Renal System NCLEX Questions (11-15)

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11. A nurse is developing a plan of care for a client with nephrotic syndrome. The nurse documents that which important parameter needs to be assessed on a daily basis?

a) total protein levels
b) weight
c) blood urea nitrogen (BUN)
d) activity tolerance

12. A client with renal malignancy is admitted to the hospital for a diagnostic workup and probable surgery. During the admission assessment the nurse inquires about the presence of which common symptom related to this problem?

a)  flank pain and intermittent hematuria
b) suprapubic pain and constant slight hematuria
c) flank pain and foul-smelling urine
d) abdominal pain and decreased urine output

13. A client has undergone urinary diversion after cystectomy for bladder cancer. The nurse assesses the urostomy stoma to ensure that it is:

a)  pale and pink
b) pink and dry
c) red and moist
d) dusky to beefy colored

14. A nurse is caring for a client receiving hemodialysis who has an internal arteriovenous (AV) fistula. Which assessment finding would indicate to the nurse that the fistula is patent?

a) white fibrin specks noted in the fistula
b) palpation of a thrill over the site of the fistula
c) lack of bruit over the site of the fistula
d) a feeling of warmth at the site of the fistula

15. A nurse is caring for a client following a cystoscopy. Which assessment finding requires physician notification?

a)  bladder spasm
b) complaints of fullness and burning in the bladder
c) clots in the urine
d) back pain






Renal System NCLEX Questions
Answers and Rationale

11) B
The client with nephrotic syndrome typically presents with edema, hypoalbuminemia, and proteinuria. The nurse carefully assesses the fluid balance of the client, which includes daily monitoring of weight, intake and output, edema, and girth measurements. Albumin levels are monitored as they are ordered, as are the BUN and creatinine levels. The client's activity level is adjusted according to the amount of edema and water retention. As edema increases, the client's activity level should be restricted.

12) A
- Renal cancer is commonly manifested by hematuria and flank pain (not abdominal or suprapubic), and a palpable mass may be palpated on physical examination. Because the hematuria is gross but intermittent, the client may delay seeking medical treatment. Foul-smelling urine could indicate infection. Decreased urine output could indicate renal insufficiency.

13) C
- Following urostomy, the stoma should be red and moist. It may be edematous, but this will decrease after the first few days. A dusky or cyanotic color indicates insufficient circulation with impending necrosis and warrants notification of the surgeon immediately.

14) B
- An internal AV fistula is created through a surgical procedure in which an artery in the arm is anastomosed to a vein. To assess patency, the nurse palpates over the fistula for a thrill and auscultates for a bruit. With an internal AV fistula, the nurse would not note white fibrin specks. A feeling of warmth at the site of the fistula may indicate an inflammatory process.

15) C
- Back pain, bladder spasms, and feelings of fullness and burning in the bladder may be experienced by the client following a cystoscopy. Warm tub baths, mild analgesics, and antispasmodics will provide relief. Pink-tinged urine is common but any bright red bleeding or clots in the urine should be reported to the physician.



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Renal System NCLEX Questions (16-20)


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 Renal System NCLEX Questions (1-5)

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