Title WORKBOOK - RENAL FABS (KEY) ✅

COMPREHENSIVE PHASE WORKBOOK RENAL FABS NOVEMBER 2025 Philippine Nurse Licensure Examination Review 1. The patient with a diagnosis of ARF had a urine output of 1560 mL for the past 8 hours. The LPN/ LVN who is caring for this patient under your supervision asks how a patient with renal failure can have such a large urine output. What is your best response? A. “The patient’s renal failure was due to hypovolemia and we have administered IV fluids to correct the problem.” B. “Acute renal failure patients go through a diuretic phase when their kidneys begin to recover and may put out up to 10 L of urine per day.” C. “With that much urine output, there must have been a mistake made when the patient was diagnosed.” D. “An increase in urine output like this is an indicator that the patient is entering the recovery phase of acute renal failure.” 2. A client has developed acute renal failure (ARF) as a complication of glomerulonephritis. The nurse assesses the client for which of the following as an expected manifestation of ARF? A. Hypertension B. Bradycardia C. Decreased cardiac output D. Decreased central venous pressure 3. Which nursing diagnosis is a priority in a patient in acute renal failure? A. Risk for impaired skin integrity B. Altered nutrition less than body requirements C. Fluid volume excess D. Anxiety 4. The client with chronic renal failure complains of feeling nauseated at least part of everyday. The nurse should explain that the nausea is the result of A. Acidosis caused by the medications B. Accumulation of waste products in the blood C. Chronic anemia and fatigue D. Excess fluid loss 5. A nurse is caring for a client with ARF. When performing an assessment, the nurse would expect to note which of the following breathing patterns? A. Decreased respirations B. Apnea C. Cheyne-stokes respirations D. Kussmaul’s respiration 6. The nurse helps the client with chronic renal failure develop a home diet plan with the goal of helping the client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a client with chronic renal failure? A. High carbohydrate, high protein B. High calcium, high potassium, high protein C. Low protein, low sodium, low potassium D. Low protein, high potassium 7. The dialysis solution is warmed before use in peritoneal dialysis primarily to A. Encourage the removal of serum urea B. Force potassium back into the cells C. Add extra warmth to the body D. Promote abdominal muscle relaxation 8. Which of the following assessments would be most appropriate for the nurse to make while the dialysis solution is dwelling within the client’s abdomen? A. Assess for urticaria B. Observe respiratory status C. Check capillary refill time D. Monitor electrolyte status 9. During the client’s dialysis, the nurse observes that the solution draining from the abdomen is consistently blood- tingeD. The client has a permanent peritoneal catheter in place. Which interpretation of this observation would be correct? A. Bleeding is expected with a permanent peritoneal catheter B. Bleeding indicates abdominal blood vessel damage C. Bleeding can indicate kidney damage D. Bleeding is caused by too-rapid infusion of the dialysate 10. During dialysis, the nurse observes that the flow of dialysate stops before all the solution has drained out. The nurse should A. Have the client sit in a chair B. Turn the client from side to side C. Reposition the peritoneal catheter D. Have the client walk 11. Which of the following nursing interventions should be included in the client’s care plan during dialysis therapy? A. Limit the client’s visitors B. Monitor client’s blood pressure C. Pad the side rails of the bed D. Keep the client NPO 12. After completion of peritoneal dialysis, the nurse would expect the client to exhibit which of the following characteristics? A. Hematuria B. Weight loss C. Hypertension D. Increased urine output 13. A client with a history of chronic renal failure is admitted to the unit with pulmonary edema after missing her dialysis treatment yesterday. Blood is drawn and sent for a chemistry analysis. Which of the following results is expected? A. Alkalemia B. Hyperkalemia C. Hyponatremia D. Hypokalemia 14. 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 TOP RANK REVIEW ACADEMY, INC. Page 1 | 7
15. A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy? A. Depression B. Hemorrhage C. Infection D. Peptic ulcer disease 16. A client received a kidney transplant 2 months ago. He’s admitted to the hospital with the diagnosis of acute rejection. Which of the following assessment findings would be expected? A. Hypotension B. Normal body temperature C. Decreased WBC counts D. Elevated BUN and creatinine levels 17. 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 few changes in your lifestyle D. Use alcohol on the skin to clean it due to integumentary changes 18. A client is to undergo kidney transplantation with a living donor. Which of the following preoperative assessments is important? A. Urine output B. Signs of graft rejection C. Signs and symptoms of infection D. Client’s support system and understanding of lifestyle changes 19. A client with receiving hemodialysis treatment arrives at the hospital with a blood pressure of 200/100mmHg, heart rate of 110 beats/ minute, and a respiratory rate of 36 breaths/ minute. Oxygen saturation in 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 fluids D. Prepare the client for hemodialysis 20. A client with renal insufficiency is admitted with a diagnosis of pneumoniA. He’s being treated with IV antibiotics, which can be nephrotoxiC. Which of the following laboratory values should be monitored closely? A. BUN and creatinine levels B. ABG levels C. Platelet count D. Potassium level 21. The client asks whether her diet would change on CAPD. Which of the following would be the nurse’s best response? A. “Diet restrictions are more rigid with CAPD because standard peritoneal dialysis is a more effective technique” B. “Diet restrictions are the same for both CAPD and standard peritoneal dialysis.” C. “Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because dialysis is constant.” D. “Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because CAPD works more quickly.” 22. Which of the following is the most significant sign of peritoneal infection? A. Cloudy dialysate fluid B. Swelling in the legs C. Poor drainage of the dialysate fluid D. Redness at the catheter insertion site 23. Peritonitis is a common complication of peritoneal dialysis. Which assessment finding is considered a manifestation of peritonitis? A. Cloudiness of the drained dialysate B. Slow outflow rate C. Redness of the skin around the catheter D. Difficulty breathing 24. A nurse visits a client who has undergone renal transplantation. The nurse is monitoring for signs and symptoms of acute graft rejection and plans to assess the client with signs and symptoms of: A. Hypotension, graft tenderness, and hypothermia B. Fever, hypertension, and graft tenderness C. Fever, hypertension, and polyuria D. None of the above 25. When caring for a patent who has an arteriovenous graft in the left arm, the nurse should not: A. Take all blood pressure in the right arm B. Infuse IV solution in the left arm above the graft C. Position the patient on the right side D. Instruct the patient to exercise the left arm by squeezing a small rubber ball 26. Which information best helps the nurse evaluate the effects of dialysis on a patient? A. Blood pressure and weight measurements before and after dialysis B. Daily hemoglobin and hematocrit test results C. The patient’s continuing complaint of dry mouth D. Inspection of the patient’s extremities before and after dialysis 27. You are supervising an orienting nurse who is discharging a patient admitted with kidney stones post lithotripsy. Which statement by the nurse requires that you intervene? A. “You should finish all of your antibiotics to make sure that you don’t get a urinary tract infection.” B. “Remember to drink at least 3 liters of fluids every day to prevent another stone from forming.” C. “Report any signs of bruising to your physician immediately as this indicates bleeding.” D. “You can return to work in 2 days to 6 weeks, depending on what your physician prescribes.” 28. Which discharge teaching should the nurse question in a patient with calcium renal calculi? A. Limit amount of protein in the diet B. Drink 3 to 4 liters of fluid daily C. Void every 2 to 3 hours D. Take vitamin C daily 29. A client passes a urinary stone, and laboratory analysis indicates that it is composed of calcium oxalate. On the basis of this analysis, which of the following should the nurse specifically include in the dietary instructions? A. Increase intake of chocolates B. Avoid citrus fruits and juices C. Give cranberries, and plums to the patient D. Give green leafy vegetables such as spinach 30. While taking a nursing history on a patient with benign prostatic, hypertrophy, the nurse should expect him of complain of A. Urinary incontinence B. Difficulty initiating urination C. Nocturnal polyuria D. Persistent oliguria 31. The expected outcome for a continuous bladder irrigation after a client undergoes transurethral prostatectomy is: A. Removal of blood clots B. Application of local heat C. Prevention of bladder infection D. Restoration of bladder tone 32. The nurse should advise the middle – aged man that it is recommended that the prostate be examined: TOP RANK REVIEW ACADEMY, INC. Page 2 | 7
A. Once a month, when showering, after age 40 B. Every 3 months after age 50 C. During an annual physical examination after age 40 D. Every other year after age 50 33. A 24- year-old female client comes to an ambulatory care clinic in moderate distress with a probable diagnosis of acute cystitis. Which of the following symptoms would the nurse most likely expect the client to report during the assessment? A. Fever and chills B. Frequency and burning on urination C. Flank pain and nausea D. Hematuria 34. The client asks the nurse, “How did I get this urinary tract infection?” The nurse should explain that in most instances, cystitis is caused by A. Congenital strictures in the urethra B. An infection elsewhere in the body C. Urine stasis in the urinary bladder D. An ascending infection from the urethra 35. The nurse teaches a client who has cystitis methods to relieve her discomfort until the antibiotic takes effect. Which of the following responses by the client would indicate that she understands the nurse’s instructions? A. “I will place ice packs on my perineum.” B. “I will take warm tub baths.” C. “I will drink a cup of warm tea every hour.” D. “I will void every 5 to 6 hours.” 36. The client with cystitis is also given a prescription for phenazopyridine HCI (Pyridium). The nurse should teach the client that this drug is used to treat urinary tract infections by A. Releasing formaldehyde and providing bacteriostatic action B. Potentiating the action of the antibiotic C. Providing an analgesic effect on the bladder mucosa D. Preventing the crystallization that can occur with sulfa drugs. 37. Before the client starts taking phenazopyridine HCI (Pyridium), she should be taught about which of the drug’s side effects? A. Bright orange- red urine B. Incontinence C. Constipation D. Slight drowsiness 38. Which of the following statements by the client would indicate that she is at high risk for a recurrence of cystitis? A. “I can usually go 8 to 10 hours without needing to empty my bladder.” B. “I take a tub bath every evening.” C. “I wipe from front to back after voiding.” D. “I drink a lot of water during the day. 39. To prevent recurrence of cystitis, the nurse should plan to encourage the client to include which of the following measures in her daily routine? A. Wearing cotton underpants B. Increasing citrus juice intake C. Douching regularly with 0.25% acetic D. Using vaginal sprays 40. The client with acute pyelonephritis wants to know the possibility of developing chronic pyelonephritis. The nurse’s response is based on knowledge that which of the following disorders most commonly leads to chronic pyelonephritis? A. Acute pyelonephritis B. Recurrent urinary tract infections C. Acute renal failure D. Glomerulonephritis 41. Under your supervision, a new graduate RN is teaching the 28-year-old married female client with cystitis methods to prevent future urinary tract infections. Which statement by the new nurse requires that you intervene? A. “You should always drink 1 to 3 liters of fluid everyday.” B. “Empty your bladder regularly even if you do not feel the urge to urinate.” C. “Drinking cranberry juice daily may decrease bacteria in your bladder.” D. “It’s OK to soak in the tub with bubble bath as it will keep you clean.” 42. Data collection includes eliciting information about voiding characteristics from a client with acute cystitis. Which complaint should the nurse expect? A. Oliguria and hematuria B. Polyuria and stress incontinence C. Dark, concentrated urine and enuresis D. Frequency of and burning upon urination 43. What characteristics urinalysis findings would the nurse note in a patient with glomerulonephritis? A. Decreased specific gravity and hematuria B. Decreased specific gravity and proteinuria C. Increased specific gravity and glycosuria D. Increased specific gravity and proteinuria 44. A male client is admitted for treatment of glomerulonephritis. On initial assessment, Nurse Rose detects one of the classic signs of acute glomerulonephritis of sudden onset. Such signs include: A. generalized edema, especially of the face and periorbital area. B. green-tinged urine C. moderate to severe hypotension D.polyuria. 45. You are the admission nurse for a patient with nephrotic syndrome. Which assessment finding supports this diagnosis? A. Edema formation B. Hypotension C. Increased urine output D. Flank pain 46. Your patient is receiving IV piggyback doses of gentamicin every 12 hours. What measurement is your priority for monitoring during the period that the patient is receiving this drug? A. Serum creatinine and BUN B. Morning weight every day C. Intake and output every shift D. Temperature elevation 47. When developing a plan of care for the client with stress incontinence, the nurse should take into consideration that stress incontinence is best defined as the involuntary loss of urine associated with A. A strong urge to urinate B. Overdistention of the bladder C. Activities that increase abdominal pressure D. Obstruction of the urethra 48. The nurse is developing a teaching plan for a client with stress incontinence. Which of the following instructions should be included? A. Avoid activities that are stressful and upsetting B. Avoid caffeine and alcohol C. Do not wear a girdle D. Limit physical exertion 49. A client has urge incontinence. Which of the following signs and symptoms would the nurse expect to find in this client? A. Inability to empty the bladder B. Loss of urine when coughing C. Involuntary urination with minimal warning D. Frequent dribbling of urine 50. The patient with incontinence will be taking oxybutynin chloride (Ditropan) 5 mg by mouth three times a day after discharge. Which information would you be sure to teach this patient prior to discharge? TOP RANK REVIEW ACADEMY, INC. Page 3 | 7