RN ALTERATIONS IN KIDNEY FUNCTION AND ELIMINATION EXAM 2026 UPDATED
QUESTIONS AND ANSWERS WITH RATIONALES
A nurse is caring for a client admitted for acute glomerulonephritis.
Click to highlight the findings that require immediate follow-up.
- client reports nausea and vomits 50 ml of yellow liquid
- unable to void
- reports SOB
- fine crackles auscultated in bilateral lungs
- Bilateral nonpitting edema noted
- Periorbital edema noted
- client states "I just feel so tired."
- resp rate 28/min
- BP 184/90 mm Hg
Rationale: When recognizing relevant cues, the nurse should recognize that the increased
respiratory rate of 28/min, client report of shortness of breath, and fine crackles auscultated in
bilateral lungs as the worsening condition of fluid overload and pulmonary edema requiring
immediate follow-up. The nurse should also recognize the client's nausea, and vomiting as signs
of uraemia from severe kidney impairment which also requires immediate follow-up. The nurse
should also recognize that the increase in the blood pressure from the client's baseline blood
pressure requires follow-up.
A nurse is caring for a group of clients, who all are incontinent of urine, on the med surg unit.
Which comorbidities should the nurse expect to find in their medical records? (select all that
apply)
,- Chronic Obstructive Pulmonary Disease
- Heart Failure
- Diabetes Mellitus
- Multiple Sclerosis
- Lupus
- Chronic obstructive pulmonary disease
Rationale: Chronic obstructive pulmonary disease (COPD) is correct. COPD causes a chronic
cough which is a contributing factor for incontinence.
Heart failure is correct. Heart failure includes fluid overload and diuresis which may be difficult
to deal with for some clients leading to incontinence.
Diabetes mellitus is incorrect. Diabetes mellitus is a possible comorbidity for urinary tract
infections, type 2 renal calculi, and acute and chronic kidney failure.
Multiple sclerosis is correct. Multiple sclerosis causes limited mobility and a physical barrier to
toileting.
Lupus is incorrect. Lupus is a comorbidity for glomerulonephritis, which causes inflammation in
the kidneys.
A nurse is caring for a client admitted to the urology unit with complaints of SOB and a diagnosis
of CKD. Which of the following pathophysiology changes in the renal system led to the admitting
diagnosis of CKD?
, - Chronic nephropathies that lead to fibrosis and destruction of normal kidney structure and
function
- Obstruction leading to the filtration system backing up and eventually shutting the kidneys
down
- Reduction of blood flow to the kidneys
- Acute tubular necrosis caused by the damage to the cells of the renal tubules leading to cell
death and a decreased glomerular filtration rate
Rationale: These are the pathophysiological processes of chronic kidney failure.
A nurse is conducting an admission assessment of a client with BPH. The client states they avoid
social events due to this condition. Which of the following client findings should the nurse
expect to find in the assessment? (select all that apply)
- Inability to void
- Dysuria
- Urinary urgency
- Incontinence
- Urinary frequency
- Impotence
- Inability to void
Rationale: Inability to void is correct. This is a clinical manifestation of BPH.
Dysuria is correct. This is a clinical manifestation of BPH.
QUESTIONS AND ANSWERS WITH RATIONALES
A nurse is caring for a client admitted for acute glomerulonephritis.
Click to highlight the findings that require immediate follow-up.
- client reports nausea and vomits 50 ml of yellow liquid
- unable to void
- reports SOB
- fine crackles auscultated in bilateral lungs
- Bilateral nonpitting edema noted
- Periorbital edema noted
- client states "I just feel so tired."
- resp rate 28/min
- BP 184/90 mm Hg
Rationale: When recognizing relevant cues, the nurse should recognize that the increased
respiratory rate of 28/min, client report of shortness of breath, and fine crackles auscultated in
bilateral lungs as the worsening condition of fluid overload and pulmonary edema requiring
immediate follow-up. The nurse should also recognize the client's nausea, and vomiting as signs
of uraemia from severe kidney impairment which also requires immediate follow-up. The nurse
should also recognize that the increase in the blood pressure from the client's baseline blood
pressure requires follow-up.
A nurse is caring for a group of clients, who all are incontinent of urine, on the med surg unit.
Which comorbidities should the nurse expect to find in their medical records? (select all that
apply)
,- Chronic Obstructive Pulmonary Disease
- Heart Failure
- Diabetes Mellitus
- Multiple Sclerosis
- Lupus
- Chronic obstructive pulmonary disease
Rationale: Chronic obstructive pulmonary disease (COPD) is correct. COPD causes a chronic
cough which is a contributing factor for incontinence.
Heart failure is correct. Heart failure includes fluid overload and diuresis which may be difficult
to deal with for some clients leading to incontinence.
Diabetes mellitus is incorrect. Diabetes mellitus is a possible comorbidity for urinary tract
infections, type 2 renal calculi, and acute and chronic kidney failure.
Multiple sclerosis is correct. Multiple sclerosis causes limited mobility and a physical barrier to
toileting.
Lupus is incorrect. Lupus is a comorbidity for glomerulonephritis, which causes inflammation in
the kidneys.
A nurse is caring for a client admitted to the urology unit with complaints of SOB and a diagnosis
of CKD. Which of the following pathophysiology changes in the renal system led to the admitting
diagnosis of CKD?
, - Chronic nephropathies that lead to fibrosis and destruction of normal kidney structure and
function
- Obstruction leading to the filtration system backing up and eventually shutting the kidneys
down
- Reduction of blood flow to the kidneys
- Acute tubular necrosis caused by the damage to the cells of the renal tubules leading to cell
death and a decreased glomerular filtration rate
Rationale: These are the pathophysiological processes of chronic kidney failure.
A nurse is conducting an admission assessment of a client with BPH. The client states they avoid
social events due to this condition. Which of the following client findings should the nurse
expect to find in the assessment? (select all that apply)
- Inability to void
- Dysuria
- Urinary urgency
- Incontinence
- Urinary frequency
- Impotence
- Inability to void
Rationale: Inability to void is correct. This is a clinical manifestation of BPH.
Dysuria is correct. This is a clinical manifestation of BPH.
