NSG 4100 Exam 1: Adult Health III Practice
Exam with questions and well verified answers
real exam (Latest 2026 Update)
ANSWER KEY AND RATIONALE AT THE END
Renal and Urological Disorders (Questions 1-35)
1. A nurse is assessing a client suspected of having acute glomerulonephritis. Which clinical
manifestation is characteristic of this health problem?
A. Glucosuria
B. Hypotension
C. Hematuria
D. Polyuria
2. The nurse is caring for an acutely ill client. What assessment finding should prompt the nurse to
inform the healthcare provider that the client may be exhibiting signs of acute kidney injury (AKI)?
A. An inability to initiate voiding for 2 days.
B. Average urine output of 10 mL/hr for several hours.
C. The urine is cloudy and has a foul odor.
D. Client reports left-sided flank pain.
3. A client with a history of systemic lupus erythematosus is diagnosed with end-stage kidney disease
(ESKD) and has an elevated phosphorus level. The prescription is for calcium acetate. When should
the nurse teach the client to take this medication?
A. First thing in the morning
B. Daily at bedtime
C. With each meal
D. One hour before meals
4. To reduce the risk of infection in a client with a newly transplanted kidney, what is the nurse's most
important action?
A. Ensure immediate function of the donated kidney.
,B. Wash hands carefully and frequently.
C. Instruct the client to wear a face mask.
D. Place the client in a private room.
5. A client is receiving hemodialysis three times weekly via an arteriovenous (AV) fistula. What is most
important for the nurse to remember when providing care?
A. The client feels best immediately after dialysis.
B. Taking a blood pressure on the affected arm can damage the fistula.
C. Using a stethoscope to auscultate the fistula is contraindicated.
D. The client should not feel pain during initiation of dialysis.
6. A client has a glomerular filtration rate (GFR) of 43 mL/min/1.73 m². Based on this GFR, the nurse
interprets that the client's chronic kidney disease is at what stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
7. A client admitted with nephrotic syndrome is being cared for on the medical unit. Which nursing
diagnosis should be prioritized in the client's care plan?
A. Constipation related to immobility
B. Risk for injury related to altered thought processes
C. Excess fluid volume related to generalized edema
D. Hyperthermia related to the inflammatory process
8. The nurse is taking a report on four clients. Which client is at the greatest risk for developing ESKD?
A. A client with severe COPD
B. A client with a history of polycystic kidney disease
C. A client with diabetes mellitus and poorly controlled hypertension
D. A client who is morbidly obese with a history of vascular disorders
9. The nurse is caring for a client post-operative day 4 following a kidney transplant. When assessing
for potential signs of rejection, what assessment should the nurse prioritize?
A. Assessment of the client's incision
B. Assessment of the quantity of the client's urine output
C. Assessment for flank or abdominal pain
D. Assessment of the client's abdominal girth
10. The nurse is caring for a client in acute kidney injury (AKI). Which complication would most clearly
warrant the administration of polystyrene sulfonate (Kayexalate)?
A. Hypernatremia
B. Hypomagnesemia
C. Hyperkalemia
D. Hypercalcemia
11. The nurse is caring for a client whose AKI resulted from a prerenal cause. Which condition most
likely caused this client's health problem?
, A. Glomerulonephritis
B. Ureterolithiasis
C. Burns
D. Aminoglycoside toxicity
12. A client with end-stage renal disease receives continuous ambulatory peritoneal dialysis (CAPD).
The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate
action?
A. Flush the peritoneal catheter with normal saline.
B. Inform the HCP and assess the client for signs of infection.
C. Remove the catheter promptly and culture the tip.
D. Document this as an expected finding.
13. A client with diabetic nephropathy has end-stage renal disease and is starting dialysis. What
should the nurse teach the client about hemodialysis?
A. "Hemodialysis is a treatment option that is usually required three times a week."
B. "This will require surgery to insert a catheter into your abdomen."
C. "Hemodialysis is used for a few months until your kidney heals."
D. "Hemodialysis is a program that will require you to commit to daily treatment."
14. A client with ESKD has an arteriovenous fistula in the left arm for hemodialysis. Which nursing
action is appropriate to maintain the patency of the fistula?
A. Keep the left arm elevated on a pillow at all times.
B. Use the left arm for all blood pressure readings.
C. Assess the left arm for a palpable thrill and audible bruit.
D. Apply a warm compress to the fistula site continuously.
15. The nurse is teaching a client with ESKD about dietary restrictions. Which food should the nurse
instruct the client to avoid because it is high in potassium?
A. Applesauce
B. White bread
C. Oranges
D. Grapes
16. A client with chronic kidney disease (CKD) is experiencing pruritus. Which nursing intervention is
most appropriate to help manage this symptom?
A. Apply alcohol-based lotions to the skin.
B. Use hot water for bathing to clean the skin.
C. Encourage the client to use warm water and mild soap for bathing.
D. Keep the client's skin dry at all times.
17. The nurse is reviewing the laboratory results for a client with CKD. Which finding would be most
concerning?
A. Serum calcium of 9.0 mg/dL
B. Serum potassium of 6.2 mEq/L
C. Serum sodium of 138 mEq/L
D. Serum hemoglobin of 11 g/dL
Exam with questions and well verified answers
real exam (Latest 2026 Update)
ANSWER KEY AND RATIONALE AT THE END
Renal and Urological Disorders (Questions 1-35)
1. A nurse is assessing a client suspected of having acute glomerulonephritis. Which clinical
manifestation is characteristic of this health problem?
A. Glucosuria
B. Hypotension
C. Hematuria
D. Polyuria
2. The nurse is caring for an acutely ill client. What assessment finding should prompt the nurse to
inform the healthcare provider that the client may be exhibiting signs of acute kidney injury (AKI)?
A. An inability to initiate voiding for 2 days.
B. Average urine output of 10 mL/hr for several hours.
C. The urine is cloudy and has a foul odor.
D. Client reports left-sided flank pain.
3. A client with a history of systemic lupus erythematosus is diagnosed with end-stage kidney disease
(ESKD) and has an elevated phosphorus level. The prescription is for calcium acetate. When should
the nurse teach the client to take this medication?
A. First thing in the morning
B. Daily at bedtime
C. With each meal
D. One hour before meals
4. To reduce the risk of infection in a client with a newly transplanted kidney, what is the nurse's most
important action?
A. Ensure immediate function of the donated kidney.
,B. Wash hands carefully and frequently.
C. Instruct the client to wear a face mask.
D. Place the client in a private room.
5. A client is receiving hemodialysis three times weekly via an arteriovenous (AV) fistula. What is most
important for the nurse to remember when providing care?
A. The client feels best immediately after dialysis.
B. Taking a blood pressure on the affected arm can damage the fistula.
C. Using a stethoscope to auscultate the fistula is contraindicated.
D. The client should not feel pain during initiation of dialysis.
6. A client has a glomerular filtration rate (GFR) of 43 mL/min/1.73 m². Based on this GFR, the nurse
interprets that the client's chronic kidney disease is at what stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
7. A client admitted with nephrotic syndrome is being cared for on the medical unit. Which nursing
diagnosis should be prioritized in the client's care plan?
A. Constipation related to immobility
B. Risk for injury related to altered thought processes
C. Excess fluid volume related to generalized edema
D. Hyperthermia related to the inflammatory process
8. The nurse is taking a report on four clients. Which client is at the greatest risk for developing ESKD?
A. A client with severe COPD
B. A client with a history of polycystic kidney disease
C. A client with diabetes mellitus and poorly controlled hypertension
D. A client who is morbidly obese with a history of vascular disorders
9. The nurse is caring for a client post-operative day 4 following a kidney transplant. When assessing
for potential signs of rejection, what assessment should the nurse prioritize?
A. Assessment of the client's incision
B. Assessment of the quantity of the client's urine output
C. Assessment for flank or abdominal pain
D. Assessment of the client's abdominal girth
10. The nurse is caring for a client in acute kidney injury (AKI). Which complication would most clearly
warrant the administration of polystyrene sulfonate (Kayexalate)?
A. Hypernatremia
B. Hypomagnesemia
C. Hyperkalemia
D. Hypercalcemia
11. The nurse is caring for a client whose AKI resulted from a prerenal cause. Which condition most
likely caused this client's health problem?
, A. Glomerulonephritis
B. Ureterolithiasis
C. Burns
D. Aminoglycoside toxicity
12. A client with end-stage renal disease receives continuous ambulatory peritoneal dialysis (CAPD).
The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate
action?
A. Flush the peritoneal catheter with normal saline.
B. Inform the HCP and assess the client for signs of infection.
C. Remove the catheter promptly and culture the tip.
D. Document this as an expected finding.
13. A client with diabetic nephropathy has end-stage renal disease and is starting dialysis. What
should the nurse teach the client about hemodialysis?
A. "Hemodialysis is a treatment option that is usually required three times a week."
B. "This will require surgery to insert a catheter into your abdomen."
C. "Hemodialysis is used for a few months until your kidney heals."
D. "Hemodialysis is a program that will require you to commit to daily treatment."
14. A client with ESKD has an arteriovenous fistula in the left arm for hemodialysis. Which nursing
action is appropriate to maintain the patency of the fistula?
A. Keep the left arm elevated on a pillow at all times.
B. Use the left arm for all blood pressure readings.
C. Assess the left arm for a palpable thrill and audible bruit.
D. Apply a warm compress to the fistula site continuously.
15. The nurse is teaching a client with ESKD about dietary restrictions. Which food should the nurse
instruct the client to avoid because it is high in potassium?
A. Applesauce
B. White bread
C. Oranges
D. Grapes
16. A client with chronic kidney disease (CKD) is experiencing pruritus. Which nursing intervention is
most appropriate to help manage this symptom?
A. Apply alcohol-based lotions to the skin.
B. Use hot water for bathing to clean the skin.
C. Encourage the client to use warm water and mild soap for bathing.
D. Keep the client's skin dry at all times.
17. The nurse is reviewing the laboratory results for a client with CKD. Which finding would be most
concerning?
A. Serum calcium of 9.0 mg/dL
B. Serum potassium of 6.2 mEq/L
C. Serum sodium of 138 mEq/L
D. Serum hemoglobin of 11 g/dL
