NURS 661 Exam 3(Latest 2026 Update) |Questions and
Correct Verified Answers/Exam 3 NURS661 Already
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The patient with chronic renal failure who is scheduled for
haemodialysis this morning is scheduled to receive a daily dose of
enalapril. The nurse plans to administer this medication:
A. During dialysis
B. Just before dialysis
C. The day after dialysis
D. Upon return from dialysis - Answer -D. Upon return from dialysis
Antihypertensive medications, such as enalapril, are administered to
the patient following haemodialysis. This prevents the patient from
becoming hypotensive during dialysis and also having the medication
removed from the bloodstream by dialysis. There is no rationale for
waiting a full day to resume this medication, and could lead to
ineffective control of the blood pressure.
A patient with a history of heart failure who is undergoing peritoneal
dialysis has developed crackles in the lower lung fields. The nurse
interprets this finding is most likely related to:
A. Natural progression of renal failure
B. Compliance with dietary sodium restriction
C. Intake greater than output on the dialysis record
D. Adherence to digoxin therapy schedule - Answer -C. Intake greater
than output on the dialysis record
Crackles in the lung fields of the peritoneal dialysis patient result
from overhydration or from insufficient fluid removal during dialysis.
An intake that is greater than the output of peritoneal dialysis would
overhydrate the patient, resulting in lung crackles. Adherence to
medication and diet therapy should control this sign, not exacerbate it.
pg. 1
,If dialysis is effective, there is no connection between the progression
of renal failure.
Which assessment data reported by a 28-year-old client (assigned
female at birth) is consistent with a lower urinary tract infection
(UTI)?
A. Poor urine output
B. Bilateral flank pain
C. Nausea and vomiting
D. Burning on urination - Answer -D. Burning on urination
Pain with urination is a common symptom of a lower UTI. Urine
output does not decrease, but frequency may be experienced. Flank
pain and nausea are associated with an upper UTI.
Nursing staff on a hospital unit are reviewing rates of hospital-
acquired infections (HAI) of the urinary tract. Which nursing action
will be most helpful in decreasing the risk for HAI in clients admitted
to the hospital?
A. Encouraging adequate oral fluid intake
B. Testing urine with a dipstick daily for nitrites
C. Avoiding unnecessary urinary catheterizations
D. Providing frequent perineal hygiene to patients - Answer -C.
Avoiding unnecessary urinary catheterizations
Because catheterization bypasses many of the protective mechanisms
that prevent urinary tract infection (UTI), avoidance of catheterization
is the most effective means of reducing HAI. The other actions will
also be helpful, but are not as useful as decreasing urinary catheter
use.
The nurse is caring for an acutely ill client. What assessment finding
should prompt the nurse to inform the physician that the client may be
exhibiting signs of acute kidney injury (AKI)?
pg. 2
,A. The client's average urine output has been 10 mL/hr for several
hours.
B. The client reports an inability to initiate voiding.
C. The client's urine is cloudy with a foul odour.
D. The client reports abdominal/flank pain. - Answer -A. The client's
average urine output has been 10 mL/hr for several hours.
Oliguria is the most common clinical situation seen in AKI. Flank
pain and inability to initiate voiding are not characteristic of AKI.
Cloudy, foul-smelling urine is suggestive of a urinary tract infection.
A client with kidney stones is scheduled for extracorporeal shock
wave lithotripsy (ESWL). What should the nurse include in the
client's post procedure care?
A. Strain the client's urine following the procedure.
B. Administer a bolus of 500 mL normal saline following the
procedure.
C. Monitor the client for fluid overload following the procedure.
D. Insert a urinary catheter for 24 to 48 hours after the procedure. -
Answer -A. Strain the client's urine following the procedure.
Which finding by the nurse will be most helpful in determining
whether a 67-year-old client with benign prostatic hyperplasia (BPH)
has an upper urinary tract infection (UTI)?
A. Bladder distention
B. Foul-smelling urine
C. Suprapubic discomfort
D. Costovertebral tenderness - Answer -D. Costovertebral tenderness
Costovertebral tenderness is characteristic of pyelonephritis. Bladder
distention, foul-smelling urine, and suprapubic discomfort are
pg. 3
, characteristic of lower UTI and are likely to be present if the patient
also has an upper UTI.
A patient with acute renal failure is ordered to be on a fluid restriction
of 1500 mL per day. The nurse best plans to assist the patient with
maintaining the restriction by:
A. Removing the water pitcher from the bedside
B. Using mouthwash with alcohol for mouth care
C. Prohibiting beverages with sugar to minimize thirst
D. Asking the client to calculate the IV fluids into the total daily
allotment - Answer -A. Removing the water pitcher from the bedside
The nurse can help the patient to maintain fluid restriction through a
variety of means. One way is to provide frequent mouth care;
however, alcohol-based products should be avoided because they are
drying to mucous membranes. The use of ice chips and lip ointments
is another intervention that may be helpful. Beverages that the patient
enjoys are provided and not restricted based on sugar content. The
patient is not asked to keep track of IV fluid intake; this is the nurse's
responsibility. The water pitcher should be removed to aid in
compliance.
The nurse is caring for a client who has a fluid volume deficit. When
evaluating this client's urinalysis results, what should the nurse
anticipate?
A. A fluctuating urine specific gravity
B. A fixed urine specific gravity
C. A decreased urine specific gravity
D. An increased urine specific gravity - Answer -D. An increased
urine specific gravity
Urine specific gravity depends largely on hydration status. A decrease
in fluid intake will lead to an increase in the urine specific gravity.
With high fluid intake, specific gravity decreases. In clients with
pg. 4
Correct Verified Answers/Exam 3 NURS661 Already
Graded A+|Brand New!!!!
The patient with chronic renal failure who is scheduled for
haemodialysis this morning is scheduled to receive a daily dose of
enalapril. The nurse plans to administer this medication:
A. During dialysis
B. Just before dialysis
C. The day after dialysis
D. Upon return from dialysis - Answer -D. Upon return from dialysis
Antihypertensive medications, such as enalapril, are administered to
the patient following haemodialysis. This prevents the patient from
becoming hypotensive during dialysis and also having the medication
removed from the bloodstream by dialysis. There is no rationale for
waiting a full day to resume this medication, and could lead to
ineffective control of the blood pressure.
A patient with a history of heart failure who is undergoing peritoneal
dialysis has developed crackles in the lower lung fields. The nurse
interprets this finding is most likely related to:
A. Natural progression of renal failure
B. Compliance with dietary sodium restriction
C. Intake greater than output on the dialysis record
D. Adherence to digoxin therapy schedule - Answer -C. Intake greater
than output on the dialysis record
Crackles in the lung fields of the peritoneal dialysis patient result
from overhydration or from insufficient fluid removal during dialysis.
An intake that is greater than the output of peritoneal dialysis would
overhydrate the patient, resulting in lung crackles. Adherence to
medication and diet therapy should control this sign, not exacerbate it.
pg. 1
,If dialysis is effective, there is no connection between the progression
of renal failure.
Which assessment data reported by a 28-year-old client (assigned
female at birth) is consistent with a lower urinary tract infection
(UTI)?
A. Poor urine output
B. Bilateral flank pain
C. Nausea and vomiting
D. Burning on urination - Answer -D. Burning on urination
Pain with urination is a common symptom of a lower UTI. Urine
output does not decrease, but frequency may be experienced. Flank
pain and nausea are associated with an upper UTI.
Nursing staff on a hospital unit are reviewing rates of hospital-
acquired infections (HAI) of the urinary tract. Which nursing action
will be most helpful in decreasing the risk for HAI in clients admitted
to the hospital?
A. Encouraging adequate oral fluid intake
B. Testing urine with a dipstick daily for nitrites
C. Avoiding unnecessary urinary catheterizations
D. Providing frequent perineal hygiene to patients - Answer -C.
Avoiding unnecessary urinary catheterizations
Because catheterization bypasses many of the protective mechanisms
that prevent urinary tract infection (UTI), avoidance of catheterization
is the most effective means of reducing HAI. The other actions will
also be helpful, but are not as useful as decreasing urinary catheter
use.
The nurse is caring for an acutely ill client. What assessment finding
should prompt the nurse to inform the physician that the client may be
exhibiting signs of acute kidney injury (AKI)?
pg. 2
,A. The client's average urine output has been 10 mL/hr for several
hours.
B. The client reports an inability to initiate voiding.
C. The client's urine is cloudy with a foul odour.
D. The client reports abdominal/flank pain. - Answer -A. The client's
average urine output has been 10 mL/hr for several hours.
Oliguria is the most common clinical situation seen in AKI. Flank
pain and inability to initiate voiding are not characteristic of AKI.
Cloudy, foul-smelling urine is suggestive of a urinary tract infection.
A client with kidney stones is scheduled for extracorporeal shock
wave lithotripsy (ESWL). What should the nurse include in the
client's post procedure care?
A. Strain the client's urine following the procedure.
B. Administer a bolus of 500 mL normal saline following the
procedure.
C. Monitor the client for fluid overload following the procedure.
D. Insert a urinary catheter for 24 to 48 hours after the procedure. -
Answer -A. Strain the client's urine following the procedure.
Which finding by the nurse will be most helpful in determining
whether a 67-year-old client with benign prostatic hyperplasia (BPH)
has an upper urinary tract infection (UTI)?
A. Bladder distention
B. Foul-smelling urine
C. Suprapubic discomfort
D. Costovertebral tenderness - Answer -D. Costovertebral tenderness
Costovertebral tenderness is characteristic of pyelonephritis. Bladder
distention, foul-smelling urine, and suprapubic discomfort are
pg. 3
, characteristic of lower UTI and are likely to be present if the patient
also has an upper UTI.
A patient with acute renal failure is ordered to be on a fluid restriction
of 1500 mL per day. The nurse best plans to assist the patient with
maintaining the restriction by:
A. Removing the water pitcher from the bedside
B. Using mouthwash with alcohol for mouth care
C. Prohibiting beverages with sugar to minimize thirst
D. Asking the client to calculate the IV fluids into the total daily
allotment - Answer -A. Removing the water pitcher from the bedside
The nurse can help the patient to maintain fluid restriction through a
variety of means. One way is to provide frequent mouth care;
however, alcohol-based products should be avoided because they are
drying to mucous membranes. The use of ice chips and lip ointments
is another intervention that may be helpful. Beverages that the patient
enjoys are provided and not restricted based on sugar content. The
patient is not asked to keep track of IV fluid intake; this is the nurse's
responsibility. The water pitcher should be removed to aid in
compliance.
The nurse is caring for a client who has a fluid volume deficit. When
evaluating this client's urinalysis results, what should the nurse
anticipate?
A. A fluctuating urine specific gravity
B. A fixed urine specific gravity
C. A decreased urine specific gravity
D. An increased urine specific gravity - Answer -D. An increased
urine specific gravity
Urine specific gravity depends largely on hydration status. A decrease
in fluid intake will lead to an increase in the urine specific gravity.
With high fluid intake, specific gravity decreases. In clients with
pg. 4
