NCLEX RN Questions Urinary System

NCLEX RN Questions Urinary System Related

Review NCLEX RN Questions Urinary System related questions and content

The following scenario applies to the next 1 items
The medical-surgical nurse is caring for a 67-year-old client
Item 1 of 1
Nurses’ Note
1535: Client returned from hemodialysis via stretcher to assigned room. The client was alert, oriented x 4. Denied any pain. He stated he felt ‘tired and dizzy.’ The client reported that the dizziness occurred when he quickly changed positions. The client was assessed, and vital signs were obtained.

Vital Signs
• Temperature 97° F (36° C)
• Pulse 94/minute; irregular
• Respirations 14/minute
• Blood Pressure 91/58 mm Hg
• Oxygen saturation 92% on room air

Assessment
Neurological:
Alert and completely oriented; reports dizziness. Pupils, equal, round, and reactive to light.
Cardiovascular:
Peripheral pulses intact; no edema; S1/S2 heart tones. Positive bruit and thrill in left arm A/V fistula. Gauze dressing applied which is dry with a scant amount of dry blood
Respiratory:
Diminished lung sounds, occasional cough
GI/GU:
Normoactive bowel sounds in all quadrants. Anuria.
Skin:
Warm and dry

Medical History
• End-stage renal disease (ESRD)
• Uncontrolled hypertension
• Chronic obstructive pulmonary disease
• Atrial fibrillation

The nurse reviews the nursing note, vital signs, assessment, and medical history. Which clinical data is most concerning to the nurse? Select all that apply.

  • A. A/V fistula assessment
  • B. Oxygen saturation
  • C. Pulse
  • D. Blood pressure
  • E. Neurological assessment
  • F. Temperature
  • G. Anuria
Correct Answer: C,D,E,G

Rationale: Irregular pulse, low blood pressure (91/58 mmHg), dizziness, and anuria indicate potential cardiovascular and renal complications post-hemodialysis.

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The nurse is caring for a client with urge incontinence. Which of the following actions would be appropriate for the nurse to take?

  • A. Administer prophylactic antibiotics.
  • B. Teach the client intermittent self-catheterization.
  • C. Have the client void on a timed schedule.
  • D. Provide caffeinated beverages with meals.
Correct Answer: C

Rationale: Timed voiding helps manage urge incontinence by preventing bladder overfilling, reducing involuntary contractions.

The nurse is caring for a client with end-stage renal disease who receives prescribed sevelamer. Which of the following findings would indicate a therapeutic response?

  • A. Decreased serum calcium levels
  • B. Increased hemoglobin and hematocrit
  • C. Decreased serum potassium levels
  • D. Decreased serum phosphorus levels
Correct Answer: D

Rationale: Sevelamer is a phosphate binder used to lower serum phosphorus levels in end-stage renal disease, making decreased phosphorus levels the therapeutic response. It does not directly affect calcium (A), hemoglobin/hematocrit (B), or potassium (C).

The nurse is providing education to a group of nursing students regarding the causes of hypercalcemia. Which of the following information should be included? Select all that apply.

  • A. hypoparathyroidism.
  • B. thiazide diuretics.
  • C. malignancy.
  • D. end-stage kidney disease.
  • E. Crohn's disease.
Correct Answer: B,C,D

Rationale: Thiazide diuretics, malignancy, and end-stage kidney disease cause hypercalcemia by increasing calcium retention or release.

The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?

  • A. WBC 19,000 mm3 [5,000-10,000 mm3]
  • B. Hemoglobin 9 g/dL [Male: 14-18 g/dL (140-180 g/L) Female: 12-16 g/dL (120-160 g/L)]
  • C. Calcium 8.6 mg/dL [9.0-10.5 mg/dL]
  • D. Serum pH 7.33 [7.35-7.45]
Correct Answer: A

Rationale: Elevated WBC (19,000 mm3) suggests infection, a serious complication in peritoneal dialysis.

The nurse cares for a client diagnosed with end-stage renal disease who just returned from initial hemodialysis. Which of the following assessment findings is of the highest concern?

  • A. Headache and nausea
  • B. Scant blood on the AV fistula
  • C. Potassium 3.7 mEq/L (mmol/L) [3.5-5.0 mEq/L, mmol/L]
  • D. Hemoglobin 8.8 g/dL [Male: 14-18 g/dL; Female: 12-16 g/dL, Female 115-155 g/L Male 125-170 g/L]
Correct Answer: A

Rationale: Headache and nausea may indicate dialysis disequilibrium syndrome, a serious complication requiring immediate attention.

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