NCLEX - Renal & Urinary
A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hr for 2
hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the
subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is
45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of
these findings, the nurse would anticipate that the client is at risk for which problem? -
✅Acute kidney injury
A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The
nurse should plan which actions as a priority? Select all that apply. -
✅Place the client on a cardiac monitor.
Notify the primary health care provider (PHCP).
Review the client's medications to determine whether any contain or retain potassium.
A client arrives at the emergency department with complaints of low abdominal pain and hematuria.
The client is afebrile. The nurse next assesses the client to determine a history of which condition? -
✅Trauma to the bladder or abdomen
The nurse discusses plans for future treatment options with a client with symptomatic polycystic
kidney disease. Which treatment should be included in this discussion? Select all that apply. -
✅Hemodialysis
Kidney transplant
Bilateral nephrectomy
A client is admitted to the emergency department following a fall from a horse, and the primary
health care provider (PHCP) prescribes insertion of a urinary catheter. While preparing for the
procedure, the nurse notes blood at the urinary meatus. The nurse should take which action? -
✅Notify the PHCP before performing the catheterization.
The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating
hemodialysis. Which finding indicates that the fistula is patent? -
✅Palpation of a thrill over the fistula.
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which
manifestation of the disorder? -
✅Dysuria and penile discharge
The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical
examination? -
✅Fever, nausea, vomiting, and painful scrotal edema
A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess
whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the
prostate examination for which characteristic of this disorder? -
✅Tender, indurated prostate gland that is warm to the touch
The nurse is collecting data from a client. Which symptom described by the client is characteristic
of an early symptom of benign prostatic hyperplasia? -
✅Decreased force in the stream of urine
1
, The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than
the inflow. Which actions should the nurse take? Select all that apply. -
✅Check the level of the drainage bag.
Reposition the client to her or his side.
Place the client in good body alignment.
Check the peritoneal dialysis system for kinks.
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse should
assess for which manifestations of this complication? -
✅Pallor, diminished pulse, and pain in the left hand
The nurse is reviewing a client's record and notes that the primary health care provider has
documented that the client has chronic kidney disease. On review of the laboratory results, the nurse
most likely would expect to note which finding? -
✅Elevated creatinine level
A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment.
On assessment, the nurse notes that the client's temperature is 38.5° C (101.2° F). Which nursing
action is most appropriate? -
✅Notify the primary health care provider.
The nurse is performing an assessment on a client who has returned from the dialysis unit following
hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is
the priority nursing action? -
✅Notify the primary health care provider (PHCP).
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. -
✅Insertion of a nephrostomy tube
Placement of a ureteral stent with ureteroscopy
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? -
✅Hyperglycemia
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? -
✅Increased immunosuppression therapy
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 primary health care provider (PHCP)? -
✅Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute
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? -
2
A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hr for 2
hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the
subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is
45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of
these findings, the nurse would anticipate that the client is at risk for which problem? -
✅Acute kidney injury
A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The
nurse should plan which actions as a priority? Select all that apply. -
✅Place the client on a cardiac monitor.
Notify the primary health care provider (PHCP).
Review the client's medications to determine whether any contain or retain potassium.
A client arrives at the emergency department with complaints of low abdominal pain and hematuria.
The client is afebrile. The nurse next assesses the client to determine a history of which condition? -
✅Trauma to the bladder or abdomen
The nurse discusses plans for future treatment options with a client with symptomatic polycystic
kidney disease. Which treatment should be included in this discussion? Select all that apply. -
✅Hemodialysis
Kidney transplant
Bilateral nephrectomy
A client is admitted to the emergency department following a fall from a horse, and the primary
health care provider (PHCP) prescribes insertion of a urinary catheter. While preparing for the
procedure, the nurse notes blood at the urinary meatus. The nurse should take which action? -
✅Notify the PHCP before performing the catheterization.
The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating
hemodialysis. Which finding indicates that the fistula is patent? -
✅Palpation of a thrill over the fistula.
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which
manifestation of the disorder? -
✅Dysuria and penile discharge
The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical
examination? -
✅Fever, nausea, vomiting, and painful scrotal edema
A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess
whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the
prostate examination for which characteristic of this disorder? -
✅Tender, indurated prostate gland that is warm to the touch
The nurse is collecting data from a client. Which symptom described by the client is characteristic
of an early symptom of benign prostatic hyperplasia? -
✅Decreased force in the stream of urine
1
, The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than
the inflow. Which actions should the nurse take? Select all that apply. -
✅Check the level of the drainage bag.
Reposition the client to her or his side.
Place the client in good body alignment.
Check the peritoneal dialysis system for kinks.
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse should
assess for which manifestations of this complication? -
✅Pallor, diminished pulse, and pain in the left hand
The nurse is reviewing a client's record and notes that the primary health care provider has
documented that the client has chronic kidney disease. On review of the laboratory results, the nurse
most likely would expect to note which finding? -
✅Elevated creatinine level
A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment.
On assessment, the nurse notes that the client's temperature is 38.5° C (101.2° F). Which nursing
action is most appropriate? -
✅Notify the primary health care provider.
The nurse is performing an assessment on a client who has returned from the dialysis unit following
hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is
the priority nursing action? -
✅Notify the primary health care provider (PHCP).
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. -
✅Insertion of a nephrostomy tube
Placement of a ureteral stent with ureteroscopy
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? -
✅Hyperglycemia
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? -
✅Increased immunosuppression therapy
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 primary health care provider (PHCP)? -
✅Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute
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? -
2
