NCLEXz -z Renalz &z Urinary
Az clientz whoz hadz cardiacz surgeryz 24z hoursz agoz hasz hadz az urinez
outputz averagingz 20z mL/hrz forz 2z hours.z Thez clientz receivedz az singlez
bolusz ofz 500z mLz ofz intravenousz fluid.z Urinez outputz forz thez subsequentz
hourz wasz 25z mL.z Dailyz laboratoryz resultsz indicatez thatz thez bloodz ureaz
nitrogenz levelz isz 45z mg/dLz (16z mmol/L)z andz thez serumz creatininez levelz
isz 2.2z mg/dLz (194z mcmol/L).z Onz thez basisz ofz thesez findings,z thez nursez
wouldz anticipatez thatz thez clientz isz atz riskz forz whichz problem?z -z
z z z z z z z z z z z z z z z z z z z z z Acutez kidneyz injury
Az clientz withz acutez kidneyz injuryz hasz az serumz potassiumz levelz ofz 7.0z
mEq/Lz (7.0z mmol/L).z Thez nursez shouldz planz whichz actionsz asz az priority?z
Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Placez thez clientz onz az cardiacz
monitor.
Notifyz thez primaryz healthz carez providerz (PHCP).
Reviewz thez client'sz medicationsz toz determinez whetherz anyz containz orz
retainz potassium.
Az clientz arrivesz atz thez emergencyz departmentz withz complaintsz ofz lowz
abdominalz painz andz hematuria.z Thez clientz isz afebrile.z Thez nursez nextz
assessesz thez clientz toz determinez az historyz ofz whichz condition?z -z
z z z z z z z z z z z z z z z z z z z z z Traumaz toz thez bladderz orz
abdomen
Thez nursez discussesz plansz forz futurez treatmentz optionsz withz az clientz withz
symptomaticz polycysticz kidneyz disease.z Whichz treatmentz shouldz bez includedz
inz thisz discussion?z Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Hemodialysis
Kidneyz transplant
Bilateralz nephrectomy
Az clientz isz admittedz toz thez emergencyz departmentz followingz az fallz fromz
az horse,z andz thez primaryz healthz carez providerz (PHCP)z prescribesz insertionz
ofz az urinaryz catheter.z Whilez preparingz forz thez procedure,z thez nursez notesz
bloodz atz thez urinaryz meatus.z Thez nursez shouldz takez whichz action?z -z
z z z z z z z z z z z z z z z z z z z z z Notifyz thez PHCPz beforez
performingz thez catheterization.
Thez nursez isz assessingz thez patencyz ofz az client'sz leftz armz arteriovenousz
fistulaz priorz toz initiatingz hemodialysis.z Whichz findingz indicatesz thatz thez
fistulaz isz patent?z -z
z z z z z z z z z z z z z z z z z z z z z Palpationz ofz az thrillz overz thez
fistula.
Az malez clientz hasz az tentativez diagnosisz ofz urethritis.z Thez nursez shouldz
assessz thez clientz forz whichz manifestationz ofz thez disorder?z -z
1z |z P a g e
,z z z z z z z z z z z z z z z z z z z z z Dysuriaz andz penilez discharge
Thez nursez isz assessingz az clientz withz epididymitis.z Thez nursez anticipatesz
whichz findingsz onz physicalz examination?z -z
z z z z z z z z z z z z z z z z z z z z z Fever,z nausea,z vomiting,z andz
painfulz scrotalz edema
Az clientz complainsz ofz fever,z perinealz pain,z andz urinaryz urgency,z
frequency,z andz dysuria.z Toz assessz whetherz thez client'sz problemz isz relatedz
toz bacterialz prostatitis,z thez nursez reviewsz thez resultsz ofz thez prostatez
examinationz forz whichz characteristicz ofz thisz disorder?z -z
z z z z z z z z z z z z z z z z z z z z z Tender,z induratedz prostatez glandz
thatz isz warmz toz thez touch
Thez nursez isz collectingz dataz fromz az client.z Whichz symptomz describedz byz
thez clientz isz characteristicz ofz anz earlyz symptomz ofz benignz prostaticz
hyperplasia?z -z
z z z z z z z z z z z z z z z z z z z z z Decreasedz forcez inz thez streamz
ofz urine
Thez nursez monitoringz az clientz receivingz peritonealz dialysisz notesz thatz thez
client'sz outflowz isz lessz thanz thez inflow.z Whichz actionsz shouldz thez nursez
take?z Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Checkz thez levelz ofz thez drainagez
bag.
Repositionz thez clientz toz herz orz hisz side.
Placez thez clientz inz goodz bodyz alignment.
Checkz thez peritonealz dialysisz systemz forz kinks.
Az hemodialysisz clientz withz az leftz armz fistulaz isz atz riskz forz arterialz
stealz syndrome.z Thez nursez shouldz assessz forz whichz manifestationsz ofz thisz
complication?z -z
z z z z z z z z z z z z z z z z z z z z z Pallor,z diminishedz pulse,z andz
painz inz thez leftz hand
Thez nursez isz reviewingz az client'sz recordz andz notesz thatz thez primaryz
healthz carez providerz hasz documentedz thatz thez clientz hasz chronicz kidneyz
disease.z Onz reviewz ofz thez laboratoryz results,z thez nursez mostz likelyz wouldz
expectz toz notez whichz finding?z -z
z z z z z z z z z z z z z z z z z z z z z Elevatedz creatininez level
Az clientz withz chronicz kidneyz diseasez returnsz toz thez nursingz unitz
followingz az hemodialysisz treatment.z Onz assessment,z thez nursez notesz thatz
thez client'sz temperaturez isz 38.5°z Cz (101.2°z F).z Whichz nursingz actionz isz
mostz appropriate?z -z
z z z z z z z z z z z z z z z z z z z z z Notifyz thez primaryz healthz carez
provider.
Thez nursez isz performingz anz assessmentz onz az clientz whoz hasz returnedz
fromz thez dialysisz unitz followingz hemodialysis.z Thez clientz isz complainingz
2z |z P a g e
, ofz headachez andz nauseaz andz isz extremelyz restless.z Whichz isz thez priorityz
nursingz action?z -z
z z z z z z z z z z z z z z z z z z z z z Notifyz thez primaryz healthz carez
providerz (PHCP).
Az clientz withz severez backz painz andz hematuriaz isz foundz toz havez
hydronephrosisz duez toz urolithiasis.z Thez nursez anticipatesz whichz treatmentz
willz bez donez toz relievez thez obstruction?z Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Insertionz ofz az nephrostomyz tube
Placementz ofz az ureteralz stentz withz ureteroscopy
Thez nursez isz instructingz az clientz withz diabetesz mellitusz aboutz peritonealz
dialysis.z Thez nursez tellsz thez clientz thatz itz isz importantz toz maintainz thez
prescribedz dwellz timez forz thez dialysisz becausez ofz thez riskz ofz whichz
complication?z -z
z z z z z z z z z z z z z z z z z z z z z Hyperglycemia
Az weekz afterz kidneyz transplantation,z az clientz developsz az temperaturez ofz
101°z Fz (38.3°z C),z thez bloodz pressurez isz elevated,z andz therez isz
tendernessz overz thez transplantedz kidney.z Thez serumz creatininez isz risingz
andz urinez outputz isz decreased.z Thez x-rayz indicatesz thatz thez transplantedz
kidneyz isz enlarged.z Basedz onz thesez assessmentz findings,z thez nursez
anticipatesz whichz treatment?z -z
z z z z z z z z z z z z z z z z z z z z z Increasedz immunosuppressionz
therapy
Az clientz isz admittedz toz thez hospitalz withz az diagnosisz ofz benignz prostaticz
hyperplasia,z andz az transurethralz resectionz ofz thez prostatez isz performed.z
Fourz hoursz afterz surgery,z thez nursez takesz thez client'sz vitalz signsz andz
emptiesz thez urinaryz drainagez bag.z Whichz assessmentz findingz indicatesz thez
needz toz notifyz thez primaryz healthz carez providerz (PHCP)?z -z
z z z z z z z z z z z z z z z z z z z z z Bloodz pressure,z 100/50z mmz Hg;z
pulse,z 130z beatsz perz minute
Thez clientz newlyz diagnosedz withz chronicz kidneyz diseasez recentlyz hasz
begunz hemodialysis.z Knowingz thatz thez clientz isz atz riskz forz disequilibriumz
syndrome,z thez nursez shouldz assessz thez clientz duringz dialysisz forz whichz
associatedz manifestations?z -z
z z z z z z z z z z z z z z z z z z z z z Headache,z deterioratingz levelz ofz
consciousness,z andz twitching
Az clientz whoz hasz az coldz isz seenz inz thez emergencyz departmentz withz anz
inabilityz toz void.z Becausez thez clientz hasz az historyz ofz benignz prostaticz
hyperplasia,z thez nursez determinesz thatz thez clientz shouldz bez questionedz
aboutz thez usez ofz whichz medication?z -z
z z z z z z z z z z z z z z z z z z z z z Decongestants
Thez nursez isz conductingz anz interviewz ofz anz olderz clientz andz isz
concernedz aboutz thez possibilityz ofz benignz prostaticz hyperplasiaz (BPH).z
Whichz arez characteristicsz ofz thisz disorder?z Selectz allz thatz apply.z -z
3z |z P a g e
Az clientz whoz hadz cardiacz surgeryz 24z hoursz agoz hasz hadz az urinez
outputz averagingz 20z mL/hrz forz 2z hours.z Thez clientz receivedz az singlez
bolusz ofz 500z mLz ofz intravenousz fluid.z Urinez outputz forz thez subsequentz
hourz wasz 25z mL.z Dailyz laboratoryz resultsz indicatez thatz thez bloodz ureaz
nitrogenz levelz isz 45z mg/dLz (16z mmol/L)z andz thez serumz creatininez levelz
isz 2.2z mg/dLz (194z mcmol/L).z Onz thez basisz ofz thesez findings,z thez nursez
wouldz anticipatez thatz thez clientz isz atz riskz forz whichz problem?z -z
z z z z z z z z z z z z z z z z z z z z z Acutez kidneyz injury
Az clientz withz acutez kidneyz injuryz hasz az serumz potassiumz levelz ofz 7.0z
mEq/Lz (7.0z mmol/L).z Thez nursez shouldz planz whichz actionsz asz az priority?z
Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Placez thez clientz onz az cardiacz
monitor.
Notifyz thez primaryz healthz carez providerz (PHCP).
Reviewz thez client'sz medicationsz toz determinez whetherz anyz containz orz
retainz potassium.
Az clientz arrivesz atz thez emergencyz departmentz withz complaintsz ofz lowz
abdominalz painz andz hematuria.z Thez clientz isz afebrile.z Thez nursez nextz
assessesz thez clientz toz determinez az historyz ofz whichz condition?z -z
z z z z z z z z z z z z z z z z z z z z z Traumaz toz thez bladderz orz
abdomen
Thez nursez discussesz plansz forz futurez treatmentz optionsz withz az clientz withz
symptomaticz polycysticz kidneyz disease.z Whichz treatmentz shouldz bez includedz
inz thisz discussion?z Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Hemodialysis
Kidneyz transplant
Bilateralz nephrectomy
Az clientz isz admittedz toz thez emergencyz departmentz followingz az fallz fromz
az horse,z andz thez primaryz healthz carez providerz (PHCP)z prescribesz insertionz
ofz az urinaryz catheter.z Whilez preparingz forz thez procedure,z thez nursez notesz
bloodz atz thez urinaryz meatus.z Thez nursez shouldz takez whichz action?z -z
z z z z z z z z z z z z z z z z z z z z z Notifyz thez PHCPz beforez
performingz thez catheterization.
Thez nursez isz assessingz thez patencyz ofz az client'sz leftz armz arteriovenousz
fistulaz priorz toz initiatingz hemodialysis.z Whichz findingz indicatesz thatz thez
fistulaz isz patent?z -z
z z z z z z z z z z z z z z z z z z z z z Palpationz ofz az thrillz overz thez
fistula.
Az malez clientz hasz az tentativez diagnosisz ofz urethritis.z Thez nursez shouldz
assessz thez clientz forz whichz manifestationz ofz thez disorder?z -z
1z |z P a g e
,z z z z z z z z z z z z z z z z z z z z z Dysuriaz andz penilez discharge
Thez nursez isz assessingz az clientz withz epididymitis.z Thez nursez anticipatesz
whichz findingsz onz physicalz examination?z -z
z z z z z z z z z z z z z z z z z z z z z Fever,z nausea,z vomiting,z andz
painfulz scrotalz edema
Az clientz complainsz ofz fever,z perinealz pain,z andz urinaryz urgency,z
frequency,z andz dysuria.z Toz assessz whetherz thez client'sz problemz isz relatedz
toz bacterialz prostatitis,z thez nursez reviewsz thez resultsz ofz thez prostatez
examinationz forz whichz characteristicz ofz thisz disorder?z -z
z z z z z z z z z z z z z z z z z z z z z Tender,z induratedz prostatez glandz
thatz isz warmz toz thez touch
Thez nursez isz collectingz dataz fromz az client.z Whichz symptomz describedz byz
thez clientz isz characteristicz ofz anz earlyz symptomz ofz benignz prostaticz
hyperplasia?z -z
z z z z z z z z z z z z z z z z z z z z z Decreasedz forcez inz thez streamz
ofz urine
Thez nursez monitoringz az clientz receivingz peritonealz dialysisz notesz thatz thez
client'sz outflowz isz lessz thanz thez inflow.z Whichz actionsz shouldz thez nursez
take?z Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Checkz thez levelz ofz thez drainagez
bag.
Repositionz thez clientz toz herz orz hisz side.
Placez thez clientz inz goodz bodyz alignment.
Checkz thez peritonealz dialysisz systemz forz kinks.
Az hemodialysisz clientz withz az leftz armz fistulaz isz atz riskz forz arterialz
stealz syndrome.z Thez nursez shouldz assessz forz whichz manifestationsz ofz thisz
complication?z -z
z z z z z z z z z z z z z z z z z z z z z Pallor,z diminishedz pulse,z andz
painz inz thez leftz hand
Thez nursez isz reviewingz az client'sz recordz andz notesz thatz thez primaryz
healthz carez providerz hasz documentedz thatz thez clientz hasz chronicz kidneyz
disease.z Onz reviewz ofz thez laboratoryz results,z thez nursez mostz likelyz wouldz
expectz toz notez whichz finding?z -z
z z z z z z z z z z z z z z z z z z z z z Elevatedz creatininez level
Az clientz withz chronicz kidneyz diseasez returnsz toz thez nursingz unitz
followingz az hemodialysisz treatment.z Onz assessment,z thez nursez notesz thatz
thez client'sz temperaturez isz 38.5°z Cz (101.2°z F).z Whichz nursingz actionz isz
mostz appropriate?z -z
z z z z z z z z z z z z z z z z z z z z z Notifyz thez primaryz healthz carez
provider.
Thez nursez isz performingz anz assessmentz onz az clientz whoz hasz returnedz
fromz thez dialysisz unitz followingz hemodialysis.z Thez clientz isz complainingz
2z |z P a g e
, ofz headachez andz nauseaz andz isz extremelyz restless.z Whichz isz thez priorityz
nursingz action?z -z
z z z z z z z z z z z z z z z z z z z z z Notifyz thez primaryz healthz carez
providerz (PHCP).
Az clientz withz severez backz painz andz hematuriaz isz foundz toz havez
hydronephrosisz duez toz urolithiasis.z Thez nursez anticipatesz whichz treatmentz
willz bez donez toz relievez thez obstruction?z Selectz allz thatz apply.z -z
z z z z z z z z z z z z z z z z z z z z z Insertionz ofz az nephrostomyz tube
Placementz ofz az ureteralz stentz withz ureteroscopy
Thez nursez isz instructingz az clientz withz diabetesz mellitusz aboutz peritonealz
dialysis.z Thez nursez tellsz thez clientz thatz itz isz importantz toz maintainz thez
prescribedz dwellz timez forz thez dialysisz becausez ofz thez riskz ofz whichz
complication?z -z
z z z z z z z z z z z z z z z z z z z z z Hyperglycemia
Az weekz afterz kidneyz transplantation,z az clientz developsz az temperaturez ofz
101°z Fz (38.3°z C),z thez bloodz pressurez isz elevated,z andz therez isz
tendernessz overz thez transplantedz kidney.z Thez serumz creatininez isz risingz
andz urinez outputz isz decreased.z Thez x-rayz indicatesz thatz thez transplantedz
kidneyz isz enlarged.z Basedz onz thesez assessmentz findings,z thez nursez
anticipatesz whichz treatment?z -z
z z z z z z z z z z z z z z z z z z z z z Increasedz immunosuppressionz
therapy
Az clientz isz admittedz toz thez hospitalz withz az diagnosisz ofz benignz prostaticz
hyperplasia,z andz az transurethralz resectionz ofz thez prostatez isz performed.z
Fourz hoursz afterz surgery,z thez nursez takesz thez client'sz vitalz signsz andz
emptiesz thez urinaryz drainagez bag.z Whichz assessmentz findingz indicatesz thez
needz toz notifyz thez primaryz healthz carez providerz (PHCP)?z -z
z z z z z z z z z z z z z z z z z z z z z Bloodz pressure,z 100/50z mmz Hg;z
pulse,z 130z beatsz perz minute
Thez clientz newlyz diagnosedz withz chronicz kidneyz diseasez recentlyz hasz
begunz hemodialysis.z Knowingz thatz thez clientz isz atz riskz forz disequilibriumz
syndrome,z thez nursez shouldz assessz thez clientz duringz dialysisz forz whichz
associatedz manifestations?z -z
z z z z z z z z z z z z z z z z z z z z z Headache,z deterioratingz levelz ofz
consciousness,z andz twitching
Az clientz whoz hasz az coldz isz seenz inz thez emergencyz departmentz withz anz
inabilityz toz void.z Becausez thez clientz hasz az historyz ofz benignz prostaticz
hyperplasia,z thez nursez determinesz thatz thez clientz shouldz bez questionedz
aboutz thez usez ofz whichz medication?z -z
z z z z z z z z z z z z z z z z z z z z z Decongestants
Thez nursez isz conductingz anz interviewz ofz anz olderz clientz andz isz
concernedz aboutz thez possibilityz ofz benignz prostaticz hyperplasiaz (BPH).z
Whichz arez characteristicsz ofz thisz disorder?z Selectz allz thatz apply.z -z
3z |z P a g e
