NCLEX Renal Questions (56-60)

Welcome to the NCLEX Renal Questions. Before you begin answering this questions, I recommend that you start from the beginning:

NCLEX Renal Questions (1-7)


Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck


56. A client who has a renal mass asks the nurse why an ultrasound has been scheduled, as opposed to other diagnostic tests that may be ordered. The nurse formulates a response based on the understanding that:

a) all other tests are more invasive than an ultrasound
b) all other tests require more elaborate postprocedure care
c) an ultrasound can differentiate a solid mass from a fluid-filled cyst
d) an ultrasound is much more cost effective than other diagnostic tests

57. A client has been admitted to the hospital with a diagnosis of acute glomerulonephritis. During history-taking the nurse first asks the client about a recent history of:

a) bleeding ulcer
b) deep vein thrombosis
c) myocardial infarction
d) streptococcal infection

58. A nurse is assigned to care for a client with nephrotic syndrome. The nurse assesses which important parameter on a daily basis?

a) weight
b) albumin levels
c) activity tolerance
d) blood urea nitrogen (BUN) level

59. A client is being admitted to the hospital with a diagnosis of urolithiasis and ureteral colic. The nurse assesses the client for pain that is:

a) dull and aching in the costovetebal area
b) aching and camplike throughout the abdomen
c) sharp and radiating posteriorly to the spinal column
d) excruciating, wavelike, and radiating toward the genitalia

60. A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell (RBC) production?

a) iron supplement
b) zinc supplement
c) calcium supplement
d) magnesium supplement




NCLEX Renal Questions:
Answers and Rationale

56) C
- A significant advantage of an ultrasound is that it can differentiate a solid mass from a fluid-filled cyst. It is noninvasive and does not require any special aftercare. Other diagnostic tests, such as magnetic resonance imaging and computed tomography scanning, are also noninvasive (unless contrast is used) and require no special aftercare, either. However, the ultrasound can discriminate between solid and fluid masses most optimally.

57) D
- The predominant cause of acute glomerulonephritis is infection with beta hemolytic Streptococcus 3 weeks before the onset of symptoms. In addition to bacteria, other infectious agents that could trigger the disorder include viruses, fungi, and parasites. Bleeding ulcer, deep vein thrombosis, and myocardial infarction are not precipitating causes.

58) A
- 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 prescribed, 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.

59) D
- The pain of ureteral colic is caused by movement of a stone through the ureter and is sharp, excruciating, and wavelike, radiating to the genitalia and thigh. The stone causes reduced flow of urine, and the urine also contains blood because of its abrasive action on urinary tract mucosa. Stones in the renal pelvis cause pain that is a deep ache in the costovertebral area. Renal colic is characterized by pain that is acute, with tenderness over the costovertebral area.

60) A
- Iron is needed for RBC production. Otherwise, the body cannot produce sufficient erythrocytes. In either case, the client is not receiving the full benefit of epoetin alfa therapy if iron is not taken. Options B, C, and D are not needed for RBC production.


After you reviewed your answers through its rationale, you can now proceed to the next set of questions: 

NCLEX Renal Questions (61-65)

NCLEX Renal Questions (51-55)

Welcome to the NCLEX Renal Questions. Before you begin answering this questions, I recommend that you start from the beginning:

NCLEX Renal Questions (1-7)


Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck



51. A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safely?

a) take blood pressures only on the right arm to ensure accuracy
b) use the fistula for all venipunctures and intravenous infusions
c) ensure that small clamps are attached to the AV fistula dressing
d) assess the fistula for the presence of a bruit and thrill every 4 hours

52. A nurse is assessing a client who is diagnosed with cystitis. Which assessment finding is inconsistent with the typical clinical manifestations noted in this disorder?

a) hematuria
b) low back pain
c) urinary retention
d) burning on urination

53. A client with urolithiasis is scheduled for extracorporeal shock wave lithotripsy (ESWL). The nurse assesses to ensure that which of the following items are in place or maintained before sending the client for the procedure?

a) IV line and a foley catheter
b) NPO status and a foley catheter
c) signed informed consent, NPO status, and an IV line
d) signed informed consent and clear liquid restriction preprocedure

54. The home care nurse is making follow-up visits to a client following renal transplant. The nurse assesses the client for which signs of acute graft rejection?

a) hypotension, graft tenderness, and anemia
b) hypertension, oliguria, thirst, and hypothermia
c) fever, hypertension, graft tenderness, and malaise
d) fever, vomiting, hypotension, and copious amounts of dilute urine

55. A client is scheduled for computed tomography (CT) of the kidneys to rule out renal disease. As an essential preprocedure component of the nursing assessment, the nurse plans to ask the client about a history of:

a) familial renal disease
b) frequent antibiotic use
c) long-term diuretic therapy
d) allergy to shellfish or iodine





NCLEX Renal Questions:
Answers and Rationale

51) D
- Arteriovenous fistulas are created by anastomosis of an artery and a vein within the subcutaneous tissues to create access for hemodialysis. Fistulas should be evaluated for presence of thrills (palpate over the area) and bruits (auscultate with a stethoscope) as an assessment of patency.

52) C
- Clinical manifestations of cystitis usually include urinary frequency, urgency, dysuria, inability to void, or voiding only small amounts. The urine may be cloudy, with hematuria and bacteriuria. The client may complain of pain that is suprapubic or in the lower back. Nonspecific signs include fever, chills, malaise, and nausea and vomiting. Some clients may be asymptomatic, particularly the older client.

53) C
- ESWL is done with conscious sedation or general anesthesia. The client must sign an informed consent form for the procedure and must be NPO for the procedure. The client needs an IV line for the procedure as well. A Foley catheter is not needed.

54) C
- Acute rejection usually occurs within the first 3 months after transplant, although it can occur for up to 2 years posttransplant. The client exhibits fever, hypertension, malaise, and graft tenderness. Treatment is immediately begun with corticosteroids and possibly also with monoclonal antibodies and antilymphocyte agents.

55) D
- The client undergoing any type of diagnostic testing involving possible dye administration should be questioned about allergy to shellfish or iodine. This is essential to identify the risk for potential allergic reaction to contrast dye, which may be used. The other items are also useful as part of the assessment but are not as critical as the allergy determination in the preprocedure period.


After you reviewed your answers through its rationale, you can now proceed to the next set of questions: 

NCLEX Renal Questions (56-60)