ATI Renal + Urinary System Practice
Questions
A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client
reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the
following actions should the nurse take first?
A.
Administer an analgesic to the client
B.
Check the client's electrolyte values
C.
Measure the client's weight
D.
Restrict the client's protein intake - ANSCorrect Answer: B.
Check the client's electrolyte values
The nurse should apply the urgent versus nonurgent priority-setting framework when caring for
the client. Using this framework, the nurse should consider urgent needs to be the priority
because they pose a greater threat to the client. The nurse might also need to use Maslow's
hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify
which finding is the most urgent. The nurse should check the client's most recent potassium
value because these findings are manifestations of hyperkalemia, which can lead to cardiac
dysrhythmias.
Incorrect Answers:A. Administering an analgesic for a dull headache is important to manage the
client's pain; however, there is another action that the nurse should take first.
C. Measuring the client's weight is important to monitor the client's fluid balance; however, there
is another action the nurse should take first.
D. Restricting the client's protein intake is important to manage the client's acute kidney injury;
however, there is another action the nurse should take first.
A nurse is assessing a client who has urolithiasis and reports pain in his thigh. This finding
indicates the stone is in which of the following structures?
A.
Ureter
B.
Bladder
C.
Renal pelvis
D.
Renal tubules - ANSCorrect Answer: A.
Ureter
,When stones are in the ureters, pain radiates to the genitalia and to the thighs.
Incorrect Answers:B. Stones in the bladder produce manifestations of irritation that resemble a
urinary tract infection. They can also cause pain in the vulva and scrotal areas.
C. The renal pelvis is part of the kidney. Stones in the kidneys cause pain in the costovertebral
region.
D. The renal tubules are within the nephron, which is part of the kidney. Stones in the kidneys
cause flank pain
A nurse is reviewing the laboratory report of a client who has chronic kidney disease (CKD). The
nurse finds the following laboratory test results: potassium 6.8 mEq/L, calcium 7.4 mg/dL,
hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which finding is the priority for the nurse to
report to the provider?
A.
Hypocalcemia
B.
Hyperkalemia
C.
Anemia
D.
Hypoalbuminemia - ANSCorrect Answer: B.
Hyperkalemia
The nurse should apply the urgent versus nonurgent priority-setting framework when caring for
this client. Using this framework, the nurse should consider urgent needs the priority need
because they pose more of a threat to the client. The nurse may also need to use Maslow's
hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify
which finding is the most urgent. Hyperkalemia, which can cause life-threatening cardiac
dysrhythmias, is the priority for the nurse to report to the provider.
Incorrect Answers: A. Hypocalcemia is an expected finding with CKD; therefore, another finding
is the priority for the nurse to report to the provider. The decreased calcium level would require
reporting if the client developed muscle spasms or twitching.
C. Anemia is an expected finding with CKD; therefore, another finding is the priority for the
nurse to report to the provider.
D. Hyperphosphatemia is an expected finding with CKD; therefore, another finding is the priority
for the nurse to report to the provider.
A nurse is assessing a client who is receiving continuous ambulatory peritoneal dialysis. Which
of the following findings should the nurse report to the provider?
A.
WBC 6,000/mm^3
B.
Potassium 3.0 mEq/L
C.
, Clear, pale yellow drainage
D.
Report of abdominal fullness - ANSCorrect Answer: B.
Potassium 3.0 mEq/L
A potassium level of 3.0 mEq/L is below the expected reference range and can cause
dysrhythmias. Dialysis removes fluid, waste products, and electrolytes from the blood and can
cause hypokalemia.
Incorrect Answers:A. A WBC count of 6,000/mm^3 is within the expected reference range.
C. Clear, pale yellow drainage is an expected finding after peritoneal dialysis has been
established.
D. Abdominal fullness is an expected finding during the dwell period, when the dialysate stays in
the peritoneal cavity. A supine low-Fowler's position can reduce abdominal pressure.
A nurse is assessing a client who is receiving peritoneal dialysis. Which of the following findings
should the nurse report to the provider immediately?
A.
Difficulty draining the effluent
B.
Redness at the access site
C.
Fluid flowing from the catheter site
D.
Cloudy effluent - ANSCorrect Answer: D.
Cloudy effluent
A cloudy or opaque effluent indicates the client is at high risk for peritonitis, a bacterial infection
of the peritoneum. Therefore, this is the priority finding for the nurse to report to the provider.
Incorrect Answers:A. Difficulty draining the effluent indicates the client is experiencing clamped
tubing, a fibrin clot, or a kinked catheter that is impeding outflow, which requires further
assessment by the nurse. However, another finding is the priority for the nurse to report.
B. Redness at the access site indicates the client is at risk for local infection, which can lead to
catheter failure and peritonitis. However, another finding is the priority for the nurse to report.
C. Fluid flowing from the catheter site indicates the client is at risk for dialysate leakage, which
can create a need for hemodialysis support. However, another finding is the priority for the
nurse to report.
A nurse is assessing a client who is postoperative following a transurethral resection of the
prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following
findings should the nurse report to the provider?
A.
Pink-tinged urine
B.
Report of burning upon urination
Questions
A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client
reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the
following actions should the nurse take first?
A.
Administer an analgesic to the client
B.
Check the client's electrolyte values
C.
Measure the client's weight
D.
Restrict the client's protein intake - ANSCorrect Answer: B.
Check the client's electrolyte values
The nurse should apply the urgent versus nonurgent priority-setting framework when caring for
the client. Using this framework, the nurse should consider urgent needs to be the priority
because they pose a greater threat to the client. The nurse might also need to use Maslow's
hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify
which finding is the most urgent. The nurse should check the client's most recent potassium
value because these findings are manifestations of hyperkalemia, which can lead to cardiac
dysrhythmias.
Incorrect Answers:A. Administering an analgesic for a dull headache is important to manage the
client's pain; however, there is another action that the nurse should take first.
C. Measuring the client's weight is important to monitor the client's fluid balance; however, there
is another action the nurse should take first.
D. Restricting the client's protein intake is important to manage the client's acute kidney injury;
however, there is another action the nurse should take first.
A nurse is assessing a client who has urolithiasis and reports pain in his thigh. This finding
indicates the stone is in which of the following structures?
A.
Ureter
B.
Bladder
C.
Renal pelvis
D.
Renal tubules - ANSCorrect Answer: A.
Ureter
,When stones are in the ureters, pain radiates to the genitalia and to the thighs.
Incorrect Answers:B. Stones in the bladder produce manifestations of irritation that resemble a
urinary tract infection. They can also cause pain in the vulva and scrotal areas.
C. The renal pelvis is part of the kidney. Stones in the kidneys cause pain in the costovertebral
region.
D. The renal tubules are within the nephron, which is part of the kidney. Stones in the kidneys
cause flank pain
A nurse is reviewing the laboratory report of a client who has chronic kidney disease (CKD). The
nurse finds the following laboratory test results: potassium 6.8 mEq/L, calcium 7.4 mg/dL,
hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which finding is the priority for the nurse to
report to the provider?
A.
Hypocalcemia
B.
Hyperkalemia
C.
Anemia
D.
Hypoalbuminemia - ANSCorrect Answer: B.
Hyperkalemia
The nurse should apply the urgent versus nonurgent priority-setting framework when caring for
this client. Using this framework, the nurse should consider urgent needs the priority need
because they pose more of a threat to the client. The nurse may also need to use Maslow's
hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify
which finding is the most urgent. Hyperkalemia, which can cause life-threatening cardiac
dysrhythmias, is the priority for the nurse to report to the provider.
Incorrect Answers: A. Hypocalcemia is an expected finding with CKD; therefore, another finding
is the priority for the nurse to report to the provider. The decreased calcium level would require
reporting if the client developed muscle spasms or twitching.
C. Anemia is an expected finding with CKD; therefore, another finding is the priority for the
nurse to report to the provider.
D. Hyperphosphatemia is an expected finding with CKD; therefore, another finding is the priority
for the nurse to report to the provider.
A nurse is assessing a client who is receiving continuous ambulatory peritoneal dialysis. Which
of the following findings should the nurse report to the provider?
A.
WBC 6,000/mm^3
B.
Potassium 3.0 mEq/L
C.
, Clear, pale yellow drainage
D.
Report of abdominal fullness - ANSCorrect Answer: B.
Potassium 3.0 mEq/L
A potassium level of 3.0 mEq/L is below the expected reference range and can cause
dysrhythmias. Dialysis removes fluid, waste products, and electrolytes from the blood and can
cause hypokalemia.
Incorrect Answers:A. A WBC count of 6,000/mm^3 is within the expected reference range.
C. Clear, pale yellow drainage is an expected finding after peritoneal dialysis has been
established.
D. Abdominal fullness is an expected finding during the dwell period, when the dialysate stays in
the peritoneal cavity. A supine low-Fowler's position can reduce abdominal pressure.
A nurse is assessing a client who is receiving peritoneal dialysis. Which of the following findings
should the nurse report to the provider immediately?
A.
Difficulty draining the effluent
B.
Redness at the access site
C.
Fluid flowing from the catheter site
D.
Cloudy effluent - ANSCorrect Answer: D.
Cloudy effluent
A cloudy or opaque effluent indicates the client is at high risk for peritonitis, a bacterial infection
of the peritoneum. Therefore, this is the priority finding for the nurse to report to the provider.
Incorrect Answers:A. Difficulty draining the effluent indicates the client is experiencing clamped
tubing, a fibrin clot, or a kinked catheter that is impeding outflow, which requires further
assessment by the nurse. However, another finding is the priority for the nurse to report.
B. Redness at the access site indicates the client is at risk for local infection, which can lead to
catheter failure and peritonitis. However, another finding is the priority for the nurse to report.
C. Fluid flowing from the catheter site indicates the client is at risk for dialysate leakage, which
can create a need for hemodialysis support. However, another finding is the priority for the
nurse to report.
A nurse is assessing a client who is postoperative following a transurethral resection of the
prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following
findings should the nurse report to the provider?
A.
Pink-tinged urine
B.
Report of burning upon urination
