NSG 4100 Exam 2026/2027 | Nursing Practice
Questions & Answer Explanations
1. The nurse assesses a client who is recovering from a paracentesis 1
hour ago. Which assessment finding would require immediate action by the
nurse?
a. Urine output via indwelling urinary catheter is 20 mL/hr.
b. Blood pressure increases from 110/58 to 120/62 mm Hg
c. Respiratory rate decreases from 22 to 16 breaths/min
d. A decrease in the client’s weight by 3 lb (1.4 kg)
2. The nurse is caring for a client with hepatic portal-systemic encephalopathy
(PSE). The client is thin and cachectic, and the family expresses distress that the
patient is receiving little dietary protein. How would the nurse respond?
a. “A low-protein diet will help the liver rest and will restore liver function.”
b. “Less protein in the diet will help prevent confusion associated with liver failure.”
c. “Increasing dietary protein will help the patient gain weight and muscle mass”
d. “Low dietary protein is needed to prevent fluid from leaking into the abdomen”
3. The nurse is caring for a client that has been admitted with acute-on-chronic
kidney disease. Which of the following should the nurse recognize as a possible
etiology for this problem?
a. Phlebotomy
b. Pulmonary congestion
c. Systemic infections.
d. Edema
4. The nurse is providing education to a client who has chronic kidney
disease (CKD) about associated anemia. Which of the following statements should
the nurse make?
a. “Because you are now on dialysis, you will have to increase the amount of iron you
eat so that you can reverse your anemia”
b. “Your kidneys are not producing enough erythropoietin needed for your bone
marrow to produce red blood cells (RBC).”
c. “The diseased kidney is not able to make red blood cells (RBC) as it should, which
can lead to anemia”
d. “The effect this has had on your whole body has left you unable to absorb vitamin B₁₂
which has caused your anemia"
, 5. The nurse is caring for a client who has chronic kidney disease (CKD). Which of
the following does the nurse attribute to the correct pathophysiology and progression
of this disease process?
a. Normal renal function may be maintained until there is 75-80% nephron damage.
b. The client’s damaged nephrons will need time to heal and regain function
c. Undamaged nephrons are not capable of functionally compensating for renal damage
d. The progression of CKD is erratic and there is no way to monitor the course of the
disease
6. A client has been diagnosed to have chronic renal failure. Sodium
polysterene sulfonate (exchange resin kayexalate) is prescribed. The action of the
medication is that it releases
a) bicarbonate in exchange for primarily sodium ions
b) sodium ions in exchange for primarily bicarbonate ions
c) sodium ions in exchange for primarily potassium ions.
d) potassium ions in exchange for primarily sodium ions
7. The client with chronic renal failure is undergoing peritoneal dialysis. He asks
why the nurse monitors his blood glucose levels. Which of the following will be the
most appropriate response by the nurse?
a) I have to check if you have diabetes mellitus
b) the dialysate contains glucose.
c) the procedure may lower your blood glucose levels
d) it is a routine procedure for every client who undergoes the treatment
8. A nurse is caring for a client receiving hemodialysis who has an internal
arteriovenous (AV) fistula. Which assessment finding would indicate to the nurse
that the fistula is patent? A.white fibrin specks noted in the fistula
B.palpation of a thrill over the site of the fistula
c) lack of bruit over the site of the fistula
d) a feeling of warmth at the site of the fistula
9. The client with chronic renal failure is scheduled for hemodialysis this morning
is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer
this medication:
1. During dialysis
2. Just before dialysis
3. The day after dialysis
4. On return from dialysis.
Questions & Answer Explanations
1. The nurse assesses a client who is recovering from a paracentesis 1
hour ago. Which assessment finding would require immediate action by the
nurse?
a. Urine output via indwelling urinary catheter is 20 mL/hr.
b. Blood pressure increases from 110/58 to 120/62 mm Hg
c. Respiratory rate decreases from 22 to 16 breaths/min
d. A decrease in the client’s weight by 3 lb (1.4 kg)
2. The nurse is caring for a client with hepatic portal-systemic encephalopathy
(PSE). The client is thin and cachectic, and the family expresses distress that the
patient is receiving little dietary protein. How would the nurse respond?
a. “A low-protein diet will help the liver rest and will restore liver function.”
b. “Less protein in the diet will help prevent confusion associated with liver failure.”
c. “Increasing dietary protein will help the patient gain weight and muscle mass”
d. “Low dietary protein is needed to prevent fluid from leaking into the abdomen”
3. The nurse is caring for a client that has been admitted with acute-on-chronic
kidney disease. Which of the following should the nurse recognize as a possible
etiology for this problem?
a. Phlebotomy
b. Pulmonary congestion
c. Systemic infections.
d. Edema
4. The nurse is providing education to a client who has chronic kidney
disease (CKD) about associated anemia. Which of the following statements should
the nurse make?
a. “Because you are now on dialysis, you will have to increase the amount of iron you
eat so that you can reverse your anemia”
b. “Your kidneys are not producing enough erythropoietin needed for your bone
marrow to produce red blood cells (RBC).”
c. “The diseased kidney is not able to make red blood cells (RBC) as it should, which
can lead to anemia”
d. “The effect this has had on your whole body has left you unable to absorb vitamin B₁₂
which has caused your anemia"
, 5. The nurse is caring for a client who has chronic kidney disease (CKD). Which of
the following does the nurse attribute to the correct pathophysiology and progression
of this disease process?
a. Normal renal function may be maintained until there is 75-80% nephron damage.
b. The client’s damaged nephrons will need time to heal and regain function
c. Undamaged nephrons are not capable of functionally compensating for renal damage
d. The progression of CKD is erratic and there is no way to monitor the course of the
disease
6. A client has been diagnosed to have chronic renal failure. Sodium
polysterene sulfonate (exchange resin kayexalate) is prescribed. The action of the
medication is that it releases
a) bicarbonate in exchange for primarily sodium ions
b) sodium ions in exchange for primarily bicarbonate ions
c) sodium ions in exchange for primarily potassium ions.
d) potassium ions in exchange for primarily sodium ions
7. The client with chronic renal failure is undergoing peritoneal dialysis. He asks
why the nurse monitors his blood glucose levels. Which of the following will be the
most appropriate response by the nurse?
a) I have to check if you have diabetes mellitus
b) the dialysate contains glucose.
c) the procedure may lower your blood glucose levels
d) it is a routine procedure for every client who undergoes the treatment
8. A nurse is caring for a client receiving hemodialysis who has an internal
arteriovenous (AV) fistula. Which assessment finding would indicate to the nurse
that the fistula is patent? A.white fibrin specks noted in the fistula
B.palpation of a thrill over the site of the fistula
c) lack of bruit over the site of the fistula
d) a feeling of warmth at the site of the fistula
9. The client with chronic renal failure is scheduled for hemodialysis this morning
is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer
this medication:
1. During dialysis
2. Just before dialysis
3. The day after dialysis
4. On return from dialysis.
