ATI Renal an d Urinary Exam Practice
Questions with Co rrect A+ Answers
A nurse is planning care for a client who has chronic kidney disease and a potassium level of 7.3 mEq/L.
Which of the following interventions should the nurse plan to take?
a. Initiate an IV infusion of lactated Ringer's solution.
b. Give spironolactone 50 mg PO BID.
C. Infuse regular insulin in dextrose 10% in water.
d. Administer supplemental phosphorus. - Answer Infuse regular insulin in dextrose 10% in water.
The nurses should infuse regular insulin in dextrose 10% to 20% in water to a client who has
hyperkalemia. The administration of insulin will drive the potassium from the extracellular fluid into the
intracellular fluid to decrease the serum potassium level. The dextrose in the solution will counter the
insulin to prevent hypoglycemia from occurring.
Initiate an IV infusion of lactated Ringer's solution. The nurse should not infuse lactated Ringer's solution
because it contains potassium and is not a treatment for hyperkalemia.
Give spironolactone 50 mg PO BID. The nurse should not administer spironolactone to a client who has
hyperkalemia because this medication is a potassium-sparing diuretic. Spironolactone can be used to
treat diuretic-induced hypokalemia.
Administer supplemental phosphorus.
The nurse should not administer supplemental phosphorus to a client who has chronic kidney failure
due to the risk for hyperphosphatemia.
A nurse is providing discharge teaching for a client who has chronic kidney disease (CKD). Which of the
following statements by the client indicates an understanding of the teaching?
A. "I will consume foods high in protein."
B. "I will decrease my intake of foods high in phosphorus."
C. "I will limit my intake of foods high in calcium."
D. "I will add salt to the foods I consume." - Answer B. "I will decrease my intake of foods high in
phosphorus."
,A. Clients who have CKD should consume a diet low in protein because the phosphorus content of
protein becomes elevated and can cause osteodystrophy.
B. Clients who have CKD should limit the intake of foods high in phosphorus due to the decrease in the
kidneys' ability to excrete it
.C. Clients who have CKD often need supplemental calcium and vitamin D.
D. Clients who have CKD retain sodium and fluid. They should consume foods low in sodium.
A nurse is teaching a client who has urge urinary incontinence about bladder retraining. Which of the
following instructions should the nurse include?
a."If you are unable to urinate, sit on the toilet every 4 hours with water running in the sink."
b."Increase the intervals between urination by 15 minutes per day when able to remain continent."
c."Immediately empty your bladder when you have the urge to urinate."
d."If you are unable to urinate, plan to self-catheterize every 3 to 4 hours." - Answer "Increase the
intervals between urination by 15 minutes per day when able to remain continent."
"Increase the intervals between urination by 15 minutes per day when able to remain continent."
MY ANSWER
The nurse should instruct the client to increase the length of time between urination by 15 min per day
when able to remain continent. The goal is to have 3- to 4-hr intervals between urination.
"If you are unable to urinate, sit on the toilet every 4 hours with water running in the sink."
The sound of running water is a sensory stimulus that promotes normal micturition, but it does not
reduce urinary incontinence.
"Immediately empty your bladder when you have the urge to urinate."The nurse should teach the client
to delay urination in order to lengthen the intervals between urination. By increasing the bladder's
ability to suppress urination, the client should be able to develop continence.
"If you are unable to urinate, plan to self-catheterize every 3 to 4 hours."The nurse should recommend
self-catheterization for a client who has functional urinary incontinence, not urge incontinence.
A nurse is caring for a client who has nephrotic syndrome and has been taking prednisone for 3 days.
Which of the following adverse effects should the nurse monitor for and report to the provider?
, A. Sore throat
B. Frequent stools
C. Drowsiness
D. Tremors - Answer A. Sore throat
A. Glucocorticoids depress the natural immune system and increase the client's risk for infection. A sore
throat can indicate an infection.
B. Frequent stools are not an adverse effect of prednisone therapy. The nurse should monitor for black,
tarry stools.
C. Insomnia is an adverse effect of prednisone therapy.
D. Tremors are not an adverse reaction related to prednisone therapy. The nurse should monitor the
client for psychological alterations
A nurse is preparing to assess a client who received hemodialysis 1 hr ago. Which of the following
assessments should the nurse perform first?
a.Potassium level
b.Body weight
c.Creatinine level
d.Vital signs - Answer Vital signs
When using the airway, breathing, circulation approach to client care, the nurse should determine that
the priority information to assess is the client's vital signs. After hemodialysis, the client is at risk for
hemodynamic instability, which includes hypotension, dysrhythmia, and hemorrhage.
Potassium level
The nurse should check the client's potassium level following hemodialysis and report it to the provider
if it is outside the expected reference range. However, another assessment is the priority.
Body weight
The nurse should compare the client's body weight before and after dialysis to determine the amount of
fluid lost. However, another assessment is the priority.
Creatinine level
Questions with Co rrect A+ Answers
A nurse is planning care for a client who has chronic kidney disease and a potassium level of 7.3 mEq/L.
Which of the following interventions should the nurse plan to take?
a. Initiate an IV infusion of lactated Ringer's solution.
b. Give spironolactone 50 mg PO BID.
C. Infuse regular insulin in dextrose 10% in water.
d. Administer supplemental phosphorus. - Answer Infuse regular insulin in dextrose 10% in water.
The nurses should infuse regular insulin in dextrose 10% to 20% in water to a client who has
hyperkalemia. The administration of insulin will drive the potassium from the extracellular fluid into the
intracellular fluid to decrease the serum potassium level. The dextrose in the solution will counter the
insulin to prevent hypoglycemia from occurring.
Initiate an IV infusion of lactated Ringer's solution. The nurse should not infuse lactated Ringer's solution
because it contains potassium and is not a treatment for hyperkalemia.
Give spironolactone 50 mg PO BID. The nurse should not administer spironolactone to a client who has
hyperkalemia because this medication is a potassium-sparing diuretic. Spironolactone can be used to
treat diuretic-induced hypokalemia.
Administer supplemental phosphorus.
The nurse should not administer supplemental phosphorus to a client who has chronic kidney failure
due to the risk for hyperphosphatemia.
A nurse is providing discharge teaching for a client who has chronic kidney disease (CKD). Which of the
following statements by the client indicates an understanding of the teaching?
A. "I will consume foods high in protein."
B. "I will decrease my intake of foods high in phosphorus."
C. "I will limit my intake of foods high in calcium."
D. "I will add salt to the foods I consume." - Answer B. "I will decrease my intake of foods high in
phosphorus."
,A. Clients who have CKD should consume a diet low in protein because the phosphorus content of
protein becomes elevated and can cause osteodystrophy.
B. Clients who have CKD should limit the intake of foods high in phosphorus due to the decrease in the
kidneys' ability to excrete it
.C. Clients who have CKD often need supplemental calcium and vitamin D.
D. Clients who have CKD retain sodium and fluid. They should consume foods low in sodium.
A nurse is teaching a client who has urge urinary incontinence about bladder retraining. Which of the
following instructions should the nurse include?
a."If you are unable to urinate, sit on the toilet every 4 hours with water running in the sink."
b."Increase the intervals between urination by 15 minutes per day when able to remain continent."
c."Immediately empty your bladder when you have the urge to urinate."
d."If you are unable to urinate, plan to self-catheterize every 3 to 4 hours." - Answer "Increase the
intervals between urination by 15 minutes per day when able to remain continent."
"Increase the intervals between urination by 15 minutes per day when able to remain continent."
MY ANSWER
The nurse should instruct the client to increase the length of time between urination by 15 min per day
when able to remain continent. The goal is to have 3- to 4-hr intervals between urination.
"If you are unable to urinate, sit on the toilet every 4 hours with water running in the sink."
The sound of running water is a sensory stimulus that promotes normal micturition, but it does not
reduce urinary incontinence.
"Immediately empty your bladder when you have the urge to urinate."The nurse should teach the client
to delay urination in order to lengthen the intervals between urination. By increasing the bladder's
ability to suppress urination, the client should be able to develop continence.
"If you are unable to urinate, plan to self-catheterize every 3 to 4 hours."The nurse should recommend
self-catheterization for a client who has functional urinary incontinence, not urge incontinence.
A nurse is caring for a client who has nephrotic syndrome and has been taking prednisone for 3 days.
Which of the following adverse effects should the nurse monitor for and report to the provider?
, A. Sore throat
B. Frequent stools
C. Drowsiness
D. Tremors - Answer A. Sore throat
A. Glucocorticoids depress the natural immune system and increase the client's risk for infection. A sore
throat can indicate an infection.
B. Frequent stools are not an adverse effect of prednisone therapy. The nurse should monitor for black,
tarry stools.
C. Insomnia is an adverse effect of prednisone therapy.
D. Tremors are not an adverse reaction related to prednisone therapy. The nurse should monitor the
client for psychological alterations
A nurse is preparing to assess a client who received hemodialysis 1 hr ago. Which of the following
assessments should the nurse perform first?
a.Potassium level
b.Body weight
c.Creatinine level
d.Vital signs - Answer Vital signs
When using the airway, breathing, circulation approach to client care, the nurse should determine that
the priority information to assess is the client's vital signs. After hemodialysis, the client is at risk for
hemodynamic instability, which includes hypotension, dysrhythmia, and hemorrhage.
Potassium level
The nurse should check the client's potassium level following hemodialysis and report it to the provider
if it is outside the expected reference range. However, another assessment is the priority.
Body weight
The nurse should compare the client's body weight before and after dialysis to determine the amount of
fluid lost. However, another assessment is the priority.
Creatinine level
