NCLEXi Renali andi Urinary
(#1)i Ai clienti withi acutei kidneyi injuryi hasi ai serumi potassiumi leveli ofi 7.0i
mEq/Li (7.0i mmol/L).i Thei nursei shouldi plani whichi actionsi asi ai priority?i
Selecti alli thati apply.
1.i Placei thei clienti oni ai cardiaci monitor.
2.i Notifyi thei healthi carei provideri (HCP).
3.i Puti thei clienti oni NPOi (nothingi byi mouth)i statusi excepti fori icei chips.
4.i Reviewi thei client'si medicationsi toi determinei ifi anyi containi ori retaini
potassium.
5.i Allowi ani extrai 500i mLi ofi intravenousi fluidi intakei toi dilutei thei
electrolytei concentration.i -i
i i i i i i i i i i i i i i 1,i 2,i 4
R:i NPOi isi unnecessary.i Addingi extrai fluidi mayi worseni thei situationi andi
leadi toi fluidi overload.i Excessi Ki cani causei hearti dysrhythmias,i soi 1&4i arei
appropriate.i Callingi thei HCPi isi alsoi necessaryi fori furtheri orders.
(#2)i Ai clienti arrivesi ati thei emergencyi departmenti withi complaintsi ofi lowi
abdominali paini andi hematuria.i Thei clienti isi afebrile.i Thei nursei nexti
assessesi thei clienti toi determinei ai historyi ofi whichi condition?
1.i Pyelonephritis
2.i Glomerulonephritis
3.i Traumai toi thei bladderi ori abdomen
4.i Renali canceri ini thei client'si familyi -i
i i i i i i i i i i i i i i 3
R:i 1&i 2i arei similar/alike,i andi theyi wouldi involvei ai fever.i 4i wouldi havei
flanki paini insteadi ofi lowi abdi pain.
(#i 3)i Thei nursei discussesi plansi fori futurei treatmenti optionsi withi ai clienti
withi symptomatici polycystici kidneyi disease.i Whichi treatmenti shouldi bei
includedi ini thisi discussion?i Selecti alli thati apply.
1.i Hemodialysis
2.i Peritoneali dialysis
3.i Kidneyi transplant
4.i Bilaterali nephrectomy
5.i Intensei immunosuppressioni therapyi -i
i i i i i i i i i i i i i i 1,3,4
R:i Polycystici KDi involvesi cystsi thati eventuallyi rupturei andi damagei thei
kidneys,i leadingi toi end-stagei renali disease.i Thisi requiresi optionsi 1,i 3,i ori 4.i
2i isi contraindicatedi r/ti infection.i 5i won'ti helpi thei pt'si condition.
1i |i P a g e
,Ai clienti isi admittedi toi thei emergencyi departmenti followingi ai falli fromi ai
horsei andi thei healthi carei provideri (HCP)i prescribesi insertioni ofi ai urinaryi
catheter.i Whilei preparingi fori thei procedure,i thei nursei notesi bloodi ati thei
urinaryi meatus.i Thei nursei shouldi takei whichi action?
1.i Notifyi thei HCPi beforei performingi thei catheterization.
2.i Usei ai small-sizedi catheteri andi ani anesthetici geli asi ai lubricant.
3.i Administeri parenterali paini medicationi beforei insertingi thei catheter.
4.i Cleani thei meatusi withi soapi andi wateri beforei openingi thei catheterizationi
kit.i -i
i i i i i i i i i i i i i i 1
R:i bloodi mayi =i urethrali trauma,i soi youi needi toi notifyi thei HCPi firsti soi
youi cani identifyi thei truei causei ofi bloodi beforei catheterization.
Sincei there'si bloodi fromi ani unknowni cause,i youi needi toi assessi firsti beforei
doingi anythingi thati cani worseni it.
Thei nursei isi assessingi thei patencyi ofi ai client'si lefti armi arteriovenousi
fistulai priori toi initiatingi hemodialysis.i Whichi findingi indicatesi thati thei fistulai
isi patent?
1.i Palpationi ofi ai thrilli overi thei fistula
2.i Presencei ofi ai radiali pulsei ini thei lefti wrist
3.i Visualizationi ofi enlargedi bloodi vesselsi ati thei fistulai site
4.i Capillaryi refilli lessi thani 3i secondsi ini thei naili bedsi ofi thei fingersi oni
thei lefti handi -i
i i i i i i i i i i i i i i 1.
R:i listeni fori ai thrilli ori bruiti overi AVi fistulai site.i Alli otheri optionsi don'ti
REALLYi showi ifi thei AVi fistulai isi patent,i justi thati there'si perfusioni toi
thei hand.
Ai malei clienti hasi ai tentativei diagnosisi ofi urethritis.i Thei nursei shouldi
assessi thei clienti fori whichi manifestationi ofi thei disorder?
1.i Hematuriai andi pyuria
2.i Dysuriai andi proteinuria
3.i Hematuriai andi urgency
4.i Dysuriai andi penilei dischargei -i
i i i i i i i i i i i i i i 4.
R:i Urethritisi usuallyi involvesi dysuria,i soi 1&3i arei incorrect.i Proteinuriai isi r/ti
kidneyi dysfunction,i soi optioni 2i isi alsoi incorrect.i Urethritisi isi alsoi associatedi
withi chlamydia,i soi dischargei isi expected.i Hematuriai isi noti assoc.i withi
urethritis.
Thei nursei isi assessingi ai clienti withi epididymitis.i Thei nursei anticipatesi
whichi findingsi oni physicali examination?
1.i Fever,i diarrhea,i groini pain,i andi ecchymosis
2i |i P a g e
,2.i Nausea,i painfuli scrotali edema,i andi ecchymosis
3.i Fever,i nausea,i vomiting,i andi painfuli scrotali edema
4.i Diarrhea,i groini pain,i testiculari torsion,i andi scrotali edemai -i
i i i i i i i i i i i i i i 3
R:i -itisi isi associatedi w/i fever,i soi youi cani narrowi iti downi toi 1&3.i
Epididymitisi doesi noti involvei bleedingi soi ecchymosisi (optioni 1)i isi irrelevant.
Typicali signsi andi symptomsi ofi epididymitisi includei scrotali paini andi edema,i
whichi ofteni arei accompaniedi byi fever,i nauseai andi vomiting,i andi chills.
Ai clienti complainsi ofi fever,i perineali pain,i andi urinaryi urgency,i frequency,i
andi dysuria.i Toi assessi whetheri thei client'si problemi isi relatedi toi bacteriali
prostatitis,i thei nursei reviewsi thei resultsi ofi thei prostatei examinationi fori
whichi characteristici ofi thisi disorder?
1.i Softi andi swolleni prostatei gland
2.i Swollen,i andi boggyi prostatei gland
3.i Tenderi andi edematousi prostatei gland
4.i Tender,i induratedi prostatei glandi thati isi warmi toi thei touchi -i
i i i i i i i i i i i i i i 4
R:i Thei clienti withi bacteriali prostatitisi hasi ai swolleni andi tenderi prostatei
glandi thati isi alsoi warmi toi thei touch,i firm,i andi indurated.i Systemici
symptomsi includei feveri withi chills,i perineali andi lowi backi pain,i andi signsi
ofi urinaryi tracti infection,i whichi ofteni accompanyi thei disorder.
*Remember,i -itis=i inflammation/infection,i soi tendernessi andi locali warmthi isi
expected.i soi optioni 4i isi mosti correct.
Thei nursei isi collectingi datai fromi ai client.i Whichi symptomi describedi byi
thei clienti isi characteristici ofi ani earlyi symptomi ofi benigni prostatici
hyperplasia?
1.i Nocturia
2.i Scrotali edema
3.i Occasionali constipation
4.i Decreasedi forcei ini thei streami ofi urinei -i
i i i i i i i i i i i i i i 4
R:i Optioni 1i isi ai lateri sign.i 2&3i arei irrelevanti toi BPH.
Thei nursei monitoringi ai clienti receivingi peritoneali dialysisi notesi thati thei
client'si outflowi isi lessi thani thei inflow.i Whichi actionsi shouldi thei nursei
take?i Selecti alli thati apply.
1.i Checki thei leveli ofi thei drainagei bag.
2.i Repositioni thei clienti toi hisi ori heri side.
3.i Contacti thei healthi carei provideri (HCP).
4.i Placei thei clienti ini goodi bodyi alignment.
5.i Checki thei peritoneali dialysisi systemi fori kinks.
6.i Increasei thei flowi ratei ofi thei peritoneali dialysisi solution.i -i
3i |i P a g e
, i i i i i i i i i i i i i i 1,2,4,5
R:i Tryi toi fixi thei flowi yourselfi beforei callingi thei HCPi ori messingi withi
thei flowi rate.i Imbalancei mayi bei r/ti ai kinki ori improperi positioningi soi fixi
thosei first.
Ai hemodialysisi clienti withi ai lefti armi fistulai isi ati riski fori arteriali steali
syndrome.i Thei nursei shouldi assessi fori whichi manifestationsi ofi thisi
complication?
1.i Warmth,i redness,i andi paini ini thei lefti hand
2.i Ecchymosisi andi audiblei bruiti overi thei fistula
3.i Edemai andi reddishi discolorationi ofi thei lefti arm
4.i Pallor,i diminishedi pulse,i andi paini ini thei lefti handi -i
i i i i i i i i i i i i i i 4
R:i Arteriali STEALi syndromei involvesi vasculari insufficiencyi (literallyi stealingi
thei bloodi thati thei hand'si tissuei needs!).i Soi you'di seei pallori andi otheri
signsi ofi decr.i perfusion.
1&3i soundi morei likei ani infectioni soi they'rei incorrect.i Optioni 2i isi ai
normali findingi fori ai fistula.
Thei nursei isi reviewingi ai client'si recordi andi notesi thati thei healthi carei
provideri hasi documentedi thati thei clienti hasi chronici renali disease.i Oni
reviewi ofi thei laboratoryi results,i thei nursei mosti likelyi wouldi expecti toi notei
whichi finding?
1.i Elevatedi creatininei level
2.i Decreasedi hemoglobini level
3.i Decreasedi redi bloodi celli count
4.i Increasedi numberi ofi whitei bloodi cellsi ini thei urinei -i
i i i i i i i i i i i i i i 1
R:i Creati isi increasedi onlyi byi kidneyi dysfunctioni ofi ati leasti 50%i loss.i
2&3i arei irrelevant.i 4i isi morei involvedi w/i UTIs.
Ai clienti withi chronici kidneyi diseasei returnsi toi thei nursingi uniti followingi ai
hemodialysisi treatment.i Oni assessment,i thei nursei notesi thati thei client'si
temperaturei isi 38.5°Ci (101.2°F).i Whichi nursingi actioni isi mosti appropriate?
1.i Encouragei fluidi intake.
2.i Notifyi thei healthi carei provider.
3.i Continuei toi monitori vitali signs.
4.i Monitori thei sitei ofi thei shunti fori infection.i -i
i i i i i i i i i i i i i i 2
R:i Optionsi 3&4i involvei assessment,i whichi isi normallyi goodi buti noti fori ai
priorityi situationi likei thisi soi they'rei incorrecti (you'lli justi watchi thei pti
deterioratei lol).i Youi knowi thati dialysisi patientsi havei fluidi restrictions,i soi
optioni 2i isi thei besti choicei sincei thei HCPi cani orderi furtheri &i treatment.
4i |i P a g e
(#1)i Ai clienti withi acutei kidneyi injuryi hasi ai serumi potassiumi leveli ofi 7.0i
mEq/Li (7.0i mmol/L).i Thei nursei shouldi plani whichi actionsi asi ai priority?i
Selecti alli thati apply.
1.i Placei thei clienti oni ai cardiaci monitor.
2.i Notifyi thei healthi carei provideri (HCP).
3.i Puti thei clienti oni NPOi (nothingi byi mouth)i statusi excepti fori icei chips.
4.i Reviewi thei client'si medicationsi toi determinei ifi anyi containi ori retaini
potassium.
5.i Allowi ani extrai 500i mLi ofi intravenousi fluidi intakei toi dilutei thei
electrolytei concentration.i -i
i i i i i i i i i i i i i i 1,i 2,i 4
R:i NPOi isi unnecessary.i Addingi extrai fluidi mayi worseni thei situationi andi
leadi toi fluidi overload.i Excessi Ki cani causei hearti dysrhythmias,i soi 1&4i arei
appropriate.i Callingi thei HCPi isi alsoi necessaryi fori furtheri orders.
(#2)i Ai clienti arrivesi ati thei emergencyi departmenti withi complaintsi ofi lowi
abdominali paini andi hematuria.i Thei clienti isi afebrile.i Thei nursei nexti
assessesi thei clienti toi determinei ai historyi ofi whichi condition?
1.i Pyelonephritis
2.i Glomerulonephritis
3.i Traumai toi thei bladderi ori abdomen
4.i Renali canceri ini thei client'si familyi -i
i i i i i i i i i i i i i i 3
R:i 1&i 2i arei similar/alike,i andi theyi wouldi involvei ai fever.i 4i wouldi havei
flanki paini insteadi ofi lowi abdi pain.
(#i 3)i Thei nursei discussesi plansi fori futurei treatmenti optionsi withi ai clienti
withi symptomatici polycystici kidneyi disease.i Whichi treatmenti shouldi bei
includedi ini thisi discussion?i Selecti alli thati apply.
1.i Hemodialysis
2.i Peritoneali dialysis
3.i Kidneyi transplant
4.i Bilaterali nephrectomy
5.i Intensei immunosuppressioni therapyi -i
i i i i i i i i i i i i i i 1,3,4
R:i Polycystici KDi involvesi cystsi thati eventuallyi rupturei andi damagei thei
kidneys,i leadingi toi end-stagei renali disease.i Thisi requiresi optionsi 1,i 3,i ori 4.i
2i isi contraindicatedi r/ti infection.i 5i won'ti helpi thei pt'si condition.
1i |i P a g e
,Ai clienti isi admittedi toi thei emergencyi departmenti followingi ai falli fromi ai
horsei andi thei healthi carei provideri (HCP)i prescribesi insertioni ofi ai urinaryi
catheter.i Whilei preparingi fori thei procedure,i thei nursei notesi bloodi ati thei
urinaryi meatus.i Thei nursei shouldi takei whichi action?
1.i Notifyi thei HCPi beforei performingi thei catheterization.
2.i Usei ai small-sizedi catheteri andi ani anesthetici geli asi ai lubricant.
3.i Administeri parenterali paini medicationi beforei insertingi thei catheter.
4.i Cleani thei meatusi withi soapi andi wateri beforei openingi thei catheterizationi
kit.i -i
i i i i i i i i i i i i i i 1
R:i bloodi mayi =i urethrali trauma,i soi youi needi toi notifyi thei HCPi firsti soi
youi cani identifyi thei truei causei ofi bloodi beforei catheterization.
Sincei there'si bloodi fromi ani unknowni cause,i youi needi toi assessi firsti beforei
doingi anythingi thati cani worseni it.
Thei nursei isi assessingi thei patencyi ofi ai client'si lefti armi arteriovenousi
fistulai priori toi initiatingi hemodialysis.i Whichi findingi indicatesi thati thei fistulai
isi patent?
1.i Palpationi ofi ai thrilli overi thei fistula
2.i Presencei ofi ai radiali pulsei ini thei lefti wrist
3.i Visualizationi ofi enlargedi bloodi vesselsi ati thei fistulai site
4.i Capillaryi refilli lessi thani 3i secondsi ini thei naili bedsi ofi thei fingersi oni
thei lefti handi -i
i i i i i i i i i i i i i i 1.
R:i listeni fori ai thrilli ori bruiti overi AVi fistulai site.i Alli otheri optionsi don'ti
REALLYi showi ifi thei AVi fistulai isi patent,i justi thati there'si perfusioni toi
thei hand.
Ai malei clienti hasi ai tentativei diagnosisi ofi urethritis.i Thei nursei shouldi
assessi thei clienti fori whichi manifestationi ofi thei disorder?
1.i Hematuriai andi pyuria
2.i Dysuriai andi proteinuria
3.i Hematuriai andi urgency
4.i Dysuriai andi penilei dischargei -i
i i i i i i i i i i i i i i 4.
R:i Urethritisi usuallyi involvesi dysuria,i soi 1&3i arei incorrect.i Proteinuriai isi r/ti
kidneyi dysfunction,i soi optioni 2i isi alsoi incorrect.i Urethritisi isi alsoi associatedi
withi chlamydia,i soi dischargei isi expected.i Hematuriai isi noti assoc.i withi
urethritis.
Thei nursei isi assessingi ai clienti withi epididymitis.i Thei nursei anticipatesi
whichi findingsi oni physicali examination?
1.i Fever,i diarrhea,i groini pain,i andi ecchymosis
2i |i P a g e
,2.i Nausea,i painfuli scrotali edema,i andi ecchymosis
3.i Fever,i nausea,i vomiting,i andi painfuli scrotali edema
4.i Diarrhea,i groini pain,i testiculari torsion,i andi scrotali edemai -i
i i i i i i i i i i i i i i 3
R:i -itisi isi associatedi w/i fever,i soi youi cani narrowi iti downi toi 1&3.i
Epididymitisi doesi noti involvei bleedingi soi ecchymosisi (optioni 1)i isi irrelevant.
Typicali signsi andi symptomsi ofi epididymitisi includei scrotali paini andi edema,i
whichi ofteni arei accompaniedi byi fever,i nauseai andi vomiting,i andi chills.
Ai clienti complainsi ofi fever,i perineali pain,i andi urinaryi urgency,i frequency,i
andi dysuria.i Toi assessi whetheri thei client'si problemi isi relatedi toi bacteriali
prostatitis,i thei nursei reviewsi thei resultsi ofi thei prostatei examinationi fori
whichi characteristici ofi thisi disorder?
1.i Softi andi swolleni prostatei gland
2.i Swollen,i andi boggyi prostatei gland
3.i Tenderi andi edematousi prostatei gland
4.i Tender,i induratedi prostatei glandi thati isi warmi toi thei touchi -i
i i i i i i i i i i i i i i 4
R:i Thei clienti withi bacteriali prostatitisi hasi ai swolleni andi tenderi prostatei
glandi thati isi alsoi warmi toi thei touch,i firm,i andi indurated.i Systemici
symptomsi includei feveri withi chills,i perineali andi lowi backi pain,i andi signsi
ofi urinaryi tracti infection,i whichi ofteni accompanyi thei disorder.
*Remember,i -itis=i inflammation/infection,i soi tendernessi andi locali warmthi isi
expected.i soi optioni 4i isi mosti correct.
Thei nursei isi collectingi datai fromi ai client.i Whichi symptomi describedi byi
thei clienti isi characteristici ofi ani earlyi symptomi ofi benigni prostatici
hyperplasia?
1.i Nocturia
2.i Scrotali edema
3.i Occasionali constipation
4.i Decreasedi forcei ini thei streami ofi urinei -i
i i i i i i i i i i i i i i 4
R:i Optioni 1i isi ai lateri sign.i 2&3i arei irrelevanti toi BPH.
Thei nursei monitoringi ai clienti receivingi peritoneali dialysisi notesi thati thei
client'si outflowi isi lessi thani thei inflow.i Whichi actionsi shouldi thei nursei
take?i Selecti alli thati apply.
1.i Checki thei leveli ofi thei drainagei bag.
2.i Repositioni thei clienti toi hisi ori heri side.
3.i Contacti thei healthi carei provideri (HCP).
4.i Placei thei clienti ini goodi bodyi alignment.
5.i Checki thei peritoneali dialysisi systemi fori kinks.
6.i Increasei thei flowi ratei ofi thei peritoneali dialysisi solution.i -i
3i |i P a g e
, i i i i i i i i i i i i i i 1,2,4,5
R:i Tryi toi fixi thei flowi yourselfi beforei callingi thei HCPi ori messingi withi
thei flowi rate.i Imbalancei mayi bei r/ti ai kinki ori improperi positioningi soi fixi
thosei first.
Ai hemodialysisi clienti withi ai lefti armi fistulai isi ati riski fori arteriali steali
syndrome.i Thei nursei shouldi assessi fori whichi manifestationsi ofi thisi
complication?
1.i Warmth,i redness,i andi paini ini thei lefti hand
2.i Ecchymosisi andi audiblei bruiti overi thei fistula
3.i Edemai andi reddishi discolorationi ofi thei lefti arm
4.i Pallor,i diminishedi pulse,i andi paini ini thei lefti handi -i
i i i i i i i i i i i i i i 4
R:i Arteriali STEALi syndromei involvesi vasculari insufficiencyi (literallyi stealingi
thei bloodi thati thei hand'si tissuei needs!).i Soi you'di seei pallori andi otheri
signsi ofi decr.i perfusion.
1&3i soundi morei likei ani infectioni soi they'rei incorrect.i Optioni 2i isi ai
normali findingi fori ai fistula.
Thei nursei isi reviewingi ai client'si recordi andi notesi thati thei healthi carei
provideri hasi documentedi thati thei clienti hasi chronici renali disease.i Oni
reviewi ofi thei laboratoryi results,i thei nursei mosti likelyi wouldi expecti toi notei
whichi finding?
1.i Elevatedi creatininei level
2.i Decreasedi hemoglobini level
3.i Decreasedi redi bloodi celli count
4.i Increasedi numberi ofi whitei bloodi cellsi ini thei urinei -i
i i i i i i i i i i i i i i 1
R:i Creati isi increasedi onlyi byi kidneyi dysfunctioni ofi ati leasti 50%i loss.i
2&3i arei irrelevant.i 4i isi morei involvedi w/i UTIs.
Ai clienti withi chronici kidneyi diseasei returnsi toi thei nursingi uniti followingi ai
hemodialysisi treatment.i Oni assessment,i thei nursei notesi thati thei client'si
temperaturei isi 38.5°Ci (101.2°F).i Whichi nursingi actioni isi mosti appropriate?
1.i Encouragei fluidi intake.
2.i Notifyi thei healthi carei provider.
3.i Continuei toi monitori vitali signs.
4.i Monitori thei sitei ofi thei shunti fori infection.i -i
i i i i i i i i i i i i i i 2
R:i Optionsi 3&4i involvei assessment,i whichi isi normallyi goodi buti noti fori ai
priorityi situationi likei thisi soi they'rei incorrecti (you'lli justi watchi thei pti
deterioratei lol).i Youi knowi thati dialysisi patientsi havei fluidi restrictions,i soi
optioni 2i isi thei besti choicei sincei thei HCPi cani orderi furtheri &i treatment.
4i |i P a g e
