LEWIS MED SURG URINARY KIDNEY NCLEX
REVIEW PRACTICE QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
To palpate the right kidney, the patient is positioned supine, and the nurse's left hand is placed behind and
supports the patient's right side between the rib cage and the iliac crest. The right flank is elevated with
the left hand, and the right hand is used to palpate deeply for the right kidney. The normal-sized left
kidney is rarely palpable because the spleen lies directly on top of it.
Eight months after the delivery of her first child, a 31-year-old woman has sought care because of
occasional incontinence that she experiences when sneezing or laughing. Which measure should the
nurse first recommend in an attempt to resolve the woman's incontinence?
A. Kegel exercises
B. Use of adult incontinence pads
C. Intermittent self-catheterization
D. Dietary changes including fluid restriction - ansA. Kegel exercises
Patients who experience stress incontinence frequently benefit from Kegel exercises (pelvic floor muscle
exercises). The use of incontinence pads does not resolve the problem, and intermittent self-
catheterization would be a premature recommendation. Dietary changes are not likely to influence the
patient's urinary continence.
he patient has had type 1 diabetes mellitus for 25 years and is now reporting fatigue, edema, and an
irregular heartbeat. On assessment, the nurse finds that the patient has newly developed hypertension
and difficulty with blood glucose control. The nurse should know that which diagnostic study will be most
indicative of chronic kidney disease (CKD) in this patient?
A. Serum creatinine
B. Serum potassium
C. Microalbuminuria
D. Calculated glomerular filtration rate (GFR) - ansD. Calculated glomerular filtration rate (GFR)
The best study to determine kidney function or chronic kidney disease (CKD) that would be expected in
the patient with diabetes is the calculated GFR that is obtained from the patient's age, gender, race, and
serum creatinine. It would need to be abnormal for 3 months to establish a diagnosis of CKD. A creatinine
clearance test done with a blood sample and a 24-hour urine collection is also important. Serum
, LEWIS MED SURG URINARY KIDNEY NCLEX
REVIEW PRACTICE QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
creatinine is not the best test for CKD because the level varies with different patients. Serum potassium
levels could explain why the patient has an irregular heartbeat. The finding of microalbuminuria can alert
the patient with diabetes about potential renal involvement and potentially failing kidneys. However, urine
albumin levels are not used for diagnosis of CKD.
In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions
important to the maintenance of homeostasis. Which physiologic processes are performed by the
kidneys? Select all that apply.
A. Production of renin
B. Activation of vitamin D
C. Carbohydrate metabolism
D. Erythropoietin production
E. Hemolysis of old red blood cells (RBCs) - ansA, B, D.
In addition to urine formation, the kidneys release renin to maintain blood pressure, activate vitamin D to
maintain calcium levels, and produce erythropoietin to stimulate RBC production. Carbohydrate
metabolism and hemolysis of old RBCs are not physiologic functions that are performed by the kidneys.
Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before
administering the medication, the nurse should assess the
a. bowel sounds.
b. blood glucose.
c. blood urea nitrogen (BUN).
d. level of consciousness (LOC). - ansa. bowel sounds.
Rationale: Only sodium polystyrene sulfonate (Kayexalate) and dialysis actually remove potassium from
the body. Never give this drug to a patient with a paralytic ileus because bowel necrosis can occur.
The nurse is providing care for a patient who has been admitted to the hospital for the treatment of
nephrotic syndrome. What are priority nursing assessments in the care of this patient?
REVIEW PRACTICE QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
To palpate the right kidney, the patient is positioned supine, and the nurse's left hand is placed behind and
supports the patient's right side between the rib cage and the iliac crest. The right flank is elevated with
the left hand, and the right hand is used to palpate deeply for the right kidney. The normal-sized left
kidney is rarely palpable because the spleen lies directly on top of it.
Eight months after the delivery of her first child, a 31-year-old woman has sought care because of
occasional incontinence that she experiences when sneezing or laughing. Which measure should the
nurse first recommend in an attempt to resolve the woman's incontinence?
A. Kegel exercises
B. Use of adult incontinence pads
C. Intermittent self-catheterization
D. Dietary changes including fluid restriction - ansA. Kegel exercises
Patients who experience stress incontinence frequently benefit from Kegel exercises (pelvic floor muscle
exercises). The use of incontinence pads does not resolve the problem, and intermittent self-
catheterization would be a premature recommendation. Dietary changes are not likely to influence the
patient's urinary continence.
he patient has had type 1 diabetes mellitus for 25 years and is now reporting fatigue, edema, and an
irregular heartbeat. On assessment, the nurse finds that the patient has newly developed hypertension
and difficulty with blood glucose control. The nurse should know that which diagnostic study will be most
indicative of chronic kidney disease (CKD) in this patient?
A. Serum creatinine
B. Serum potassium
C. Microalbuminuria
D. Calculated glomerular filtration rate (GFR) - ansD. Calculated glomerular filtration rate (GFR)
The best study to determine kidney function or chronic kidney disease (CKD) that would be expected in
the patient with diabetes is the calculated GFR that is obtained from the patient's age, gender, race, and
serum creatinine. It would need to be abnormal for 3 months to establish a diagnosis of CKD. A creatinine
clearance test done with a blood sample and a 24-hour urine collection is also important. Serum
, LEWIS MED SURG URINARY KIDNEY NCLEX
REVIEW PRACTICE QUESTIONS
AND ANSWERS LATEST VERSION VERIFIED
RATIONALE GRADED A+
creatinine is not the best test for CKD because the level varies with different patients. Serum potassium
levels could explain why the patient has an irregular heartbeat. The finding of microalbuminuria can alert
the patient with diabetes about potential renal involvement and potentially failing kidneys. However, urine
albumin levels are not used for diagnosis of CKD.
In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions
important to the maintenance of homeostasis. Which physiologic processes are performed by the
kidneys? Select all that apply.
A. Production of renin
B. Activation of vitamin D
C. Carbohydrate metabolism
D. Erythropoietin production
E. Hemolysis of old red blood cells (RBCs) - ansA, B, D.
In addition to urine formation, the kidneys release renin to maintain blood pressure, activate vitamin D to
maintain calcium levels, and produce erythropoietin to stimulate RBC production. Carbohydrate
metabolism and hemolysis of old RBCs are not physiologic functions that are performed by the kidneys.
Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before
administering the medication, the nurse should assess the
a. bowel sounds.
b. blood glucose.
c. blood urea nitrogen (BUN).
d. level of consciousness (LOC). - ansa. bowel sounds.
Rationale: Only sodium polystyrene sulfonate (Kayexalate) and dialysis actually remove potassium from
the body. Never give this drug to a patient with a paralytic ileus because bowel necrosis can occur.
The nurse is providing care for a patient who has been admitted to the hospital for the treatment of
nephrotic syndrome. What are priority nursing assessments in the care of this patient?
