ATI Renal and Urinary Disorders Practice Exam
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1. A patient with chronic kidney disease (CKD) is scheduled for
hemodialysis. Which of the following laboratory values would be most
concerning to the nurse prior to the procedure?
A) Serum potassium of 5.2 mEq/L
B) Serum sodium of 135 mEq/L
C) Serum calcium of 9.0 mg/dL
D) Serum phosphorus of 4.5 mg/dL
Answer: A) Serum potassium of 5.2 mEq/L
Explanation: A serum potassium level of 5.2 mEq/L indicates
hyperkalemia, a life-threatening electrolyte imbalance frequently seen
in CKD. While this value is not critically high, it is the most concerning
among the options listed because of its potential to cause cardiac
dysrhythmias. The other options are within normal limits (sodium 135-
145 mEq/L, calcium 8.5-10.5 mg/dL, phosphorus 2.5-4.5 mg/dL) and are
not immediately life-threatening.
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2. A nurse is caring for a patient in the oliguric phase of acute kidney
injury (AKI). Which dietary restriction should the nurse anticipate
including in the plan of care?
A) Increased protein intake to promote healing
B) Sodium restriction to prevent fluid retention
C) Increased potassium intake to replace losses
D) Fluid restriction to match output plus insensible losses
Answer: D) Fluid restriction to match output plus insensible losses
Explanation: During the oliguric phase of AKI, urine output is
significantly decreased (less than 400 mL/day), leading to fluid volume
overload. The standard fluid management approach is to restrict intake
to the previous day's urine output plus 500-600 mL for insensible losses.
Sodium restriction is also important, but the most critical intervention
directly related to the oliguric state is fluid restriction.
3. A patient with a urinary tract infection (UTI) is prescribed
ciprofloxacin. Which instruction is most important for the nurse to
provide to the patient?
A) Take the medication with an antacid to reduce gastrointestinal
upset.
B) Avoid taking the medication with dairy products or calcium
supplements.
C) Expect the urine to turn orange-red in color while on this medication.
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D) Discontinue the medication if improvement is seen in 2 days.
Answer: B) Avoid taking the medication with dairy products or calcium
supplements.
Explanation: Ciprofloxacin, a fluoroquinolone antibiotic, binds with
divalent and trivalent cations such as calcium, magnesium, iron, and
zinc. This binding significantly reduces the absorption of the medication,
making it less effective. Patients should be instructed to take
ciprofloxacin either 2 hours before or 4 hours after these products. The
other options are incorrect: antacids are not recommended, orange-red
urine is associated with rifampin, and antibiotics should be completed
as prescribed even if symptoms improve.
4. A patient is diagnosed with glomerulonephritis. Which assessment
finding is consistent with this diagnosis?
A) Severe flank pain radiating to the groin
B) Cola-colored urine and periorbital edema
C) Urinary frequency and dysuria
D) Suprapubic pain and cloudy urine
Answer: B) Cola-colored urine and periorbital edema
Explanation: Glomerulonephritis is an inflammatory condition affecting
the glomeruli, which can allow red blood cells to leak into the urine,
resulting in cola-colored or tea-colored urine. The inflammation also
causes decreased glomerular filtration, leading to fluid retention,
periorbital edema, and hypertension. The other options describe
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symptoms of renal calculi (flank pain radiating to groin) and lower UTI
(frequency, dysuria, cloudy urine).
5. A nurse is educating a patient with benign prostatic hyperplasia
(BPH) about managing the condition. Which statement by the patient
indicates a need for further teaching?
A) "I should avoid drinking large amounts of fluid before bedtime."
B) "I can take over-the-counter decongestants for my cold symptoms."
C) "I should limit my intake of caffeine and alcohol."
D) "I will need to have my PSA levels checked regularly."
Answer: B) "I can take over-the-counter decongestants for my cold
symptoms."
Explanation: Decongestants, particularly those containing
sympathomimetic agents like pseudoephedrine, can cause smooth
muscle contraction in the prostate and bladder neck, worsening urinary
retention in patients with BPH. Patients should avoid these medications
or consult their healthcare provider before use. The other statements
indicate good understanding: limiting fluid intake before bed reduces
nocturia, limiting caffeine and alcohol (which are diuretics and bladder
irritants) is beneficial, and regular PSA monitoring is appropriate as BPH
and prostate cancer share similar symptoms.
6. A patient is receiving peritoneal dialysis. Which observation indicates
a potential complication of the procedure?
A) The effluent is clear and pale yellow.