinine 8 mg/dL
      C)
      BUN 8 mg/dL and creatinine 0.7 mg/dL
      D)
      BUN 10 mg/dL and creatinine 0.3 mg/dL
    3. A nurse is teaching a client who has a new diagnosis of urge incontinence. Which of the following information should the nurse include in the teaching? (Select all that apply)
      A)
      "You might require an anterior vaginal repair"
      B)
      "You should restrict your intake of caffeine”
      C)
      "Your provider might prescribe anticholinergic medications."
      D)
      "You should limit fluids in the evening."
      E)
      "You might require intermittent urinary catheterization.”
    4. Nursing staff on a hospital unit are reviewing rates of health care-associated infections (HAI) of the urinary tract. Which nursing action will be most helpful in decreasing the risk for urinary HAI in patients admitted to the hospital?
      A)
      Providing perineal hygiene to patients dally and as needed
      B)
      Encouraging adequate oral fluid and nutritional intake
      C)
      Avoiding unnecessary urinary catheterization
      D)
      Testing urine with a dipstick dally for nitrites
    Page 3 of 17

    Exam Review

    1. A patient passing bloody urine has scheduled a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate?
      A)
      "Your doctor will place a catheter into an artery in your groin and inject a dye to visualize the blood supply to the kidneys”
      B)
      "Your doctor will insert a lighted tube in the bladder through your urethra, inspect the bladder, and instill dye to outline your bladder on x-ray"
      C)
      "Your doctor will inject a radioactive solution into a vein in your arm, then the isotope in your kidneys and bladder will be visible on a scanner “
      D)
      "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidneys."
    2. What is the significance of detecting a thrill and bruit in an AV fistula?
      A)
      It shows that the access site is not sale for dialysis.
      B)
      it suggests a blockage in the access site
      C)
      it confirms the maturation of the access site.
      D)
      It indicates the presence of an infection.
    3. A55-yr-old woman admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which intervention is appropriate to include in the care plan?
      A)
      Demonstrate how to perform the Crede maneuver.
      B)
      Assist the patient to the bathroom 3hr
      C)
      Place a commode at the patients bedside.
      D)
      Teach the patient how to perform Kegel exercises
    4. A 58-yr-old male patient who is diagnosed with nephrotic syndrome has ascites and 4+ leg edema. Which patient problem is present, based on these findings?
      A)
      inadequate nutrition
      B)
      Poor perfusion
      C)
      Activity intolerance
      D)
      Excess fluid volume
    Page 4 of 17

    Exam Review

    1. Which action will the nurse include in the plan of care to maintain the patency of a patient's left arm arteriovenous fistula?
      A)
      Compare blood pressures in the left and right arms.
      B)
      Assess the quality of the left radial pulse.
      C)
      Auscultate for a bruit at the fistula site.
      D)
      Irrigate the fistula site with saline every 8 to 12 hours.
    2. A 55-yr-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication?
      A)
      Blood pressure 98/56 mm Hg
      B)
      Creatinine 1.6 mg/dL
      C)
      Oxygen saturation 89%
      D)
      Hemoglobin level 13 g/dL
    3. A nurse is planning care for a client who has urolithiasis. Which of the following actions should the nurse take?
      A)
      Encourage intake of at least 3 L of fluids per day.
      B)
      Apply cold compress to the client's flank area.
      C)
      Restrict protein intake to 2 servings per day.
      D)
      Discourage ambulation.
    4. Which finding for a patient admitted with glomerulonephritis indicates to the nurse that treatment has been effective?
      A)
      The antistreptolysin-O (ASO) titer has decreased.
      B)
      The urine dipstick is negative for nitrites.
      C)
      The patient denies pain or burning with voiding
      D)
      The periorbital and peripheral edema are resolved
    Page 5 of 17

    Exam Review

    1. A nurse is caring for a client on a pediatric unit. Exhibits Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
    2. A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor
      A)
      Diuretic use
      B)
      BMI less than 25
      C)
      Family history
      D)
      Hypocalcemia
    3. Which medication taken by a patient with decreased renal function will be of most concern to the nurse?
      A)
      folic acid (vitamin B5)
      B)
      penicillin (Bicillin C-R)
      C)
      warfarin (Coumadin
      D)
      Ibuprofen (Motrin)
    4. A nurse is caring for a client who has chronic glomerulonephritis. The nurse should expect to find a decrease in which of the following serum laboratory values?
      A)
      RBC
      B)
      Potassium
      C)
      Phosphate
      D)
      Creatinine
    Page 6 of 17