NU NUR 340 Module 7 (pdf) | 2026/2027 | Nursing Care of Adults and
Older Adults II Q&A | Nursing
1. A nurse is caring for a patient with acute kidney injury (AKI) in the oliguric
phase. Which of the following assessment findings is most concerning and
requires immediate intervention?
A) Serum potassium level of 5.2 mEq/L
B) Urine output of 250 mL over 24 hours
C) Serum creatinine level of 3.5 mg/dL
D) Blood pressure of 145/90 mmHg
Correct Answer: Serum potassium level of 5.2 mEq/L
Rationale: A potassium level of 5.2 mEq/L, while elevated, is concerning but
not immediately life-threatening in the context of the other options. Urine
output of 250 mL over 24 hours is a hallmark of the oliguric phase of AKI.
Elevated creatinine is expected, and hypertension is a common finding. The
most critical immediate concern is often hyperkalemia, but a level of 5.2 is
relatively moderate; however, in AKI, potassium can rise rapidly. The most
urgent finding is actually the oliguria itself, but the question asks for the
most concerning finding requiring immediate intervention. Considering the
options, urine output of 250 mL/24hrs indicates severe oliguria and is a key
defining feature of the oliguric phase, which carries significant risks. While
hyperkalemia is a serious complication, a potassium of 5.2 is a warning sign.
The most immediate and defining finding of the oliguric phase that warrants
intervention is the low urine output.
2. A patient is admitted with a diagnosis of chronic kidney disease (CKD)
stage 4. The nurse should monitor the patient for which of the following
electrolyte imbalances?
A) Hypernatremia and hypokalemia
B) Hyponatremia and hyperkalemia
C) Hypercalcemia and hypophosphatemia
,D) Hypocalcemia and hyperphosphatemia
Correct Answer: Hypocalcemia and hyperphosphatemia
Rationale: In CKD, the kidneys lose the ability to excrete phosphorus, leading
to hyperphosphatemia. Additionally, the kidneys fail to convert vitamin D to
its active form, leading to decreased calcium absorption and hypocalcemia.
This combination is a classic finding in advanced CKD.
3. A patient with end-stage renal disease (ESRD) is scheduled for
hemodialysis. Which of the following is a priority nursing action before the
procedure?
A) Administer the patient's morning dose of antihypertensive medication
B) Assess the patient's weight and vital signs
C) Encourage the patient to eat a high-protein breakfast
D) Prepare the patient for a blood transfusion
Correct Answer: Assess the patient's weight and vital signs
Rationale: Pre-dialysis assessment includes obtaining the patient's weight to
calculate fluid removal and vital signs to establish a baseline.
Antihypertensives are often held, and food is typically restricted. A blood
transfusion may be needed but is not the priority pre-dialysis action.
4. A nurse is teaching a patient with a new arteriovenous (AV) fistula for
hemodialysis. Which of the following instructions is most important for the
patient to understand?
A) "You can have blood pressures taken on that arm if the cuff is placed
carefully."
B) "You should sleep on the arm with the fistula to protect it."
,C) "You should check for a thrill and bruit over the fistula daily."
D) "You can wear tight clothing over the fistula to support it."
Correct Answer: "You should check for a thrill and bruit over the fistula daily."
Rationale: A thrill (palpable vibration) and bruit (audible whooshing sound)
indicate patency of the AV fistula. The patient should check for these daily
and report any changes. Blood pressures and venipunctures should be
avoided in that arm, and tight clothing should not be worn.
5. A patient with benign prostatic hyperplasia (BPH) is prescribed tamsulosin.
The nurse should monitor the patient for which adverse effect?
A) Urinary retention
B) Orthostatic hypotension
C) Tachycardia
D) Hyperglycemia
Correct Answer: Orthostatic hypotension
Rationale: Tamsulosin is an alpha-blocker that relaxes smooth muscle in the
prostate. It can cause orthostatic hypotension, especially with the first dose.
Patients should be advised to rise slowly from a sitting or lying position.
6. A nurse is assessing a patient with acute pyelonephritis. Which of the
following findings is most consistent with this condition?
A) Suprapubic pain and cloudy urine
B) Costovertebral angle tenderness and fever
C) Dysuria and urgency
D) Hematuria and oliguria
, Correct Answer: Costovertebral angle tenderness and fever
Rationale: Acute pyelonephritis is an infection of the renal parenchyma.
Classic findings include costovertebral angle (CVA) tenderness, fever, chills,
and flank pain. Suprapubic pain, dysuria, and urgency are more consistent
with cystitis.
7. A patient with a urinary tract infection (UTI) is prescribed antibiotics.
Which of the following statements by the patient indicates a correct
understanding of the treatment?
A) "I can stop the antibiotics when my symptoms resolve."
B) "I should drink plenty of fluids to flush out the bacteria."
C) "I should avoid emptying my bladder completely."
D) "I can use bubble bath to relieve discomfort."
Correct Answer: "I should drink plenty of fluids to flush out the bacteria."
Rationale: Increasing fluid intake helps flush bacteria from the urinary tract.
Antibiotics should be taken for the full prescribed course, the bladder should
be emptied completely, and bubble baths should be avoided as they can
irritate the urethra.
8. A nurse is assessing a patient with urinary incontinence. Which of the
following interventions is most appropriate for a patient with stress
incontinence?
A) Scheduled toileting every 2 hours
B) Pelvic floor muscle (Kegel) exercises
C) Bladder training with timed voiding
D) Fluid restriction
Older Adults II Q&A | Nursing
1. A nurse is caring for a patient with acute kidney injury (AKI) in the oliguric
phase. Which of the following assessment findings is most concerning and
requires immediate intervention?
A) Serum potassium level of 5.2 mEq/L
B) Urine output of 250 mL over 24 hours
C) Serum creatinine level of 3.5 mg/dL
D) Blood pressure of 145/90 mmHg
Correct Answer: Serum potassium level of 5.2 mEq/L
Rationale: A potassium level of 5.2 mEq/L, while elevated, is concerning but
not immediately life-threatening in the context of the other options. Urine
output of 250 mL over 24 hours is a hallmark of the oliguric phase of AKI.
Elevated creatinine is expected, and hypertension is a common finding. The
most critical immediate concern is often hyperkalemia, but a level of 5.2 is
relatively moderate; however, in AKI, potassium can rise rapidly. The most
urgent finding is actually the oliguria itself, but the question asks for the
most concerning finding requiring immediate intervention. Considering the
options, urine output of 250 mL/24hrs indicates severe oliguria and is a key
defining feature of the oliguric phase, which carries significant risks. While
hyperkalemia is a serious complication, a potassium of 5.2 is a warning sign.
The most immediate and defining finding of the oliguric phase that warrants
intervention is the low urine output.
2. A patient is admitted with a diagnosis of chronic kidney disease (CKD)
stage 4. The nurse should monitor the patient for which of the following
electrolyte imbalances?
A) Hypernatremia and hypokalemia
B) Hyponatremia and hyperkalemia
C) Hypercalcemia and hypophosphatemia
,D) Hypocalcemia and hyperphosphatemia
Correct Answer: Hypocalcemia and hyperphosphatemia
Rationale: In CKD, the kidneys lose the ability to excrete phosphorus, leading
to hyperphosphatemia. Additionally, the kidneys fail to convert vitamin D to
its active form, leading to decreased calcium absorption and hypocalcemia.
This combination is a classic finding in advanced CKD.
3. A patient with end-stage renal disease (ESRD) is scheduled for
hemodialysis. Which of the following is a priority nursing action before the
procedure?
A) Administer the patient's morning dose of antihypertensive medication
B) Assess the patient's weight and vital signs
C) Encourage the patient to eat a high-protein breakfast
D) Prepare the patient for a blood transfusion
Correct Answer: Assess the patient's weight and vital signs
Rationale: Pre-dialysis assessment includes obtaining the patient's weight to
calculate fluid removal and vital signs to establish a baseline.
Antihypertensives are often held, and food is typically restricted. A blood
transfusion may be needed but is not the priority pre-dialysis action.
4. A nurse is teaching a patient with a new arteriovenous (AV) fistula for
hemodialysis. Which of the following instructions is most important for the
patient to understand?
A) "You can have blood pressures taken on that arm if the cuff is placed
carefully."
B) "You should sleep on the arm with the fistula to protect it."
,C) "You should check for a thrill and bruit over the fistula daily."
D) "You can wear tight clothing over the fistula to support it."
Correct Answer: "You should check for a thrill and bruit over the fistula daily."
Rationale: A thrill (palpable vibration) and bruit (audible whooshing sound)
indicate patency of the AV fistula. The patient should check for these daily
and report any changes. Blood pressures and venipunctures should be
avoided in that arm, and tight clothing should not be worn.
5. A patient with benign prostatic hyperplasia (BPH) is prescribed tamsulosin.
The nurse should monitor the patient for which adverse effect?
A) Urinary retention
B) Orthostatic hypotension
C) Tachycardia
D) Hyperglycemia
Correct Answer: Orthostatic hypotension
Rationale: Tamsulosin is an alpha-blocker that relaxes smooth muscle in the
prostate. It can cause orthostatic hypotension, especially with the first dose.
Patients should be advised to rise slowly from a sitting or lying position.
6. A nurse is assessing a patient with acute pyelonephritis. Which of the
following findings is most consistent with this condition?
A) Suprapubic pain and cloudy urine
B) Costovertebral angle tenderness and fever
C) Dysuria and urgency
D) Hematuria and oliguria
, Correct Answer: Costovertebral angle tenderness and fever
Rationale: Acute pyelonephritis is an infection of the renal parenchyma.
Classic findings include costovertebral angle (CVA) tenderness, fever, chills,
and flank pain. Suprapubic pain, dysuria, and urgency are more consistent
with cystitis.
7. A patient with a urinary tract infection (UTI) is prescribed antibiotics.
Which of the following statements by the patient indicates a correct
understanding of the treatment?
A) "I can stop the antibiotics when my symptoms resolve."
B) "I should drink plenty of fluids to flush out the bacteria."
C) "I should avoid emptying my bladder completely."
D) "I can use bubble bath to relieve discomfort."
Correct Answer: "I should drink plenty of fluids to flush out the bacteria."
Rationale: Increasing fluid intake helps flush bacteria from the urinary tract.
Antibiotics should be taken for the full prescribed course, the bladder should
be emptied completely, and bubble baths should be avoided as they can
irritate the urethra.
8. A nurse is assessing a patient with urinary incontinence. Which of the
following interventions is most appropriate for a patient with stress
incontinence?
A) Scheduled toileting every 2 hours
B) Pelvic floor muscle (Kegel) exercises
C) Bladder training with timed voiding
D) Fluid restriction
