Renal NCLEX Questions And Answers Rated 100%
A client diagnosed with cancer of the bladder has a nursing diagnosis of fear related to the uncertain outcome
of upcoming cystectomy and urinary diversion. The nurse determines that this diagnosis is appropriate if the
client makes which statement?
a) I'm so afraid I won't live through all this
b) what if I have no help at home after going through this awful surgery
c) I'll never feel like myself once I can't go to the bathroom normally
d) I wish I'd never gone to the doctor at all - ansA
- In order for fear to be an actual diagnosis, the client must be able to identify the object of fear. In this
question, the client is expressing a fear of the outcome related to surgery. The statement in option B relates to
a nursing diagnosis of impaired home maintenance. Option C relates to a nursing diagnosis of disturbed body
image. Option D is vague and nonspecific, and further assessment is needed to associate this statement with a
nursing diagnosis.
A client has undergone urinary diversion after cystectomy for bladder cancer. The nurse assesses the urostomy
stoma to ensure that it is:
a) pale and pink
b) pink and dry
c) red and moist
d) dusky to beefy colored - ansC
- Following urostomy, the stoma should be red and moist. It may be edematous, but this will decrease after the
first few days. A dusky or cyanotic color indicates insufficient circulation with impending necrosis and warrants
notification of the surgeon immediately.
A client is undergoing hemodialysis and receives heparin during the dialysis procedure. The nurse monitors the
results of which of the following laboratory tests during the dialysis procedure?
a) thrombin time
, b) bleeding time
c) partial thromboplastin time (PTT)
d) prothrombin time (PT) - ansC
- Heparin is used as an anticoagulant during hemodialysis. The hemodialysis nurse monitors the extent of
anticoagulation by measuring the PTT, which measures heparin effect. The PT is measured to monitor the
effect of warfarin (Coumadin) therapy. Thrombin and bleeding times are not used to measure the effect of
heparin therapy, although they are useful in the diagnosis of other clotting abnormalities.
A client undergoing hemodialysis becomes hypotensive. The nurse immediately prepares to take which action?
a) administer 1000 ml 5% dextrose in water
b) administer a 250 ml normal saline bolus
c) increase the blood flow into the dialyzer
d) lower the client's legs and feet - ansB
- To treat hypotension during hemodialysis, a normal saline bolus of up to 500 mL may be given. The client's
feet and legs are raised to enhance cardiac return. Albumin may be given as per protocol to increase colloid
oncotic pressure. The blood flow rate into the dialyzer may be decreased. All of these measures should
improve the circulating volume and blood pressure. Five percent dextrose in water is not prescribed because it
is less likely to improve the circulating volume and blood pressure.
A client with chronic renal failure has a new medication order for epoetin alfa (Epogen). The nurse plans to give
this medication in which of the following ways?
a) with a full glass of water
b) diluted in juice to enhance taste
c) subcutaneously
d) with an antacid - ansC
- Epoetin alfa is erythropoietin that has been manufactured through the use of recombinant DNA technology. It
is used to treat anemia in the client with chronic renal failure. The medication may be administered
subcutaneously or intravenously.
A client diagnosed with cancer of the bladder has a nursing diagnosis of fear related to the uncertain outcome
of upcoming cystectomy and urinary diversion. The nurse determines that this diagnosis is appropriate if the
client makes which statement?
a) I'm so afraid I won't live through all this
b) what if I have no help at home after going through this awful surgery
c) I'll never feel like myself once I can't go to the bathroom normally
d) I wish I'd never gone to the doctor at all - ansA
- In order for fear to be an actual diagnosis, the client must be able to identify the object of fear. In this
question, the client is expressing a fear of the outcome related to surgery. The statement in option B relates to
a nursing diagnosis of impaired home maintenance. Option C relates to a nursing diagnosis of disturbed body
image. Option D is vague and nonspecific, and further assessment is needed to associate this statement with a
nursing diagnosis.
A client has undergone urinary diversion after cystectomy for bladder cancer. The nurse assesses the urostomy
stoma to ensure that it is:
a) pale and pink
b) pink and dry
c) red and moist
d) dusky to beefy colored - ansC
- Following urostomy, the stoma should be red and moist. It may be edematous, but this will decrease after the
first few days. A dusky or cyanotic color indicates insufficient circulation with impending necrosis and warrants
notification of the surgeon immediately.
A client is undergoing hemodialysis and receives heparin during the dialysis procedure. The nurse monitors the
results of which of the following laboratory tests during the dialysis procedure?
a) thrombin time
, b) bleeding time
c) partial thromboplastin time (PTT)
d) prothrombin time (PT) - ansC
- Heparin is used as an anticoagulant during hemodialysis. The hemodialysis nurse monitors the extent of
anticoagulation by measuring the PTT, which measures heparin effect. The PT is measured to monitor the
effect of warfarin (Coumadin) therapy. Thrombin and bleeding times are not used to measure the effect of
heparin therapy, although they are useful in the diagnosis of other clotting abnormalities.
A client undergoing hemodialysis becomes hypotensive. The nurse immediately prepares to take which action?
a) administer 1000 ml 5% dextrose in water
b) administer a 250 ml normal saline bolus
c) increase the blood flow into the dialyzer
d) lower the client's legs and feet - ansB
- To treat hypotension during hemodialysis, a normal saline bolus of up to 500 mL may be given. The client's
feet and legs are raised to enhance cardiac return. Albumin may be given as per protocol to increase colloid
oncotic pressure. The blood flow rate into the dialyzer may be decreased. All of these measures should
improve the circulating volume and blood pressure. Five percent dextrose in water is not prescribed because it
is less likely to improve the circulating volume and blood pressure.
A client with chronic renal failure has a new medication order for epoetin alfa (Epogen). The nurse plans to give
this medication in which of the following ways?
a) with a full glass of water
b) diluted in juice to enhance taste
c) subcutaneously
d) with an antacid - ansC
- Epoetin alfa is erythropoietin that has been manufactured through the use of recombinant DNA technology. It
is used to treat anemia in the client with chronic renal failure. The medication may be administered
subcutaneously or intravenously.
