Renal Failure NCLEX Practice Questions (71-75)

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71. A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further instruction if the client states to:

a) use a strong adhesive tape to anchor the catheter dressing
b) use meticulous aseptic technique for dialysate bag changes
c) take own vital signs daily
d) monitor own weight daily

72. A nurse has given a client with a nephrostomy tube instructions to follow after hospital discharge. The nurse determines that the client understands the instructions if the client states he or she should drink at least how many glasses of water per day?

a) 1 to 3
b) 6 to 8
c) 12 to 14
d) 16 to 18

73. Renal Failure NCLEX Practice Questions about a nurse who notes that a client's urinalysis report contains a notation of positive red blood cells (RBC). The nurse interprets that this finding is unrelated to which of the following items that is part of the client's medical record?

a) diabetes mellitus
b) concurrent anticoagulant therapy
c) history of kidney stones
d) history of recent blow to the right flank

74. A client with acute glomerulonephritis has had a urinalysis sent to the laboratory. The report reveals that there are hematuria and proteinuria in the urine. The nurse interprets that these results are:

a) consistent with glomerulonephritis
b) inconsistent with glomerulonephritis
c)unclear, and no conclusion can be drawn
d) indicative of impending renal failure

75. A young female client with acute pyelonephritis is scheduled for a voiding cystourethrogram. The nurse determines that this client would likely benefit from increased support and teaching about the procedure because:

a) radiopaque contrast is injected into the bloodstream with a syringe
b) radioactive material is injected into the bladder with a syringe
c) the client must lie on an x-ray table in a cold, barren room
d) the client must void while the micturition process is filmed






Renal Failure NCLEX Practice Questions
Answers and Rationale

71) A
- The client is at risk for impairment of skin integrity because of the presence of the catheter, exposure to moisture, and irritation from tape and cleansing solutions. The client should be instructed to use paper or nonallergenic tape to prevent skin irritation and breakdown. It is proper procedure for the client to use aseptic technique, and self-monitor vital signs and weight daily.

72) B
- The client with a nephrostomy tube needs to have adequate fluid intake to dilute urinary particles that could cause calculus and to provide good mechanical flushing of the kidney and tube. The nurse encourages the client to take in at least 2000 mL of fluid per day, which is roughly equivalent to 6 to 8 glasses of water. Options C and D represent high fluid volumes and could possibly place undue distention on the renal pelvis. Option A is an amount that is lower than recommended.

73) A
- Hematuria can be caused by trauma to the kidney, such as with blunt trauma to the lower posterior trunk or flank. Kidney stones can cause hematuria as they scrape the endothelial lining of the urinary system. Anticoagulant therapy can cause hematuria as a side effect. Diabetes mellitus does not cause hematuria, although it can lead to renal failure from prerenal causes.

74) A
- Gross hematuria and proteinuria are the cardinal signs of glomerulonephritis. The urine may be small in volume, dark or smoky in color from the hematuria, and foamy from the proteinuria. Concurrent serum studies would reveal elevated blood urea nitrogen, creatinine, C-reactive protein level, and antistreptolysin O titer.

75) D
- Having to void in the presence of others can be very embarrassing for clients, and may actually interfere with the client's ability to void. The nurse teaches the client about the procedure to try to minimize stress from lack of preparation, and gives the client encouragement and emotional support. Screens may be used in the radiology department to try to provide an element of privacy during this procedure.



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Renal Failure NCLEX Practice Questions (1-7)


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Renal Failure NCLEX Practice Questions (76-80)