Title WORKBOOK - RENAL FABS (SC) ✅

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 15. A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the TOP RANK REVIEW ACADEMY, INC. Page 1 | 7

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? A. “Drink fluids or use hard candy when you experience a dry mouth.” B. “Be sure to notify your physician if you experience a heart rate of less than 60 per minute.” C. “If necessary, your physician can increase your dose up to 40 mg per day.” TOP RANK REVIEW ACADEMY, INC. Page 3 | 7