RENAL N172 HESI EXAM QUESTIONS
AND VERIFIED ANSWERS
Which response would the nurse give to a client with end-stage renal
disease who states, "I heard that it is inevitable that I will need a kidney
transplant? If so, which one of my kidneys will be removed?"
A. "Neither of your kidneys will be removed unless they become
infected."
B. "The kidney that is the most diseased is removed and replaced with a
new one."
C. "Your primary health care provider determines which kidney is
replaced with a new one."
D. "Your right kidney will be removed, because it has a longer renal vein,
making transplantation easier." - ANSWER A. "Neither of your kidneys
will be removed unless they become infected."
Rationale
During a renal transplant, removal of the recipient's own kidneys does
not occur unless a chronic infection is present. The primary health care
provider will not decide which kidney is replaced, the most diseased
kidney will not be removed, and the right kidney will stay because the
kidneys are left in place; the new kidney is placed in the right lower
quadrant and protected by the iliac crest.
Which assessment findings would the nurse expect in the client
hospitalized with a diagnosis of severe chronic kidney disease? Select
all that apply. One, some, or all responses may be correct.
A. Polyuria
B. Paresthesias
C. Hypertension
D. Metabolic alkalosis
,E. Widening pulse pressure - ANSWER B. Paresthesias
C. Hypertension
Rationale
Paresthesias occur as a result of excess nitrogenous wastes, altered
fluid and electrolytes, and altered regulatory functions. Nonfunctioning
kidneys cause fluid retention that may result in hypervolemia and
hypertension. Polyuria occurs because of extensive nephron damage
and may occur in the early stage of kidney disease but not in the severe
stage. Metabolic acidosis, not alkalosis, results from the inability to
excrete hydrogen ions and retain bicarbonate. Widening pulse pressure
occurs with increased intracranial pressure, not with kidney dysfunction.
Which laboratory test would the nurse discuss the need to monitor
throughout the course of prostate cancer when a client asks, "How much
more blood will they need? Don't they have enough?"
A. Albumin
B. Creatinine
C. Blood urea nitrogen (BUN)
D. Prostate-specific antigen (PSA) - ANSWER D. Prostate-specific
antigen (PSA)
Rationale
The PSA is an indication of the presence of prostate cancer; the higher
the level, the greater the tumor burden. The health care provider will
monitor the PSA levels throughout the course of the disease and
periodically thereafter. Albumin is a protein and an indicator of nutritional
and fluid status. Creatinine and BUN levels indicate renal function and
may elevate when blockage of the urethra occurs from an enlarged
prostate, but the reports do not indicate metastasis or prostate cancer.
Which clinical manifestation would indicate the cancer is in an early
stage in a male client with a preliminary diagnosis of cancer of the
urinary bladder?
A. Dysuria
B. Retention
, C. Hesitancy
D. Hematuria - ANSWER D. Hematuria
Rationale
Hematuria is the most common early sign of cancer of the urinary
system, probably because of the urinary system's rich vascular network.
Dysuria is not specific for bladder cancer. Retention and hesitancy are
not specific for bladder cancer; usually they are associated with an
enlarged prostate in the male.
Which condition can be prevented when a client with chronic kidney
disease receives medication to manage anemia?
A. Uremic frost
B. Chronic fatigue
C. Tubular necrosis
D. Dependent edema - ANSWER B. Chronic fatigue
Rationale
Kidney failure results in impaired erythropoietin production, which
causes anemia and chronic fatigue; treating the anemia will help in
managing the fatigue. Uremic frost results because urea compounds
and other waste products of metabolism that are not excreted by the
kidneys are brought to the skin by small, superficial capillaries and are
excreted and deposited on the skin. Tubular necrosis is a pathological
condition of the kidneys that can lead to kidney failure. The anemia and
dependent edema associated with kidney failure are not interrelated.
Which male client would the nurse note as having the highest risk for
development of clinical manifestations related to prostate cancer?
A. African American 55-year-old
B. White 45-year-old
C. Asian 55-year-old
D. Hispanic 45-year-old - ANSWER A. African American 55-year-old
Rationale
AND VERIFIED ANSWERS
Which response would the nurse give to a client with end-stage renal
disease who states, "I heard that it is inevitable that I will need a kidney
transplant? If so, which one of my kidneys will be removed?"
A. "Neither of your kidneys will be removed unless they become
infected."
B. "The kidney that is the most diseased is removed and replaced with a
new one."
C. "Your primary health care provider determines which kidney is
replaced with a new one."
D. "Your right kidney will be removed, because it has a longer renal vein,
making transplantation easier." - ANSWER A. "Neither of your kidneys
will be removed unless they become infected."
Rationale
During a renal transplant, removal of the recipient's own kidneys does
not occur unless a chronic infection is present. The primary health care
provider will not decide which kidney is replaced, the most diseased
kidney will not be removed, and the right kidney will stay because the
kidneys are left in place; the new kidney is placed in the right lower
quadrant and protected by the iliac crest.
Which assessment findings would the nurse expect in the client
hospitalized with a diagnosis of severe chronic kidney disease? Select
all that apply. One, some, or all responses may be correct.
A. Polyuria
B. Paresthesias
C. Hypertension
D. Metabolic alkalosis
,E. Widening pulse pressure - ANSWER B. Paresthesias
C. Hypertension
Rationale
Paresthesias occur as a result of excess nitrogenous wastes, altered
fluid and electrolytes, and altered regulatory functions. Nonfunctioning
kidneys cause fluid retention that may result in hypervolemia and
hypertension. Polyuria occurs because of extensive nephron damage
and may occur in the early stage of kidney disease but not in the severe
stage. Metabolic acidosis, not alkalosis, results from the inability to
excrete hydrogen ions and retain bicarbonate. Widening pulse pressure
occurs with increased intracranial pressure, not with kidney dysfunction.
Which laboratory test would the nurse discuss the need to monitor
throughout the course of prostate cancer when a client asks, "How much
more blood will they need? Don't they have enough?"
A. Albumin
B. Creatinine
C. Blood urea nitrogen (BUN)
D. Prostate-specific antigen (PSA) - ANSWER D. Prostate-specific
antigen (PSA)
Rationale
The PSA is an indication of the presence of prostate cancer; the higher
the level, the greater the tumor burden. The health care provider will
monitor the PSA levels throughout the course of the disease and
periodically thereafter. Albumin is a protein and an indicator of nutritional
and fluid status. Creatinine and BUN levels indicate renal function and
may elevate when blockage of the urethra occurs from an enlarged
prostate, but the reports do not indicate metastasis or prostate cancer.
Which clinical manifestation would indicate the cancer is in an early
stage in a male client with a preliminary diagnosis of cancer of the
urinary bladder?
A. Dysuria
B. Retention
, C. Hesitancy
D. Hematuria - ANSWER D. Hematuria
Rationale
Hematuria is the most common early sign of cancer of the urinary
system, probably because of the urinary system's rich vascular network.
Dysuria is not specific for bladder cancer. Retention and hesitancy are
not specific for bladder cancer; usually they are associated with an
enlarged prostate in the male.
Which condition can be prevented when a client with chronic kidney
disease receives medication to manage anemia?
A. Uremic frost
B. Chronic fatigue
C. Tubular necrosis
D. Dependent edema - ANSWER B. Chronic fatigue
Rationale
Kidney failure results in impaired erythropoietin production, which
causes anemia and chronic fatigue; treating the anemia will help in
managing the fatigue. Uremic frost results because urea compounds
and other waste products of metabolism that are not excreted by the
kidneys are brought to the skin by small, superficial capillaries and are
excreted and deposited on the skin. Tubular necrosis is a pathological
condition of the kidneys that can lead to kidney failure. The anemia and
dependent edema associated with kidney failure are not interrelated.
Which male client would the nurse note as having the highest risk for
development of clinical manifestations related to prostate cancer?
A. African American 55-year-old
B. White 45-year-old
C. Asian 55-year-old
D. Hispanic 45-year-old - ANSWER A. African American 55-year-old
Rationale
