Lewis Med Surg - Urinary/Kidney NCLEX
Review Practice Questions Solved 2024
A 22-year-old patient's blood pressure at her physical done for her new job was 110/68.
At the health fair two months later, her blood pressure is 154/96. What renal problem
should the nurse be aware of that could contribute to this abrupt rise in blood pressure?
A. Renal trauma
B. Renal artery stenosis
C. Renal vein thrombosis
D. Benign nephrosclerosis - ANSWER-B. Renal artery stenosis
Renal artery stenosis contributes to an abrupt rise in blood pressure, especially in
people under 30 or over 50 years of age. Renal trauma usually has hematuria. Renal
vein thrombosis causes flank pain, hematuria, fever, or nephrotic syndrome. Benign
nephrosclerosis usually occurs in adults 30 to 50 years of age and is a result of vascular
changes resulting from hypertension.
A 24-year-old female donated a kidney via a laparoscopic donor nephrectomy to a non-
related recipient. The patient is experiencing a lot of pain and refuses to get up to walk.
How should the nurse handle this situation?
A. Have the transplant psychologist convince her to walk.
B. Encourage even a short walk to avoid complications of surgery.
C. Tell the patient that no other patients have ever refused to walk.
D. Tell the patient she is lucky she did not have an open nephrectomy. - ANSWER-B.
Encourage even a short walk to avoid complications of surgery.
Because ambulating will improve bowel, lung, and kidney function with improved
circulation, even a short walk with assistance should be encouraged after pain
medication. The transplant psychologist or social worker's role is to determine if the
patient is emotionally stable enough to handle donating a kidney, while postoperative
care is the nurse's role. Trying to shame the patient into walking by telling her that other
patients have not refused and telling the patient she is lucky she did not have an open
nephrectomy (implying how much more pain she would be having if it had been open)
will not be beneficial to the patient or her postoperative recovery.
A 78-year-old patient has Stage 3 CKD and is being taught about a low potassium diet.
The nurse knows the patient understands the diet when the patient selects which foods
to eat?
A. Apple, green beans, and a roast beef sandwich
B. Granola made with dried fruits, nuts, and seeds
C. Watermelon and ice cream with chocolate sauce
, D. Bran cereal with ½ banana and milk and orange juice - ANSWER-A. Apple, green
beans, and a roast beef sandwich
When the patient selects an apple, green beans, and a roast beef sandwich, the patient
demonstrates understanding of the low potassium diet. Granola, dried fruits, nuts and
seeds, milk products, chocolate sauce, bran cereal, banana, and orange juice all have
elevated levels of potassium, at or above 200 mg per 1/2 cup.
A nurse is admitting a patient with the diagnosis of advanced renal carcinoma. Based
upon this diagnosis, the nurse will expect to find what clinical manifestations as the
"classic triad" occurring in patients with renal cancer?
A. Fever, chills, flank pain
B. Hematuria, flank pain, palpable mass
C. Hematuria, proteinuria, palpable mass
D. Flank pain, palpable abdominal mass, and proteinuria - ANSWER-B. Hematuria,
flank pain, palpable mass
There are no characteristic early symptoms of renal carcinoma. The classic
manifestations of gross hematuria, flank pain, and a palpable mass are those of
advanced disease.
A patient is recovering in the intensive care unit (ICU) after receiving a kidney transplant
approximately 24 hours ago. What is an expected assessment finding for this patient
during this early stage of recovery?
A. Hypokalemia
B. Hyponatremia
C. Large urine output
D. Leukocytosis with cloudy urine output - ANSWER-C. Large urine output
Patients frequently experience diuresis in the hours and days immediately following a
kidney transplant. Electrolyte imbalances and signs of infection are unexpected findings
that warrant prompt intervention.
A patient with a history of end-stage kidney disease secondary to diabetes mellitus has
presented to the outpatient dialysis unit for his scheduled hemodialysis. Which
assessments should the nurse prioritize before, during, and after his treatment?
A. Level of consciousness
B. Blood pressure and fluid balance
C. Temperature, heart rate, and blood pressure
D. Assessment for signs and symptoms of infection - ANSWER-B. Blood pressure and
fluid balance
Review Practice Questions Solved 2024
A 22-year-old patient's blood pressure at her physical done for her new job was 110/68.
At the health fair two months later, her blood pressure is 154/96. What renal problem
should the nurse be aware of that could contribute to this abrupt rise in blood pressure?
A. Renal trauma
B. Renal artery stenosis
C. Renal vein thrombosis
D. Benign nephrosclerosis - ANSWER-B. Renal artery stenosis
Renal artery stenosis contributes to an abrupt rise in blood pressure, especially in
people under 30 or over 50 years of age. Renal trauma usually has hematuria. Renal
vein thrombosis causes flank pain, hematuria, fever, or nephrotic syndrome. Benign
nephrosclerosis usually occurs in adults 30 to 50 years of age and is a result of vascular
changes resulting from hypertension.
A 24-year-old female donated a kidney via a laparoscopic donor nephrectomy to a non-
related recipient. The patient is experiencing a lot of pain and refuses to get up to walk.
How should the nurse handle this situation?
A. Have the transplant psychologist convince her to walk.
B. Encourage even a short walk to avoid complications of surgery.
C. Tell the patient that no other patients have ever refused to walk.
D. Tell the patient she is lucky she did not have an open nephrectomy. - ANSWER-B.
Encourage even a short walk to avoid complications of surgery.
Because ambulating will improve bowel, lung, and kidney function with improved
circulation, even a short walk with assistance should be encouraged after pain
medication. The transplant psychologist or social worker's role is to determine if the
patient is emotionally stable enough to handle donating a kidney, while postoperative
care is the nurse's role. Trying to shame the patient into walking by telling her that other
patients have not refused and telling the patient she is lucky she did not have an open
nephrectomy (implying how much more pain she would be having if it had been open)
will not be beneficial to the patient or her postoperative recovery.
A 78-year-old patient has Stage 3 CKD and is being taught about a low potassium diet.
The nurse knows the patient understands the diet when the patient selects which foods
to eat?
A. Apple, green beans, and a roast beef sandwich
B. Granola made with dried fruits, nuts, and seeds
C. Watermelon and ice cream with chocolate sauce
, D. Bran cereal with ½ banana and milk and orange juice - ANSWER-A. Apple, green
beans, and a roast beef sandwich
When the patient selects an apple, green beans, and a roast beef sandwich, the patient
demonstrates understanding of the low potassium diet. Granola, dried fruits, nuts and
seeds, milk products, chocolate sauce, bran cereal, banana, and orange juice all have
elevated levels of potassium, at or above 200 mg per 1/2 cup.
A nurse is admitting a patient with the diagnosis of advanced renal carcinoma. Based
upon this diagnosis, the nurse will expect to find what clinical manifestations as the
"classic triad" occurring in patients with renal cancer?
A. Fever, chills, flank pain
B. Hematuria, flank pain, palpable mass
C. Hematuria, proteinuria, palpable mass
D. Flank pain, palpable abdominal mass, and proteinuria - ANSWER-B. Hematuria,
flank pain, palpable mass
There are no characteristic early symptoms of renal carcinoma. The classic
manifestations of gross hematuria, flank pain, and a palpable mass are those of
advanced disease.
A patient is recovering in the intensive care unit (ICU) after receiving a kidney transplant
approximately 24 hours ago. What is an expected assessment finding for this patient
during this early stage of recovery?
A. Hypokalemia
B. Hyponatremia
C. Large urine output
D. Leukocytosis with cloudy urine output - ANSWER-C. Large urine output
Patients frequently experience diuresis in the hours and days immediately following a
kidney transplant. Electrolyte imbalances and signs of infection are unexpected findings
that warrant prompt intervention.
A patient with a history of end-stage kidney disease secondary to diabetes mellitus has
presented to the outpatient dialysis unit for his scheduled hemodialysis. Which
assessments should the nurse prioritize before, during, and after his treatment?
A. Level of consciousness
B. Blood pressure and fluid balance
C. Temperature, heart rate, and blood pressure
D. Assessment for signs and symptoms of infection - ANSWER-B. Blood pressure and
fluid balance
