Urinary System Disorders | NCLEX Quiz 116

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Urinary System Disorders NCLEX Quizzes & Trivia

. All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.

Questions and Answers

1.

Dialysis allows for the exchange of particles across a semipermeable membrane by which of the following actions?
- A.
  
  Osmosis and diffusion
- B.
  
  Passage of fluid toward a solution with a lower solute concentration
- C.
  
  Allowing the passage of blood cells and protein molecules through it.
- D.
  
  Passage of solute particles toward a solution with a higher concentration.
Correct Answer
A. Osmosis and diffusion

Explanation
Osmosis allows for the removal of fluid from the blood by allowing it to pass through the semipermeable membrane to an area of high concentrate (dialysate). and diffusion allows for passage of particles (electrolytes. urea. and creatinine) from an area of higher concentration to an area of lower concentration.Option B: Fluid passes to an area with a higher solute concentration.Option C: The pores of a semipermeable membrane are small. thus preventing the flow of blood cells and protein molecules through it.

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2.

A client is diagnosed with chronic renal failure and told she must start hemodialysis. Client teaching would include which of the following instructions?
- A.
  
  Follow a high potassium diet
- B.
  
  Strictly follow the hemodialysis schedule
- C.
  
  There will be a few changes in your lifestyle.
- D.
  
  Use alcohol on the skin and clean it due to integumentary changes.
Correct Answer
B. Strictly follow the hemodialysis schedule

Explanation
To prevent life-threatening complications. the client must follow the dialysis schedule.Option A: The client should follow a low-potassium diet because potassium levels increase in chronic renal failure.Option C: The client should know hemodialysis is time-consuming and will definitely cause a change in current lifestyle.Option D: Alcohol would further dry the client’s skin more than it already is.

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3.

A client is undergoing peritoneal dialysis. The dialysate dwell time is completed. and the dwell clamp is opened to allow the dialysate to drain. The nurse notes that the drainage has stopped and only 500 ml has drained; the amount the dialysate instilled was 1.500 ml. Which of the following interventions would be done first?
- A.
  
  Change the client’s position.
- B.
  
  Call the physician.
- C.
  
  Check the catheter for kinks or obstruction.
- D.
  
  Clamp the catheter and instill more dialysate at the next exchange time.
Correct Answer
C. Check the catheter for kinks or obstruction.

Explanation
The first intervention should be to check for kinks and obstructions because that could be preventing drainage. After checking for kinks. have the client change position to promote drainage. Don’t give the next scheduled exchange until the dialysate is drained because abdominal distention will occur. unless the output is within parameters set by the physician. If unable to get more output despite checking for kinks and changing the client’s position. the nurse should then call the physician to determine the proper intervention.

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4.

A client receiving hemodialysis treatment arrives at the hospital with a blood pressure of 200/100. a heart rate of 110. and a respiratory rate of 36. Oxygen saturation on room air is 89%. He complains of shortness of breath. and +2 pedal edema is noted. His last hemodialysis treatment was yesterday. Which of the following interventions should be done first?
- A.
  
  Administer oxygen
- B.
  
  Elevate the foot of the bed
- C.
  
  Restrict the client’s fluids
- D.
  
  Prepare the client for hemodialysis.
Correct Answer
A. Administer oxygen

Explanation
Airway and oxygenation are always the first priority. Because the client is complaining of shortness of breath and his oxygen saturation is only 89%. the nurse needs to try to increase his levels by administering oxygen.Option B: The foot of the bed may be elevated to reduce edema. but this isn’t the priority.Options C and D: The client is in pulmonary edema from fluid overload and will need to be dialyzed and have his fluids restricted. but the first interventions should be aimed at the immediate treatment of hypoxia.

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5.

A client has a history of chronic renal failure and received hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which of the following interventions is included in this client’s plan of care?
- A.
  
  Keep the AV fistula site dry.
- B.
  
  Keep the AV fistula wrapped in gauze.
- C.
  
  Take the blood pressure in the left arm
- D.
  
  Assess the AV fistula for a bruit and thrill
Correct Answer
D. Assess the AV fistula for a bruit and thrill

Explanation
Assessment of the AV fistula for bruit and thrill is important because. if not present. it indicates a non-functioning fistula.Option A: When not being dialyzed. the AV fistula site may get wet.Option B: Immediately after a dialysis treatment. the access site is covered with adhesive bandages.Option C: No blood pressures or venipunctures should be taken in the arm with the AV fistula.

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6.

Which of the following factors causes the nausea associated with renal failure?
- A.
  
  Oliguria
- B.
  
  Gastric ulcers
- C.
  
  Electrolyte imbalances
- D.
  
  Accumulation of waste products
Correct Answer
D. Accumulation of waste products

Explanation
Although clients with renal failure can develop stress ulcers. the nausea is usually related to the poisons of metabolic wastes that accumulate when the kidneys are unable to eliminate them.Options A and C: The client has electrolyte imbalances and oliguria. but these don’t directly cause nausea.

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7.

Which of the following clients is at greatest risk for developing acute renal failure?
- A.
  
  A dialysis client who gets influenza
- B.
  
  A teenager who has an appendectomy
- C.
  
  A pregnant woman who has a fractured femur
- D.
  
  A client with diabetes who has a heart catheterization
Correct Answer
D. A client with diabetes who has a heart catheterization

Explanation
Clients with diabetes are prone to renal insufficiency and renal failure. The contrast used for heart catheterization must be eliminated by the kidneys. which further stresses them and may produce acute renal failure. A dialysis client already has end-stage renal disease and wouldn’t develop acute renal failure.Options B and C: A teenager who has an appendectomy and a pregnant woman with a fractured femur isn’t at increased risk for renal failure.

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8.

In a client in renal failure. which assessment finding may indicate hypocalcemia?
- A.
  
  Headache
- B.
  
  Serum calcium level of 5 mEq/L
- C.
  
  Increased blood coagulation
- D.
  
  Diarrhea
Correct Answer
D. Diarrhea

Explanation
In renal failure. calcium absorption from the intestine declines. leading to increased smooth muscle contractions. causing diarrhea.Option A: CNS changes in renal failure rarely include headache.Option B: A serum calcium level of 5 mEq/L indicates hypercalcemia.Option C: As renal failure progresses. bleeding tendencies increase.

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9.

A nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic renal failure. Which finding indicates that the fistula is patent?
- A.
  
  Absence of bruit on auscultation of the fistula.
- B.
  
  Palpation of a thrill over the fistula
- C.
  
  Presence of a radial pulse in the left wrist
- D.
  
  Capillary refill time less than 3 seconds in the nail beds of the fingers on the left hand.
Correct Answer
B. Palpation of a thrill over the fistula

Explanation
The nurse assesses the patency of the fistula by palpating for the presence of a thrill or auscultating for a bruit.Option A: The presence of a thrill and bruit indicate patency of the fistula.Options C and D: Although the presence of a radial pulse in the left wrist and capillary refill time less than 3 seconds in the nail beds of the fingers on the left hand are normal findings; they do not assess fistula patency.

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10.

The client with chronic renal failure is at risk of developing dementia related to excessive absorption of aluminum. The nurse teaches that this is the reason that the client is being prescribed which of the following phosphate binding agents?
- A.
  
  Alu-cap (aluminum hydroxide)
- B.
  
  Tums (calcium carbonate)
- C.
  
  Amphojel (aluminum hydroxide)
- D.
  
  Basaljel (aluminum hydroxide)
Correct Answer
B. Tums (calcium carbonate)

Explanation
Phosphate binding agents that contain aluminum include Alu-caps. Basaljel. and Amphojel. These products are made from aluminum hydroxide. Tums are made from calcium carbonate and also bind phosphorus. Tums are prescribed to avoid the occurrence of dementia related to high intake of aluminum. Phosphate binding agents are needed by the client in renal failure because the kidneys cannot eliminate phosphorus.

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Urinary System Disorders | NCLEX Quiz 116

Dialysis allows for the exchange of particles across a semipermeable membrane by which of the following actions?

A client is diagnosed with chronic renal failure and told she must start hemodialysis. Client teaching would include which of the following instructions?

A client has a history of chronic renal failure and received hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which of the following interventions is included in this client’s plan of care?

Which of the following factors causes the nausea associated with renal failure?

Which of the following clients is at greatest risk for developing acute renal failure?

In a client in renal failure. which assessment finding may indicate hypocalcemia?

A nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic renal failure. Which finding indicates that the fistula is patent?

The client with chronic renal failure is at risk of developing dementia related to excessive absorption of aluminum. The nurse teaches that this is the reason that the client is being prescribed which of the following phosphate binding agents?