51. A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change?
a. Therapeutic index
b. GI absorption rate
c. Liver function studies
d. Creatinine clearance
>>See answer and rationale<<
52. A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders?
a. Acute glomerulonephritis
b. Acute renal failure
c. Nephrotic syndrome
d. Chronic renal failure
>>See answer and rationale<<
53. A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?
a. Urine output of 250 ml/24 hours
b. Temperature of 100.2° F (37.8° C)
c. Serum creatinine level of 1.2 mg/dl
d. Blood urea nitrogen (BUN) level of 22 mg/dl
>>See answer and rationale<<
54. A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find?
a. Decreased blood urea nitrogen (BUN)
b. Decreased potassium
c. Increased serum albumin
d. Increased serum creatinine
>>See answer and rationale<<
55. Which type of medication may be used in the treatment of a patient with incontinence to inhibit contraction of the bladder?
a. Anticholinergic agent
b. Over-the-counter decongestant
c. Tricyclic antidepressants
d. Estrogen hormone
>>See answer and rationale<<
56. After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the student have understood the material when they identify which of the following as a cause of stress incontinence?
a. Obstruction due to fecal impaction or enlarged prostate
b. Bladder irritation related to urinary tract infections
c. Increased urine production due to metabolic conditions
d. Decreased pelvic muscle tone due to multiple pregnancies
>>See answer and rationale<<
57. After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an I.V. infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that’s draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output?
a. It’s an abnormal finding that requires further assessment.
b. It’s a normal finding caused by blood loss during surgery.
c. It’s an abnormal finding that will correct itself when the client ambulates.
d. It’s a normal finding associated with the client’s nothing-by-mouth status.
>>See answer and rationale<<
58. The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?
a. “My urine will be eliminated with my feces.”
b. “A catheter will drain urine directly from my kidney.”
c. “I will not need to worry about being incontinent of urine.”
d. “My urine will be eliminated through a stoma.”
>>See answer and rationale<<
59. Nursing management of the client with a urinary tract infection should include:
a. Teaching the client to douche daily
b. Discouraging caffeine intake
c. Administering morphine sulfate
d. Instructing the client to limit fluid intake
>>See answer and rationale<<
60. The most common presenting objective symptoms of a urinary tract infection in older adults, especially in those with dementia, include?
a. Hematuria
b. Change in cognitive functioning
c. Back pain
d. Incontinence
>>See answer and rationale<<
61. Which of the following would be included in a teaching plan for a patient diagnosed with a urinary tract infection?
a. Drink coffee or tea to increase diuresis
b. Use tub baths as opposed to showers
c. Void every 4 to 6 hours
d. Drink liberal amount of fluids
>>See answer and rationale<<
62. The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?
a. Clean intermittent catheterization
b. Suprapubic cystostomy tube
c. Permanent drainage with a urethral catheter
d. Credé voiding procedure
>>See answer and rationale<<
63. A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?
a. “This medication will prevent re-infection.”
b. “This medication should be taken at bedtime.”
c. “This medication will relieve your pain.”
d. “This will kill the organism causing the infection.”
>>See answer and rationale<<
64. A nurse has been asked to speak to a local women’s group about preventing cystitis. Which of the following would the nurse include in the presentation?
a. Need to urinate after engaging in sexual intercourse
b. Need to wear underwear made from synthetic material
c. Importance of urinating every 4 to 6 hours while awake
d. Suggestion to take tub baths instead of showers
>>See answer and rationale<<
65. Which of the following is a factor contributing to UTI in older adults?
a. Low incidence of chronic illness
b. Sporadic use of antimicrobial agents
c. Immunocompromise
d. Active lifestyle
>>See answer and rationale<<
66. You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults?
a. Hypovolemia
b. Dehydration
c. Hypervolemia
d. Fluid volume excess
>>See answer and rationale<<
67. A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3–, 24 mEq/L. What do these values indicate?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Respiratory acidosis
>>See answer and rationale<<
68. You are caring for a client with severe hypokalemia. The physician has ordered IV potassium to be administered at 10 mEq/hr. The client complains of burning along their vein. What should you do?
a. Change the electrolyte.
b. Switch to an oral formulation.
c. Increase the speed of transfusion.
d. Dilute the infusion.
>>See answer and rationale<<
69. The calcium level of the blood is regulated by which mechanism?
a. Androgens
b. Adrenal gland
c. Parathyroid hormone (PTH)
d. Thyroid hormone (TH)
>>See answer and rationale<<
70. A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Respiratory alkalosis
>>See answer and rationale<<
71. To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body?
a. Bradycardia
b. Tachycardia
c. Increased urine output
d. Vasodilation
>>See answer and rationale<<
72. A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??’) of 26 mEq/L. What disorder is indicated by these findings?
a. Metabolic acidosis
b. Respiratory alkalosis
c. Metabolic alkalosis
d. Respiratory acidosis
>>See answer and rationale<<
73. A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
a. Nausea or vomiting
b. Hallucinations or tinnitus
c. Light-headedness or paresthesia
d. Abdominal pain or diarrhea
>>See answer and rationale<<
74. A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse’s priority should be to assess her:
a. electrocardiogram (ECG) results.
b. neuromuscular function.
c. bowel sounds.
d. respiratory rate.
>>See answer and rationale<<
75. A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure. What electrolyte imbalance is this client most likely experiencing?
a. Hyperglycemia
b. Hypercalcemia
c. Hyperkalemia
d. Hypernatremia
>>See answer and rationale<<
76. A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic alkalosis
d. Metabolic acidosis
>>See answer and rationale<<
77. Patients diagnosed with hypervolemia should avoid sweet or dry food because:
a. It obstructs water elimination.
b. It can cause dehydration.
c. It can lead to weight gain.
d. It increases the client’s desire to consume fluid.
>>See answer and rationale<<
78. A group of nursing students are studying for a test over acid-base imbalance. One student asks another what the major chemical regulator of plasma pH is. What should the second student respond?
a. Renin-angiotensin-aldosterone system
b. Bicarbonate-carbonic acid buffer system
c. Sodium-potassium pump
d. ADH-ANP buffer system
>>See answer and rationale<<
79. A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?
a. pH, 7.25; PaCO2 50 mm Hg
b. pH, 7.35; PaCO2 40 mm Hg
c. pH, 7.40; PaCO2 35 mm Hg
d. pH, 7.5; PaCO2 30 mm Hg
>>See answer and rationale<<
80. A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess:
a. Trousseau’s sign.
b. Hegar’s sign.
c. Homans’ sign.
d. Goodell’s sign.
>>See answer and rationale<<
81. A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client’s symptoms are most likely associated with which electrolyte imbalance?
a. Hypocalcemia
b. Hyperkalemia
c. Hypokalemia
d. Hypercalcemia
>>See answer and rationale<<
82. Which conditions lead to chronic respiratory acidosis in older adults?
a. Thoracic skeletal change
b. Overuse of sodium bicarbonate
c. Decreased renal function
d. Erratic meal patterns
>>See answer and rationale<<
83. A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first?
a. Prepare for gastric lavage.
b. Monitor the client’s heart rhythm.
c. Obtain a urine specimen for drug screening.
d. Prepare to assist with ventilation.
>>See answer and rationale<<
84. A priority nursing intervention for a client with hypervolemia involves which of the following?
a. Monitoring respiratory status for signs and symptoms of pulmonary complications.
b. Establishing I.V. access with a large-bore catheter.
c. Encouraging the client to consume sodium-free fluids.
d. Drawing a blood sample for typing and cross-matching.
>>See answer and rationale<<
85. A 57-year-old homeless female with a history of alcohol abuse has been admitted to your hospital unit. She was admitted with signs and symptoms of hypovolemia – minus the weight loss. She exhibits a localized enlargement of her abdomen. What condition could she be presenting?
a. Hypovolemia
b. Pitting edema
c. Third-spacing
d. Anasarca
>>See answer and rationale<<
86. The nurse is caring for a client who is exhibiting symptoms of tachypnea and circumoral paresthesias. What should be the nurse’s first course of action?
a. Stop mechanical ventilation.
b. Find and correct the cause of tachypnea.
c. Administer cardiopulmonary resuscitation (CPR).
d. Give a dose of aspirin.
>>See answer and rationale<<
87. A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client?
a. No, start with the sodium chloride IV.
b. No, sodium intake should be restricted.
c. Yes, this will correct the sodium deficit.
d. Yes, along with the hypotonic IV.
>>See answer and rationale<<
88. A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately?
a. Potassium
b. Sodium
c. Chloride
d. CO2
>>See answer and rationale<<
89. A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?
a. Urinary retention
b. Cystitis
c. Bladder stones
d. Urethral stricture
>>See answer and rationale<<
90. The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure?
a. Dehydration
b. Crackles
c. Hypertension
d. Hyperkalemia
>>See answer and rationale<<
91. A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis?
a. Perform deep-breathing exercises vigorously.
b. Avoid carrying heavy items.
c. Auscultate the lungs frequently.
d. Wear a mask when performing exchanges.
>>See answer and rationale<<
92. A 32-year-old flight attendant is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography and you are in the midst of completing client education about the procedure. The client asks what the angiography will reveal. What is your response, as her nurse?
a. Renal circulation
b. Urine production
c. Kidney function
d. Kidney structure
>>See answer and rationale<<
93. The nurse observes the color of the client’s urine which appears pale blue-green. The nurse obtains a drug history from the client based on the understanding that drugs used by the client may affect which of the following?
a. Size of the urinary bladder
b. Urinary tract tests
c. Urine specific gravity
d. Amount of urine produced
>>See answer and rationale<<
94. A nurse, when caring for a client, notes that the specific gravity of the client’s urine is low. What could have lead to the low specific gravity of urine?
a. Repeated diarrhea
b. Excess fluid intake
c. Frequent vomiting
d. Urine retention
>>See answer and rationale<<
95. Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:
a. diaphoresis.
b. tremors.
c. muscle weakness.
d. constipation.
>>See answer and rationale<<
96. Julia Lee, a 57-year-old financial officer, has been exhibiting signs and symptoms which lead her urologist to suspect the adequacy of her urinary function. Beginning with the least invasive tests, which of the following would you expect the physician to prescribe to assess kidney function? Choose all correct options.
a. Blood urea nitrogen (BUN) level
b. Creatinine clearance
c. Angiography
d. All options are correct
>>See answer and rationale<<
97. The nurse is preparing an education program on risk factors for kidney disorders. Which of the following risk factors would be inappropriate for the nurse to include in the teaching program?
a. Pregnancy
b. Diabetes mellitus
c. Neuromuscular disorders
d. Hypotension
>>See answer and rationale<<
98. Which of the following terms is used to refer to inflammation of the renal pelvis?
a. Pyelonephritis
b. Interstitial nephritis
c. Urethritis
d. Cystitis
>>See answer and rationale<<
99. A client with a genitourinary problem is being examined in the emergency department. When palpating the client’s kidneys, the nurse should keep in mind which anatomic fact?
a. The kidneys are situated just above the adrenal glands.
b. The left kidney usually is slightly higher than the right one.
c. The kidneys lie between the 10th and 12th thoracic vertebrae.
d. The average kidney is approximately 5 cm (2?) long and 2 to 3 cm (¾? to 1??) wide.
>>See answer and rationale<<
100. A patient with an obstruction of the renal artery causing renal ischemia exhibits HTN. One factor that may contribute to HTN:
a. increase renin release
b. increased ADH secretion
c. decreased aldosterone secretion
d. increased synthesis and release of prostaglandins
More NCLEX Questions:
NCLEX-RN Practice Questions (Part 1)
NCLEX-RN Practice Questions (Part 2)
NCLEX-RN Practice Questions (Part 4)
