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Home ! NCLEX Practice Questions

NCLEX Practice Questions

Urinary System Disorders

Practice Quiz #1 (50
Questions)
By Matt Vera, BSN, R.N. - Updated on April 10, 2019 " 0

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This is a 50-item NCLEX style exam that has

questions about the diseases affecting the Renal
System. Challenging questions such as Chronic
Renal Failure, Kidney Transplant, and Renal Calculi
are given in this test.

EXAM TIP: When choosing which patient to see

first, choose the patient who is the most unstable.
Patient’s who are most likely to perish, most
critical, or will suffer further injury without
immediate action should be prioritized first.

Tough times never last, but tough people do.

~ Robert H. Schuller

Topics
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Included topics in this practice quiz are:

Acute Glomerulonephritis
Chronic Renal Failure
Diabetic Nephropathy
Kidney Transplant
Neurogenic Bladder
Peritoneal Dialysis
Prostatectomy
Pyelonephritis
Renal Calculi
Urinary Tract Infection

Guidelines
Follow the guidelines below to make the most out
of this exam:

Read each question carefully and choose the

best answer.
You are given one minute per question. Spend
your time wisely!
Answers and rationales are given below. Be
sure to read them.
If you need more clarifications, please direct
them to the comments section.

Questions

EXAM MODE

In Exam Mode: All questions are shown and

the results, answers and rationales (if any)
will only be given after you’ve finished the
quiz. You are given 1 minute per question, a
total of 50 minutes for this exam.

Urinary System
Disorder Practice Quiz
#1 (50 Questions)
0:00

Congratulations - you have completed

Urinary System Disorder Practice Quiz #1
(50 Questions). You scored 6 out of 50.
Your performance has been rated as
Need more practice!

Your answers are highlighted below.

Question 1 CORRECT

You suspect kidney transplant rejection

when the patient shows which
symptoms?

Pain in the incision, general

malaise, and hypotension

Pain in the incision, general

malaise, and depression

Fever, weight gain, and

diminished urine output

Diminished urine output and

hypotension

Question 1 Explanation:

Symptoms of rejection include fever,

rapid weight gain, hypertension, pain
over the graft site, peripheral edema,
and diminished urine output.

Question 2 WRONG

Which sign indicated the second phase

of acute renal failure?

Daily doubling of urine output (4

to 5 L/day)

Urine output less than 400

ml/day

Urine output less than 100

ml/day

Stabilization of renal function

Question 2 Explanation:

Daily doubling of the urine output

indicates that the nephrons are
healing. This means the patient is
passing into the second phase
(dieresis) of acute renal failure.

Question 3 WRONG

Which criterion is required before a

patient can be considered for
continuous peritoneal dialysis?

The patient must be

hemodynamically stable

The vascular access must have

healed

The patient must be in a home

setting

Hemodialysis must have failed

Question 3 Explanation:

Hemodynamic stability must be

established before continuous
peritoneal dialysis can be started.

Question 4 CORRECT

After the first hemodialysis treatment,

your patient develops a headache,
hypertension, restlessness, mental
confusion, nausea, and vomiting. Which
condition is indicated?

Disequilibrium syndrome

Respiratory distress

Hypervolemia

Peritonitis

Question 4 Explanation:

Disequilibrium occurs when excess

solutes are cleared from the blood
more rapidly than they can diffuse
from the body’s cells into the
vascular system.

Question 5 CORRECT

A patient returns from surgery with an

indwelling urinary catheter in place and
empty. Six hours later, the volume is
120ml. The drainage system has no
obstructions. Which intervention has
priority?

Give a 500 ml bolus of isotonic

saline

Evaluate the patient’s

circulation and vital signs

Flush the urinary catheter with

sterile water or saline

Place the patient in the shock

position, and notify the surgeon

Question 5 Explanation:

A total UO of 120ml is too low. Assess

the patient’s circulation and
hemodynamic stability for signs of
hypovolemia. A fluid bolus may be
required, but only after further
nursing assessment and a doctor’s
order.

Question 6 WRONG

Which of the following causes the

majority of UTI’s in hospitalized
patients?

Lack of fluid intake

Inadequate perineal care

Invasive procedures

Immunosuppression

Question 6 Explanation:

Invasive procedures such as

catheterization can introduce
bacteria into the urinary tract. A lack
of fluid intake could cause
concentration of urine, but wouldn’t
necessarily cause infection.

Question 7 CORRECT

What is the most important nursing

diagnosis for a patient in end-stage renal
disease?

Risk for injury

Fluid volume excess

Altered nutrition: less than body

requirements

Activity intolerance

Question 7 Explanation:

Kidneys are unable to rid the body of

excess fluids which results in fluid
volume excess during ESRD.

Question 8 CORRECT

Which finding leads you to suspect

acute glomerulonephritis in your 32 y.o.
patient?

Dysuria, frequency, and urgency

Back pain, nausea, and vomiting

Hypertension, oliguria, and

fatigue

Fever, chills, and right upper

quadrant pain radiating to the
back

Question 8 Explanation:

Mild to moderate HTN may result

from sodium or water retention and
inappropriate renin release from the
kidneys. Oliguria and fatigue also may
be seen. Other signs are proteinuria
and azotemia.

Question 9 WRONG

Clinical manifestations of acute

glomerulonephritis include which of the
following?

Chills and flank pain

Oliguria and generalized edema

Hematuria and proteinuria

Dysuria and hypotension

Question 9 Explanation:

Hematuria and proteinuria indicate

acute glomerulonephritis. These
finding result from increased
permeability of the glomerular
membrane due to the antigen-
antibody reaction. Generalized
edema is seen most often in
nephrosis.

Question 10 WRONG

Your patient has complaints of severe

right-sided flank pain, nausea, vomiting
and restlessness. He appears slightly
pale and is diaphoretic. Vital signs are
BP 140/90 mmHg, Pulse 118 beats/min.,
respirations 33 breaths/minute, and
temperature, 98.0F. Which subjective
data supports a diagnosis of renal
calculi?

Pain radiating to the right upper

quadrant

History of mild flu symptoms

last week

Dark-colored coffee-ground
emesis

Dark, scanty urine output

Question 10 Explanation:

Patients with renal calculi commonly

have blood in the urine caused by the
stone’s passage through the urinary
tract. The urine appears dark, tests
positive for blood, and is typically
scant.

Question 11 WRONG

What change indicates recovery in a

patient with nephrotic syndrome?

Disappearance of protein from

the urine

Decrease in blood pressure to

normal

Increase in serum lipid levels

Gain in body weight

Question 11 Explanation:

With nephrotic syndrome, the

glomerular basement membrane of
the kidney becomes more porous,
leading to loss of protein in the urine.
As the patient recovers, less protein
is found in the urine.

Question 12 WRONG

Your patient is complaining of muscle

cramps while undergoing hemodialysis.
Which intervention is effective in
relieving muscle cramps?

Increase the rate of dialysis

Infuse normal saline solution

Administer a 5% dextrose
solution

Encourage active ROM

exercises

Question 12 Explanation:

Treatment includes administering

normal saline or hypertonic normal
saline solution because muscle
cramps can occur when the sodium
and water are removed to quickly
during dialysis. Reducing the rate of
dialysis, not increasing it, may
alleviate muscle cramps.

Question 13 WRONG

Immunosuppression following Kidney

transplantation is continued:

For life

24 hours after transplantation

A week after transplantation

Until the kidney is not anymore

rejected

Question 13 Explanation:

For life.

Question 14 WRONG

What is the best way to check for

patency of the arteriovenous fistula for
hemodialysis?

Pinch the fistula and note the

speed of filling on release

Use a needle and syringe to

aspirate blood from the fistula

Check for capillary refill of the

nail beds on that extremity

Palpate the fistula throughout its

length to assess for a thrill

Question 14 Explanation:

The vibration or thrill felt during

palpation ensures that the fistula has
the desired turbulent blood flow.
Pinching the fistula could cause
damage. Aspirating blood is a
needless invasive procedure.

Question 15 WRONG

A patient who received a kidney

transplant returns for a follow-up visit to
the outpatient clinic and reports a lump
in her breast. Transplant recipients are:

At increased risk for cancer due

to immunosuppression caused
by cyclosporine (Neoral)

Consumed with fear after the

life-threatening experience of
having a transplant

At increased risk for tumors

because of the kidney
transplant

At decreased risk for cancer, so

the lump is most likely benign

Question 15 Explanation:

Cyclosporine suppresses the immune

response to prevent rejection of the
transplanted kidney. The use of
cyclosporine places the patient at
risk for tumors.

Question 16 WRONG

Polystyrene sulfonate (Kayexalate) is

used in renal failure to:

Correct acidosis

Reduce serum phosphate levels

Exchange potassium for sodium

Prevent constipation from

sorbitol use

Question 16 Explanation:

In renal failure, patients become

hyperkalemic because they can’t
excrete potassium in the urine.
Polystyrene sulfonate acts to excrete
potassium by pulling potassium into
the bowels and exchanging it for
sodium.

Question 17 WRONG

Which statement correctly distinguishes

renal failure from prerenal failure?

With prerenal failure, vasoactive

substances such as dopamine
(Intropin) increase blood
pressure

With prerenal failure, there is

less response to such diuretics
as furosemide (Lasix)

With prerenal failure, an IV ,

isotonic saline infusion