• NSG 530 EXAM 09/15/2026
NSG 530 ACTUAL EXAM 2 2026/2027 |
Advanced Pathophysiology – Wilkes University
| Exams 1-4 Comprehensive Bank | Verified
Q&A with Detailed Rationales | Pass
Guaranteed - A+ Graded
A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse
anticipates which treatment will be done to relieve the obstruction? Select all that apply.
1.Peritoneal dialysis
2.Analysis of the urinary stone
3.Intravenous opioid analgesics
4.Insertion of a nephrostomy tube
P 1
, • NSG 530 EXAM 09/15/2026
5.Placement of a ureteral stent with ureteroscopy –
Correct Answer :4, 5
Rationale:
Urolithiasis is the condition that occurs when a stone forms in the urinary system. Hydronephrosis develops
when the stone has blocked the ureter and urine backs up and dilates and damages the kidney. Priority
treatment is to allow the urine to drain and relieve the obstruction in the ureter. This is accomplished by
placement of a percutaneous nephrostomy tube to drain urine from the kidney and placement of a ureteral
stent to keep the ureter open. Peritoneal dialysis is not needed since the kidney is functioning. Stone analysis will
be done later when the stone has been retrieved and analyzed. Opioid analgesics are necessary for pain relief
but do not treat the obstruction.
The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is
important to maintain the prescribed dwell time for the dialysis because of the risk of which complication?
1.Peritonitis
2.Hyperglycemia
3.Hyperphosphatemia
4.Disequilibrium syndrome
- Correct Answer :2
Rationale:
An extended dwell time increases the risk of hyperglycemia in the client with diabetes mellitus as a result of
absorption of glucose from the dialysate and electrolyte changes. Diabetic clients may require extra insulin when
receiving peritoneal dialysis. Peritonitis is a risk associated with breaks in aseptic technique. Hyperphosphatemia
is an electrolyte imbalance that occurs with renal dysfunction. Disequilibrium syndrome is a complication
associated with hemodialysis.
A week after kidney transplantation, a client develops a temperature of 101°F (38.3°C), the blood pressure is
elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is
decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the
nurse anticipates which treatment?
P 2
, • NSG 530 EXAM 09/15/2026
1.Antibiotic therapy
2.Peritoneal dialysis
3.Removal of the transplanted kidney
4.Increased immunosuppression therapy –
Correct Answer :4
Rationale:
Acute rejection most often occurs within 1 week after transplantation but can occur any time
posttransplantation. Clinical manifestations include fever, malaise, elevated white blood cell count, acute
hypertension, graft tenderness, and manifestations of deteriorating renal function. Treatment consists of
increasing immunosuppressive therapy. Antibiotics are used to treat infection. Peritoneal dialysis cannot be used
with a newly transplanted kidney due to the recent surgery. Removal of the transplanted kidney is indicated with
hyperacute rejection, which occurs within 48 hours of the transplant surgery.
A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection
of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the
urinary drainage bag. Which assessment finding indicates the need to notify the health care provider (HCP)?
1.Red, bloody urine
2.Pain rated as 2 on a 0-10 pain scale
3.Urinary output of 200 mL higher than intake
4.Blood pressure, 100/50 mm Hg; pulse, 130 beats/minute –
Correct Answer :4
Rationale
:Frank bleeding (arterial or venous) may occur during the first day after surgery. Some hematuria is usual for
several days after surgery. A urinary output of 200 mL more than intake is adequate. A client pain rating of 2 on a
0-10 scale indicates adequate pain control. A rapid pulse with a low blood pressure is a potential sign of
excessive blood loss. The HCP should be notified.
The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client
is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated
manifestations?
P 3
, • NSG 530 EXAM 09/15/2026
1.Hypertension, tachycardia, and fever
2.Hypotension, bradycardia, and hypothermia
3.Restlessness, irritability, and generalized weakness
4.Headache, deteriorating level of consciousness, and twitching –
Answer :4
Rationale:
Disequilibrium syndrome is characterized by headache, mental confusion, decreasing level of consciousness,
nausea, vomiting, twitching, and possible seizure activity. Disequilibrium syndrome is caused by rapid removal of
solutes from the body during hemodialysis. At the same time, the blood-brain barrier interferes with the efficient
removal of wastes from brain tissue. As a result, water goes into cerebral cells because of the osmotic gradient,
causing increased intracranial pressure and onset of symptoms. The syndrome most often occurs in clients who
are new to dialysis and is prevented by dialyzing for shorter times or at reduced blood flow rates. Tachycardia
and fever are associated with infection. Generalized weakness is associated with low blood pressure and anemia.
Restlessness and irritability are not associated with disequilibrium syndrome.
The nurse is monitoring a client who has just returned from surgery after a transurethral resection of the
prostate (TURP). The client has a 3-way Foley catheter in place for ongoing bladder irrigation. The nurse is
observing the color of the client's urine and should expect which urine color during the immediate postoperative
period?
1.Pale pink urine
2.Dark pink urine
3.Tea-colored urine
4.Bright red blood with small clots in the urine –
Correct Answer :1
Rationale:
If the bladder irrigation is infusing at a sufficient rate, the urinary drainage through the Foley tubing should be
pale pink. Dark pink urine indicates that the rate of the irrigation solution should be increased. Tea-colored urine
is not seen after TURP but may be noted in a client with other renal disorders such as renal failure. Bright red
bleeding and clots could indicate a complication, and if this is noted, it should be reported to the health care
provider.
P 4
NSG 530 ACTUAL EXAM 2 2026/2027 |
Advanced Pathophysiology – Wilkes University
| Exams 1-4 Comprehensive Bank | Verified
Q&A with Detailed Rationales | Pass
Guaranteed - A+ Graded
A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse
anticipates which treatment will be done to relieve the obstruction? Select all that apply.
1.Peritoneal dialysis
2.Analysis of the urinary stone
3.Intravenous opioid analgesics
4.Insertion of a nephrostomy tube
P 1
, • NSG 530 EXAM 09/15/2026
5.Placement of a ureteral stent with ureteroscopy –
Correct Answer :4, 5
Rationale:
Urolithiasis is the condition that occurs when a stone forms in the urinary system. Hydronephrosis develops
when the stone has blocked the ureter and urine backs up and dilates and damages the kidney. Priority
treatment is to allow the urine to drain and relieve the obstruction in the ureter. This is accomplished by
placement of a percutaneous nephrostomy tube to drain urine from the kidney and placement of a ureteral
stent to keep the ureter open. Peritoneal dialysis is not needed since the kidney is functioning. Stone analysis will
be done later when the stone has been retrieved and analyzed. Opioid analgesics are necessary for pain relief
but do not treat the obstruction.
The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is
important to maintain the prescribed dwell time for the dialysis because of the risk of which complication?
1.Peritonitis
2.Hyperglycemia
3.Hyperphosphatemia
4.Disequilibrium syndrome
- Correct Answer :2
Rationale:
An extended dwell time increases the risk of hyperglycemia in the client with diabetes mellitus as a result of
absorption of glucose from the dialysate and electrolyte changes. Diabetic clients may require extra insulin when
receiving peritoneal dialysis. Peritonitis is a risk associated with breaks in aseptic technique. Hyperphosphatemia
is an electrolyte imbalance that occurs with renal dysfunction. Disequilibrium syndrome is a complication
associated with hemodialysis.
A week after kidney transplantation, a client develops a temperature of 101°F (38.3°C), the blood pressure is
elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is
decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the
nurse anticipates which treatment?
P 2
, • NSG 530 EXAM 09/15/2026
1.Antibiotic therapy
2.Peritoneal dialysis
3.Removal of the transplanted kidney
4.Increased immunosuppression therapy –
Correct Answer :4
Rationale:
Acute rejection most often occurs within 1 week after transplantation but can occur any time
posttransplantation. Clinical manifestations include fever, malaise, elevated white blood cell count, acute
hypertension, graft tenderness, and manifestations of deteriorating renal function. Treatment consists of
increasing immunosuppressive therapy. Antibiotics are used to treat infection. Peritoneal dialysis cannot be used
with a newly transplanted kidney due to the recent surgery. Removal of the transplanted kidney is indicated with
hyperacute rejection, which occurs within 48 hours of the transplant surgery.
A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection
of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the
urinary drainage bag. Which assessment finding indicates the need to notify the health care provider (HCP)?
1.Red, bloody urine
2.Pain rated as 2 on a 0-10 pain scale
3.Urinary output of 200 mL higher than intake
4.Blood pressure, 100/50 mm Hg; pulse, 130 beats/minute –
Correct Answer :4
Rationale
:Frank bleeding (arterial or venous) may occur during the first day after surgery. Some hematuria is usual for
several days after surgery. A urinary output of 200 mL more than intake is adequate. A client pain rating of 2 on a
0-10 scale indicates adequate pain control. A rapid pulse with a low blood pressure is a potential sign of
excessive blood loss. The HCP should be notified.
The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client
is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated
manifestations?
P 3
, • NSG 530 EXAM 09/15/2026
1.Hypertension, tachycardia, and fever
2.Hypotension, bradycardia, and hypothermia
3.Restlessness, irritability, and generalized weakness
4.Headache, deteriorating level of consciousness, and twitching –
Answer :4
Rationale:
Disequilibrium syndrome is characterized by headache, mental confusion, decreasing level of consciousness,
nausea, vomiting, twitching, and possible seizure activity. Disequilibrium syndrome is caused by rapid removal of
solutes from the body during hemodialysis. At the same time, the blood-brain barrier interferes with the efficient
removal of wastes from brain tissue. As a result, water goes into cerebral cells because of the osmotic gradient,
causing increased intracranial pressure and onset of symptoms. The syndrome most often occurs in clients who
are new to dialysis and is prevented by dialyzing for shorter times or at reduced blood flow rates. Tachycardia
and fever are associated with infection. Generalized weakness is associated with low blood pressure and anemia.
Restlessness and irritability are not associated with disequilibrium syndrome.
The nurse is monitoring a client who has just returned from surgery after a transurethral resection of the
prostate (TURP). The client has a 3-way Foley catheter in place for ongoing bladder irrigation. The nurse is
observing the color of the client's urine and should expect which urine color during the immediate postoperative
period?
1.Pale pink urine
2.Dark pink urine
3.Tea-colored urine
4.Bright red blood with small clots in the urine –
Correct Answer :1
Rationale:
If the bladder irrigation is infusing at a sufficient rate, the urinary drainage through the Foley tubing should be
pale pink. Dark pink urine indicates that the rate of the irrigation solution should be increased. Tea-colored urine
is not seen after TURP but may be noted in a client with other renal disorders such as renal failure. Bright red
bleeding and clots could indicate a complication, and if this is noted, it should be reported to the health care
provider.
P 4
