NCLEXi -i Renali &i Urinary
Ai clienti whoi hadi cardiaci surgeryi 24i hoursi agoi hasi hadi ai urinei outputi
averagingi 20i mL/hri fori 2i hours.i Thei clienti receivedi ai singlei bolusi ofi 500i
mLi ofi intravenousi fluid.i Urinei outputi fori thei subsequenti houri wasi 25i mL.i
Dailyi laboratoryi resultsi indicatei thati thei bloodi ureai nitrogeni leveli isi 45i
mg/dLi (16i mmol/L)i andi thei serumi creatininei leveli isi 2.2i mg/dLi (194i
mcmol/L).i Oni thei basisi ofi thesei findings,i thei nursei wouldi anticipatei thati
thei clienti isi ati riski fori whichi problem?i -i
i i i i i i i i i i i i i i i i i i i i i Acutei kidneyi injury
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.i -i
i i i i i i i i i i i i i i i i i i i i i Placei thei clienti oni ai cardiaci monitor.
Notifyi thei primaryi healthi carei provideri (PHCP).
Reviewi thei client'si medicationsi toi determinei whetheri anyi containi ori retaini
potassium.
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?i -i
i i i i i i i i i i i i i i i i i i i i i Traumai toi thei bladderi ori abdomen
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.i -i
i i i i i i i i i i i i i i i i i i i i i Hemodialysis
Kidneyi transplant
Bilaterali nephrectomy
Ai clienti isi admittedi toi thei emergencyi departmenti followingi ai falli fromi ai
horse,i andi thei primaryi healthi carei provideri (PHCP)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?i -i
i i i i i i i i i i i i i i i i i i i i i Notifyi thei PHCPi beforei performingi thei
catheterization.
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?i -i
i i i i i i i i i i i i i i i i i i i i i Palpationi ofi ai thrilli overi thei fistula.
Ai malei clienti hasi ai tentativei diagnosisi ofi urethritis.i Thei nursei shouldi
assessi thei clienti fori whichi manifestationi ofi thei disorder?i -i
i i i i i i i i i i i i i i i i i i i i i Dysuriai andi penilei discharge
1i |i P a g e
,Thei nursei isi assessingi ai clienti withi epididymitis.i Thei nursei anticipatesi
whichi findingsi oni physicali examination?i -i
i i i i i i i i i i i i i i i i i i i i i Fever,i nausea,i vomiting,i andi painfuli
scrotali edema
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?i -i
i i i i i i i i i i i i i i i i i i i i i Tender,i induratedi prostatei glandi thati isi
warmi toi thei touch
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?i -i
i i i i i i i i i i i i i i i i i i i i i Decreasedi forcei ini thei streami ofi urine
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.i -i
i i i i i i i i i i i i i i i i i i i i i Checki thei leveli ofi thei drainagei bag.
Repositioni thei clienti toi heri ori hisi side.
Placei thei clienti ini goodi bodyi alignment.
Checki thei peritoneali dialysisi systemi fori kinks.
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?i -i
i i i i i i i i i i i i i i i i i i i i i Pallor,i diminishedi pulse,i andi paini ini
thei lefti hand
Thei nursei isi reviewingi ai client'si recordi andi notesi thati thei primaryi healthi
carei provideri hasi documentedi thati thei clienti hasi chronici kidneyi disease.i Oni
reviewi ofi thei laboratoryi results,i thei nursei mosti likelyi wouldi expecti toi notei
whichi finding?i -i
i i i i i i i i i i i i i i i i i i i i i Elevatedi creatininei level
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°i Ci (101.2°i F).i Whichi nursingi actioni isi mosti
appropriate?i -i
i i i i i i i i i i i i i i i i i i i i i Notifyi thei primaryi healthi carei provider.
Thei nursei isi performingi ani assessmenti oni ai clienti whoi hasi returnedi fromi
thei dialysisi uniti followingi hemodialysis.i Thei clienti isi complainingi ofi
headachei andi nauseai andi isi extremelyi restless.i Whichi isi thei priorityi nursingi
action?i -i
i i i i i i i i i i i i i i i i i i i i i Notifyi thei primaryi healthi carei provideri
(PHCP).
2i |i P a g e
, Ai clienti withi severei backi paini andi hematuriai isi foundi toi havei
hydronephrosisi duei toi urolithiasis.i Thei nursei anticipatesi whichi treatmenti willi
bei donei toi relievei thei obstruction?i Selecti alli thati apply.i -i
i i i i i i i i i i i i i i i i i i i i i Insertioni ofi ai nephrostomyi tube
Placementi ofi ai ureterali stenti withi ureteroscopy
Thei nursei isi instructingi ai clienti withi diabetesi mellitusi abouti peritoneali
dialysis.i Thei nursei tellsi thei clienti thati iti isi importanti toi maintaini thei
prescribedi dwelli timei fori thei dialysisi becausei ofi thei riski ofi whichi
complication?i -i
i i i i i i i i i i i i i i i i i i i i i Hyperglycemia
Ai weeki afteri kidneyi transplantation,i ai clienti developsi ai temperaturei ofi 101°i
Fi (38.3°i C),i thei bloodi pressurei isi elevated,i andi therei isi tendernessi overi
thei transplantedi kidney.i Thei serumi creatininei isi risingi andi urinei outputi isi
decreased.i Thei x-rayi indicatesi thati thei transplantedi kidneyi isi enlarged.i Basedi
oni thesei assessmenti findings,i thei nursei anticipatesi whichi treatment?i -i
i i i i i i i i i i i i i i i i i i i i i Increasedi immunosuppressioni therapy
Ai clienti isi admittedi toi thei hospitali withi ai diagnosisi ofi benigni prostatici
hyperplasia,i andi ai transurethrali resectioni ofi thei prostatei isi performed.i Fouri
hoursi afteri surgery,i thei nursei takesi thei client'si vitali signsi andi emptiesi thei
urinaryi drainagei bag.i Whichi assessmenti findingi indicatesi thei needi toi notifyi
thei primaryi healthi carei provideri (PHCP)?i -i
i i i i i i i i i i i i i i i i i i i i i Bloodi pressure,i 100/50i mmi Hg;i pulse,i
130i beatsi peri minute
Thei clienti newlyi diagnosedi withi chronici kidneyi diseasei recentlyi hasi beguni
hemodialysis.i Knowingi thati thei clienti isi ati riski fori disequilibriumi syndrome,i
thei nursei shouldi assessi thei clienti duringi dialysisi fori whichi associatedi
manifestations?i -i
i i i i i i i i i i i i i i i i i i i i i Headache,i deterioratingi leveli ofi
consciousness,i andi twitching
Ai clienti whoi hasi ai coldi isi seeni ini thei emergencyi departmenti withi ani
inabilityi toi void.i Becausei thei clienti hasi ai historyi ofi benigni prostatici
hyperplasia,i thei nursei determinesi thati thei clienti shouldi bei questionedi abouti
thei usei ofi whichi medication?i -i
i i i i i i i i i i i i i i i i i i i i i Decongestants
Thei nursei isi conductingi ani interviewi ofi ani olderi clienti andi isi concernedi
abouti thei possibilityi ofi benigni prostatici hyperplasiai (BPH).i Whichi arei
characteristicsi ofi thisi disorder?i Selecti alli thati apply.i -i
i i i i i i i i i i i i i i i i i i i i i Nocturia
Incontinence
Enlargedi prostate
Ai clienti recentlyi diagnosedi withi chronici kidneyi diseasei requiringi hemodialysisi
hasi ani arteriovenousi fistulai fori access.i Thei clienti asksi thei nursei whati
3i |i P a g e
Ai clienti whoi hadi cardiaci surgeryi 24i hoursi agoi hasi hadi ai urinei outputi
averagingi 20i mL/hri fori 2i hours.i Thei clienti receivedi ai singlei bolusi ofi 500i
mLi ofi intravenousi fluid.i Urinei outputi fori thei subsequenti houri wasi 25i mL.i
Dailyi laboratoryi resultsi indicatei thati thei bloodi ureai nitrogeni leveli isi 45i
mg/dLi (16i mmol/L)i andi thei serumi creatininei leveli isi 2.2i mg/dLi (194i
mcmol/L).i Oni thei basisi ofi thesei findings,i thei nursei wouldi anticipatei thati
thei clienti isi ati riski fori whichi problem?i -i
i i i i i i i i i i i i i i i i i i i i i Acutei kidneyi injury
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.i -i
i i i i i i i i i i i i i i i i i i i i i Placei thei clienti oni ai cardiaci monitor.
Notifyi thei primaryi healthi carei provideri (PHCP).
Reviewi thei client'si medicationsi toi determinei whetheri anyi containi ori retaini
potassium.
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?i -i
i i i i i i i i i i i i i i i i i i i i i Traumai toi thei bladderi ori abdomen
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.i -i
i i i i i i i i i i i i i i i i i i i i i Hemodialysis
Kidneyi transplant
Bilaterali nephrectomy
Ai clienti isi admittedi toi thei emergencyi departmenti followingi ai falli fromi ai
horse,i andi thei primaryi healthi carei provideri (PHCP)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?i -i
i i i i i i i i i i i i i i i i i i i i i Notifyi thei PHCPi beforei performingi thei
catheterization.
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?i -i
i i i i i i i i i i i i i i i i i i i i i Palpationi ofi ai thrilli overi thei fistula.
Ai malei clienti hasi ai tentativei diagnosisi ofi urethritis.i Thei nursei shouldi
assessi thei clienti fori whichi manifestationi ofi thei disorder?i -i
i i i i i i i i i i i i i i i i i i i i i Dysuriai andi penilei discharge
1i |i P a g e
,Thei nursei isi assessingi ai clienti withi epididymitis.i Thei nursei anticipatesi
whichi findingsi oni physicali examination?i -i
i i i i i i i i i i i i i i i i i i i i i Fever,i nausea,i vomiting,i andi painfuli
scrotali edema
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?i -i
i i i i i i i i i i i i i i i i i i i i i Tender,i induratedi prostatei glandi thati isi
warmi toi thei touch
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?i -i
i i i i i i i i i i i i i i i i i i i i i Decreasedi forcei ini thei streami ofi urine
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.i -i
i i i i i i i i i i i i i i i i i i i i i Checki thei leveli ofi thei drainagei bag.
Repositioni thei clienti toi heri ori hisi side.
Placei thei clienti ini goodi bodyi alignment.
Checki thei peritoneali dialysisi systemi fori kinks.
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?i -i
i i i i i i i i i i i i i i i i i i i i i Pallor,i diminishedi pulse,i andi paini ini
thei lefti hand
Thei nursei isi reviewingi ai client'si recordi andi notesi thati thei primaryi healthi
carei provideri hasi documentedi thati thei clienti hasi chronici kidneyi disease.i Oni
reviewi ofi thei laboratoryi results,i thei nursei mosti likelyi wouldi expecti toi notei
whichi finding?i -i
i i i i i i i i i i i i i i i i i i i i i Elevatedi creatininei level
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°i Ci (101.2°i F).i Whichi nursingi actioni isi mosti
appropriate?i -i
i i i i i i i i i i i i i i i i i i i i i Notifyi thei primaryi healthi carei provider.
Thei nursei isi performingi ani assessmenti oni ai clienti whoi hasi returnedi fromi
thei dialysisi uniti followingi hemodialysis.i Thei clienti isi complainingi ofi
headachei andi nauseai andi isi extremelyi restless.i Whichi isi thei priorityi nursingi
action?i -i
i i i i i i i i i i i i i i i i i i i i i Notifyi thei primaryi healthi carei provideri
(PHCP).
2i |i P a g e
, Ai clienti withi severei backi paini andi hematuriai isi foundi toi havei
hydronephrosisi duei toi urolithiasis.i Thei nursei anticipatesi whichi treatmenti willi
bei donei toi relievei thei obstruction?i Selecti alli thati apply.i -i
i i i i i i i i i i i i i i i i i i i i i Insertioni ofi ai nephrostomyi tube
Placementi ofi ai ureterali stenti withi ureteroscopy
Thei nursei isi instructingi ai clienti withi diabetesi mellitusi abouti peritoneali
dialysis.i Thei nursei tellsi thei clienti thati iti isi importanti toi maintaini thei
prescribedi dwelli timei fori thei dialysisi becausei ofi thei riski ofi whichi
complication?i -i
i i i i i i i i i i i i i i i i i i i i i Hyperglycemia
Ai weeki afteri kidneyi transplantation,i ai clienti developsi ai temperaturei ofi 101°i
Fi (38.3°i C),i thei bloodi pressurei isi elevated,i andi therei isi tendernessi overi
thei transplantedi kidney.i Thei serumi creatininei isi risingi andi urinei outputi isi
decreased.i Thei x-rayi indicatesi thati thei transplantedi kidneyi isi enlarged.i Basedi
oni thesei assessmenti findings,i thei nursei anticipatesi whichi treatment?i -i
i i i i i i i i i i i i i i i i i i i i i Increasedi immunosuppressioni therapy
Ai clienti isi admittedi toi thei hospitali withi ai diagnosisi ofi benigni prostatici
hyperplasia,i andi ai transurethrali resectioni ofi thei prostatei isi performed.i Fouri
hoursi afteri surgery,i thei nursei takesi thei client'si vitali signsi andi emptiesi thei
urinaryi drainagei bag.i Whichi assessmenti findingi indicatesi thei needi toi notifyi
thei primaryi healthi carei provideri (PHCP)?i -i
i i i i i i i i i i i i i i i i i i i i i Bloodi pressure,i 100/50i mmi Hg;i pulse,i
130i beatsi peri minute
Thei clienti newlyi diagnosedi withi chronici kidneyi diseasei recentlyi hasi beguni
hemodialysis.i Knowingi thati thei clienti isi ati riski fori disequilibriumi syndrome,i
thei nursei shouldi assessi thei clienti duringi dialysisi fori whichi associatedi
manifestations?i -i
i i i i i i i i i i i i i i i i i i i i i Headache,i deterioratingi leveli ofi
consciousness,i andi twitching
Ai clienti whoi hasi ai coldi isi seeni ini thei emergencyi departmenti withi ani
inabilityi toi void.i Becausei thei clienti hasi ai historyi ofi benigni prostatici
hyperplasia,i thei nursei determinesi thati thei clienti shouldi bei questionedi abouti
thei usei ofi whichi medication?i -i
i i i i i i i i i i i i i i i i i i i i i Decongestants
Thei nursei isi conductingi ani interviewi ofi ani olderi clienti andi isi concernedi
abouti thei possibilityi ofi benigni prostatici hyperplasiai (BPH).i Whichi arei
characteristicsi ofi thisi disorder?i Selecti alli thati apply.i -i
i i i i i i i i i i i i i i i i i i i i i Nocturia
Incontinence
Enlargedi prostate
Ai clienti recentlyi diagnosedi withi chronici kidneyi diseasei requiringi hemodialysisi
hasi ani arteriovenousi fistulai fori access.i Thei clienti asksi thei nursei whati
3i |i P a g e
