**The Prune Belly Paradox: Genitourinary &
Renal Nursing Mastery**
1. A post-op day 1 nephrectomy patient reports pain 8/10. What is priority?
A) Administer PRN opioid
B) Call HCP for order
C) Reposition patient
D) Apply warm compress
💫ANSWER✔️✔️: A) Administer PRN opioid
💫RATIONALE✔️✔️: Uncontrolled pain increases stress response and impedes healing; PRN orders exist
for nurse-initiated relief.
---
2. Continuous bladder irrigation (CBI) for TURP patient shows bright red clots. First action?
A) Increase irrigation rate
B) Manually irrigate
C) Notify surgeon
D) Clamp catheter
💫ANSWER✔️✔️: B) Manually irrigate
💫RATIONALE✔️✔️: Manual irrigation clears clots to maintain drainage; if unsuccessful, then notify HCP.
---
3. A patient with chronic kidney disease (CKD) has K+ 6.2 mEq/L. Which EKG change is expected?
A) U waves
B) Widened QRS
C) ST elevation
D) Prolonged PR
💫ANSWER✔️✔️: B) Widened QRS
,💫RATIONALE✔️✔️: Severe hyperkalemia widens QRS and can progress to sine wave or cardiac arrest.
---
4. Which IV fluid is safest for a hyponatremic (Na 120) patient with SIADH?
A) 0.9% NS
B) 3% saline
C) LR
D) D5W
💫ANSWER✔️✔️: B) 3% saline
💫RATIONALE✔️✔️: Hypertonic saline corrects severe symptomatic hyponatremia cautiously to prevent
osmotic demyelination.
---
5. A hemodialysis patient complains of chest pain during treatment. Priority action?
A) Check BP
B) Stop dialysis and return blood
C) Decrease flow rate
D) Give nitroglycerin
💫ANSWER✔️✔️: B) Stop dialysis and return blood
💫RATIONALE✔️✔️: Chest pain may indicate air embolism or myocardial ischemia; stopping protects
patient.
---
6. Which lab finding indicates adequate kidney function post-ATN?
A) BUN 40 mg/dL
B) Creatinine 0.9 mg/dL
C) eGFR 30 mL/min
D) K+ 5.4 mEq/L
💫ANSWER✔️✔️: B) Creatinine 0.9 mg/dL
💫RATIONALE✔️✔️: Normal creatinine (0.6-1.2) confirms recovery of glomerular filtration.
---
7. Patient with urolithiasis has nausea and flank pain. Best initial intervention?
, A) Strain all urine
B) Push oral fluids
C) IV morphine and antiemetic
D) CT scan without contrast
💫ANSWER✔️✔️: C) IV morphine and antiemetic
💫RATIONALE✔️✔️: Pain and nausea management is priority before diagnostics or interventions.
---
8. A patient with ureteral stent develops fever and chills. Most likely cause?
A) Stent encrustation
B) Urinary tract infection
C) Bladder spasms
D) Stent migration
💫ANSWER✔️✔️: B) Urinary tract infection
💫RATIONALE✔️✔️: Fever with indwelling foreign body is infection until proven otherwise.
---
9. Which medication is a potassium binder used in hyperkalemia?
A) Calcium gluconate
B) Sodium polystyrene sulfonate
C) Insulin
D) Albuterol
💫ANSWER✔️✔️: B) Sodium polystyrene sulfonate
💫RATIONALE✔️✔️: It exchanges sodium for potassium in the gut, removing fecal potassium.
---
10. Post-renal transplant, which lab suggests acute rejection?
A) Creatinine rise 0.3 mg/dL in 24h
B) Sodium 135
C) Urine output 100 mL/hr
D) Cyclosporine level therapeutic
Renal Nursing Mastery**
1. A post-op day 1 nephrectomy patient reports pain 8/10. What is priority?
A) Administer PRN opioid
B) Call HCP for order
C) Reposition patient
D) Apply warm compress
💫ANSWER✔️✔️: A) Administer PRN opioid
💫RATIONALE✔️✔️: Uncontrolled pain increases stress response and impedes healing; PRN orders exist
for nurse-initiated relief.
---
2. Continuous bladder irrigation (CBI) for TURP patient shows bright red clots. First action?
A) Increase irrigation rate
B) Manually irrigate
C) Notify surgeon
D) Clamp catheter
💫ANSWER✔️✔️: B) Manually irrigate
💫RATIONALE✔️✔️: Manual irrigation clears clots to maintain drainage; if unsuccessful, then notify HCP.
---
3. A patient with chronic kidney disease (CKD) has K+ 6.2 mEq/L. Which EKG change is expected?
A) U waves
B) Widened QRS
C) ST elevation
D) Prolonged PR
💫ANSWER✔️✔️: B) Widened QRS
,💫RATIONALE✔️✔️: Severe hyperkalemia widens QRS and can progress to sine wave or cardiac arrest.
---
4. Which IV fluid is safest for a hyponatremic (Na 120) patient with SIADH?
A) 0.9% NS
B) 3% saline
C) LR
D) D5W
💫ANSWER✔️✔️: B) 3% saline
💫RATIONALE✔️✔️: Hypertonic saline corrects severe symptomatic hyponatremia cautiously to prevent
osmotic demyelination.
---
5. A hemodialysis patient complains of chest pain during treatment. Priority action?
A) Check BP
B) Stop dialysis and return blood
C) Decrease flow rate
D) Give nitroglycerin
💫ANSWER✔️✔️: B) Stop dialysis and return blood
💫RATIONALE✔️✔️: Chest pain may indicate air embolism or myocardial ischemia; stopping protects
patient.
---
6. Which lab finding indicates adequate kidney function post-ATN?
A) BUN 40 mg/dL
B) Creatinine 0.9 mg/dL
C) eGFR 30 mL/min
D) K+ 5.4 mEq/L
💫ANSWER✔️✔️: B) Creatinine 0.9 mg/dL
💫RATIONALE✔️✔️: Normal creatinine (0.6-1.2) confirms recovery of glomerular filtration.
---
7. Patient with urolithiasis has nausea and flank pain. Best initial intervention?
, A) Strain all urine
B) Push oral fluids
C) IV morphine and antiemetic
D) CT scan without contrast
💫ANSWER✔️✔️: C) IV morphine and antiemetic
💫RATIONALE✔️✔️: Pain and nausea management is priority before diagnostics or interventions.
---
8. A patient with ureteral stent develops fever and chills. Most likely cause?
A) Stent encrustation
B) Urinary tract infection
C) Bladder spasms
D) Stent migration
💫ANSWER✔️✔️: B) Urinary tract infection
💫RATIONALE✔️✔️: Fever with indwelling foreign body is infection until proven otherwise.
---
9. Which medication is a potassium binder used in hyperkalemia?
A) Calcium gluconate
B) Sodium polystyrene sulfonate
C) Insulin
D) Albuterol
💫ANSWER✔️✔️: B) Sodium polystyrene sulfonate
💫RATIONALE✔️✔️: It exchanges sodium for potassium in the gut, removing fecal potassium.
---
10. Post-renal transplant, which lab suggests acute rejection?
A) Creatinine rise 0.3 mg/dL in 24h
B) Sodium 135
C) Urine output 100 mL/hr
D) Cyclosporine level therapeutic
