PN1 Final Exam-NCLEX Exam 2
Elimination/Ethics/Surgery Exam Study Guide
ACTUAL EXAM comprehensive questions and
verified accurate solution (detailed &
elaborated) 2025 TEST!
Section 9 - ✔ANASWER✔-Chapter 59
Which statement made by a client with chronic renal failure and
who is on hemodialysis indicates the need for further teaching?
1. "I will report any increase in my weight of 5 pounds in a 2-day
period."
2. "I take my prescribed antihypertensive drugs daily."
3. "I am careful to take precautions in the arm with the AV fistula."
4. "I comply with salt restrictions in my diet by using salt
substitutes." - ✔ANASWER✔-Answer: 4
,Rationale: Many salt substitutes use potassium chloride.
Potassium intake is carefully regulated in clients with renal failure,
and the use of salt substitutes will worsen hyperkalemia. Increases
in weight do need to be reported to the health care provider as a
possible indication of fluid volume excess. The control of
hypertension is essential in the management of a client with renal
failure. An AV fistula does need to be protected from injury that
could be caused by constricting clothing, venipunctures, and
other items
What type of renal failure would the nurse expect to see in a client
who overdosed accidentally on tobramycin (Nebcin)?
1. Prerenal failure
2. Postrenal failure
3. Extrarenal failure
4. Intrarenal failure - ✔ANASWER✔-Answer: 4
Rationale: Nephrotoxic drugs, such as aminoglycoside antibiotics
(tobramycin), can damage the nephrons and cause intrarenal
(within the kidneys) failure. Prerenal causes of renal failure include
any condition that reduces the blood flow to the kidney, such as
heart failure, shock, and other conditions. Postrenal failure can be
caused by conditions that obstruct urine outflow in the lower
urinary system. There is no condition called extrarenal failure.
,A client with urinary tract infection (UTI) is prescribed
phenazopyridine (Pyridium). Which instruction would the nurse
give the client?
1. "This drug will take care of the infection causing your
symptoms."
2. "Your urine may turn reddish orange and may cause staining of
your clothes."
3. "Take the drug before meals to minimize GI symptoms."
4. "Always keep this drug and use it at the first symptom of a UTI."
- ✔ANASWER✔-Answer: 2
Rationale: The drug makes the urine reddish orange in color, and
the client should be advised that this might stain the underwear
and other clothing. The client should also be reassured that it
should not be confused with blood in the urine. Phenazopyridine
does not target the cause of the infection. Taking the drug after
meals minimizes GI symptoms associated with the use of this
drug. Indiscriminate use of a urinary analgesic can mask
symptoms and delay initiation of treatment.
A client with a urinary diversion device has the nursing diagnosis
Risk for Impaired Skin Integrity. Which interventions will the nurse
use with this client? Select all that apply.
1. Change urine collection device every other day.
, 2. Teach self-catheterization technique.
3. Empty the bag reservoir every 2 hours.
4. Monitor for foul-smelling urine.
5. Ensure appliance wafer is not more than 1/8 inch larger than
stoma. - ✔ANASWER✔-Answer: 3, 5
Rationale: Emptying the reservoir bag every 2 hours prevents
overfilling and possible leakage of urine into the skin surface.
Ensuring that opening is not more than 1/8 inch larger than stoma
reduces the risk of skin irritation and breakdown from urine on
the skin. The urine collection device should be changed as needed
to maintain integrity of the system. Self- catheterization is not
appropriate for this nursing diagnosis. Monitoring for foul-
smelling urine and monitoring for signs of infection are more
appropriate interventions for the diagnosis risk for infection.
A client with renal calculi is advised to restrict calcium in the diet.
The nurse determines that the client understands the restriction
when the client states to avoid which types of foods?
1. Chicken, beef, and salmon
2. Green vegetables, fruit, and legumes
3. Chocolate, smoked fish, and low-fat milk
4. Eggs, meat, and poultry - ✔ANASWER✔-Answer: 3
Elimination/Ethics/Surgery Exam Study Guide
ACTUAL EXAM comprehensive questions and
verified accurate solution (detailed &
elaborated) 2025 TEST!
Section 9 - ✔ANASWER✔-Chapter 59
Which statement made by a client with chronic renal failure and
who is on hemodialysis indicates the need for further teaching?
1. "I will report any increase in my weight of 5 pounds in a 2-day
period."
2. "I take my prescribed antihypertensive drugs daily."
3. "I am careful to take precautions in the arm with the AV fistula."
4. "I comply with salt restrictions in my diet by using salt
substitutes." - ✔ANASWER✔-Answer: 4
,Rationale: Many salt substitutes use potassium chloride.
Potassium intake is carefully regulated in clients with renal failure,
and the use of salt substitutes will worsen hyperkalemia. Increases
in weight do need to be reported to the health care provider as a
possible indication of fluid volume excess. The control of
hypertension is essential in the management of a client with renal
failure. An AV fistula does need to be protected from injury that
could be caused by constricting clothing, venipunctures, and
other items
What type of renal failure would the nurse expect to see in a client
who overdosed accidentally on tobramycin (Nebcin)?
1. Prerenal failure
2. Postrenal failure
3. Extrarenal failure
4. Intrarenal failure - ✔ANASWER✔-Answer: 4
Rationale: Nephrotoxic drugs, such as aminoglycoside antibiotics
(tobramycin), can damage the nephrons and cause intrarenal
(within the kidneys) failure. Prerenal causes of renal failure include
any condition that reduces the blood flow to the kidney, such as
heart failure, shock, and other conditions. Postrenal failure can be
caused by conditions that obstruct urine outflow in the lower
urinary system. There is no condition called extrarenal failure.
,A client with urinary tract infection (UTI) is prescribed
phenazopyridine (Pyridium). Which instruction would the nurse
give the client?
1. "This drug will take care of the infection causing your
symptoms."
2. "Your urine may turn reddish orange and may cause staining of
your clothes."
3. "Take the drug before meals to minimize GI symptoms."
4. "Always keep this drug and use it at the first symptom of a UTI."
- ✔ANASWER✔-Answer: 2
Rationale: The drug makes the urine reddish orange in color, and
the client should be advised that this might stain the underwear
and other clothing. The client should also be reassured that it
should not be confused with blood in the urine. Phenazopyridine
does not target the cause of the infection. Taking the drug after
meals minimizes GI symptoms associated with the use of this
drug. Indiscriminate use of a urinary analgesic can mask
symptoms and delay initiation of treatment.
A client with a urinary diversion device has the nursing diagnosis
Risk for Impaired Skin Integrity. Which interventions will the nurse
use with this client? Select all that apply.
1. Change urine collection device every other day.
, 2. Teach self-catheterization technique.
3. Empty the bag reservoir every 2 hours.
4. Monitor for foul-smelling urine.
5. Ensure appliance wafer is not more than 1/8 inch larger than
stoma. - ✔ANASWER✔-Answer: 3, 5
Rationale: Emptying the reservoir bag every 2 hours prevents
overfilling and possible leakage of urine into the skin surface.
Ensuring that opening is not more than 1/8 inch larger than stoma
reduces the risk of skin irritation and breakdown from urine on
the skin. The urine collection device should be changed as needed
to maintain integrity of the system. Self- catheterization is not
appropriate for this nursing diagnosis. Monitoring for foul-
smelling urine and monitoring for signs of infection are more
appropriate interventions for the diagnosis risk for infection.
A client with renal calculi is advised to restrict calcium in the diet.
The nurse determines that the client understands the restriction
when the client states to avoid which types of foods?
1. Chicken, beef, and salmon
2. Green vegetables, fruit, and legumes
3. Chocolate, smoked fish, and low-fat milk
4. Eggs, meat, and poultry - ✔ANASWER✔-Answer: 3
