Urinary System Disorders | NCLEX Quiz 117

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Questions: 10 | Attempts: 4,688 | Updated: Aug 22, 2023

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Urinary System Disorders | NCLEX Quiz 117 - Quiz

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.

The client newly diagnosed with chronic renal failure recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome. the nurse assesses the client during dialysis for:
- A.
  
  Hypertension. tachycardia. and fever
- B.
  
  Hypotension. bradycardia. and hypothermia
- C.
  
  Restlessness. irritability. and generalized weakness
- D.
  
  Headache. deteriorating level of consciousness. and twitching.
Correct Answer
D. Headache. deteriorating level of consciousness. and twitching.

Explanation
Disequilibrium syndrome is characterized by headache. mental confusion. decreasing level of consciousness. nausea. and vomiting. twitching. and possible seizure activity. Disequilibrium syndrome is caused by rapid removal of solutes from the body during hemodialysis. At the same time. the blood-brain barrier interferes with the efficient removal of wastes from brain tissue. As a result. water goes into cerebral cells because of the osmotic gradient. causing brain swelling and onset of symptoms. The syndrome most often occurs in clients who are new to dialysis and is prevented by dialyzing for shorter times or at reduced blood flow rates.

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2.

A client with chronic renal failure has completed a hemodialysis treatment. The nurse would use which of the following standard indicators to evaluate the client’s status after dialysis?
- A.
  
  Potassium level and weight
- B.
  
  BUN and creatinine levels
- C.
  
  VS and BUN
- D.
  
  VS and weight.
Correct Answer
D. VS and weight.

Explanation
Following dialysis. the client’s vital signs are monitored to determine whether the client is remaining hemodynamically stable. Weight is measured and compared with the client’s predialysis weight to determine the effectiveness of fluid extraction.Options A. B. and C: Laboratory studies are done as per protocol but are not necessarily done after the hemodialysis treatment has ended.

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3.

The hemodialysis client with a left arm fistula is at risk for steal syndrome. The nurse assesses this client for which of the following clinical manifestations?
- A.
  
  Warmth. redness. and pain in the left hand.
- B.
  
  Pallor. diminished pulse. and pain in the left hand.
- C.
  
  Edema and reddish discoloration of the left arm
- D.
  
  Aching pain. pallor. and edema in the left arm.
Correct Answer
B. Pallor. diminished pulse. and pain in the left hand.

Explanation
Steal syndrome results from vascular insufficiency after the creation of a fistula. The client exhibits pallor and a diminished pulse distal to the fistula. The client also complains of pain distal to the fistula. which is due to tissue ischemia.Option A: Warmth. redness. and pain more likely would characterize a problem with infection.

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4.

A client is admitted to the hospital and has a diagnosis of early stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client?
- A.
  
  Polyuria
- B.
  
  Polydipsia
- C.
  
  Oliguria
- D.
  
  Anuria
Correct Answer
A. Polyuria

Explanation
Polyuria occurs early in chronic renal failure and if untreated can cause severe dehydration. Polyuria progresses to anuria. and the client loses all normal functions of the kidney.Options B. C. and D: Oliguria and anuria are not early signs. and polydipsia is unrelated to chronic renal failure.

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5.

The client with chronic renal failure returns to the nursing unit following a hemodialysis treatment. On assessment the nurse notes that the client’s temperature is 100.2. Which of the following is the most appropriate nursing action?
- A.
  
  Encourage fluids
- B.
  
  Notify the physician
- C.
  
  Monitor the site of the shunt for infection
- D.
  
  Continue to monitor vital signs
Correct Answer
D. Continue to monitor vital signs

Explanation
The client may have an elevated temperature following dialysis because the dialysis machine warms the blood slightly. If the temperature is elevated excessively and remains elevated. sepsis would be suspected. and a blood sample would be obtained as prescribed for culture and sensitivity purposes.

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6.

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action?
- A.
  
  Notify the physician
- B.
  
  Monitor the client
- C.
  
  Elevate the head of the bed
- D.
  
  Medicate the client for nausea
Correct Answer
A. Notify the physician

Explanation
Disequilibrium syndrome may be due to the rapid decrease in BUN levels during dialysis. These changes can cause cerebral edema that leads to increased intracranial pressure. The client is exhibiting early signs of disequilibrium syndrome and appropriate treatments with anticonvulsant medications and barbiturates may be necessary to prevent a life-threatening situation. The physician must be notified.

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7.

The nurse is assisting a client on a low-potassium diet to select food items from the menu. Which of the following food items. if selected by the client. would indicate an understanding of this dietary restriction?
- A.
  
  Cantaloupe
- B.
  
  Spinach
- C.
  
  Lima beans
- D.
  
  Strawberries
Correct Answer
C. Lima beans

Explanation
Lima beans (1/3 c) averages three (3) mEq per serving.Option A: Cantaloupe (1/4 small).Option B: Spinach (1/2 cooked).Option D: Strawberries (1 ¼ cups) are high potassium foods and average 7 mEq per serving.

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8.

If a client’s prostate enlargement is caused by a malignancy. which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred?
- A.
  
  Serum creatinine level
- B.
  
  Serum acid phosphatase level
- C.
  
  Total nonprotein nitrogen level
- D.
  
  Endogenous creatinine clearance time
Correct Answer
D. Endogenous creatinine clearance time

Explanation
Increasing the glucose concentration makes the solution increasingly more hypertonic. The more hypertonic the solution. the greater the osmotic pressure for ultrafiltration and thus the greater amount of fluid removed from the client during an exchange.

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9.

The nurse is preparing to care for a client receiving peritoneal dialysis. Which of the following would be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis?
- A.
  
  Monitor the client’s level of consciousness
- B.
  
  Maintain strict aseptic technique
- C.
  
  Add heparin to the dialysate solution
- D.
  
  Change the catheter site dressing daily
Correct Answer
B. Maintain strict aseptic technique

Explanation
The major complication of peritoneal dialysis is peritonitis. Strict aseptic technique is required in caring for the client receiving this treatment. Although option D may assist in preventing infection. this option relates to an external site.

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10.

A client newly diagnosed with renal failure is receiving peritoneal dialysis. During the infusion of the dialysate the client complains of abdominal pain. Which action by the nurse is most appropriate?
- A.
  
  Slow the infusion
- B.
  
  Decrease the amount to be infused
- C.
  
  Explain that the pain will subside after the first few exchanges
- D.
  
  Stop the dialysis
Correct Answer
C. Explain that the pain will subside after the first few exchanges

Explanation
Pain during the inflow of dialysate is common during the first few exchanges because of peritoneal irritation; however. the pain usually disappears after 1 to 2 weeks of treatment. The infusion amount should not be decreased. and the infusion should not be slowed or stopped.

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Urinary System Disorders | NCLEX Quiz 117

The client newly diagnosed with chronic renal failure recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome. the nurse assesses the client during dialysis for:

A client with chronic renal failure has completed a hemodialysis treatment. The nurse would use which of the following standard indicators to evaluate the client’s status after dialysis?

The hemodialysis client with a left arm fistula is at risk for steal syndrome. The nurse assesses this client for which of the following clinical manifestations?

A client is admitted to the hospital and has a diagnosis of early stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client?

The client with chronic renal failure returns to the nursing unit following a hemodialysis treatment. On assessment the nurse notes that the client’s temperature is 100.2. Which of the following is the most appropriate nursing action?

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action?

The nurse is assisting a client on a low-potassium diet to select food items from the menu. Which of the following food items. if selected by the client. would indicate an understanding of this dietary restriction?

If a client’s prostate enlargement is caused by a malignancy. which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred?

The nurse is preparing to care for a client receiving peritoneal dialysis. Which of the following would be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis?

A client newly diagnosed with renal failure is receiving peritoneal dialysis. During the infusion of the dialysate the client complains of abdominal pain. Which action by the nurse is most appropriate?