Title Care of Clients with Problems with Fluids and Electrolytes_ Renal and Urinary System.pdf ✅

NURSES LICENSURE EXAMINATION (NLE) Controlled Copy 2023 Rev. 00 CLASSIFIED EXAMINATION FOR CRITICAL TEST ANALYSIS Care of Clients with Problems with Fluids and Electrolytes; Renal and Urinary System Philippine Nurses Licensure Examination Warning: This material is protected by Copyright Laws. Unauthorized use shall be prosecuted in the full extent of the Philippine Laws. For exclusive use of CBRC reviewees only. 1. You are teaching a class on renal disease. Which of the following statements are CORRECT? A. Involvement of 90% of the nephrons is found in acute renal failure B. There is a direct correlation between the amount of urine produced and the severity of renal failure C. Acute renal failure follows prolonged hypotension D. The most diagnostic lab test for renal failure is the blood urea nitrogen 2. The nurse administers which of the following prescribed medications to a client with recurrent urinary tract infections caused by Escherichia coli? A. Hyoscyamine sulfate (Levsin) B. Bethanechol chloride (Urecholine) C. Sulfamethoxazole and trimethoprim (Bactrim DS) D. Phenazopyridine hydrochloride (Pyridium) 3. The nurse is caring for a client suspected of sustaining renal trauma following an automobile accident. It is a PRIORITY that the nurse monitor and report which of the following findings? A. Lethargy C. Hematuria B. Hypertension D. Bradycardia 4. The nurse is caring for a client in acute renal failure. Which of the following clinical manifestations is a PRIORITY for the nurse to monitor in this client? A. Infection C. Oliguria B. Pain D. Anemia 5. The nurse is caring for a client in acute renal failure. Which of the following would indicate to the nurse that the client is uremic? A. BUN of 32 mg/dL B. Serum calcium of 10.5 mg/dL C. Serum potassium of 2.8 mg/dL D. Urine specific gravity of 1.030 6. An intravenous pyelogram (IVP) is going to be done to the client. Which of the following would be essential for the nurse to INCLUDE? A. Instruct the client that no fasting is required B. Inform the client that a ureteral catheter will be inserted during the procedure C. Administer a laxative the night before the procedure D. Monitor for bladder spasms after the procedure 7. The nurse identifies which of the following hospitalized clients to be at greatest risk for the development of a nosocomial urinary tract infection? A. A 48-year-old male suspected of Parkinson’s disease who had been jogging prior to admission B. A 75-year-old male who has pancreatic cancer C. A 34-year-old male who drinks 2500 mL of fluids daily, following a fracture of the fibula D. A 60-year-old obese female with cholecystitis 8. The nurse identifies which of the following diagnostic laboratory tests as the one the nurse should assess FIRST to establish a diagnosis for renal disease? A. Blood urea nitrogen (BUN) B. Serum creatinine C. Serum uric acid D. Serum potassium 9. The nurse is collecting a nursing history from a client admitted with acute pyelonephritis. Which of the following questions should the nurse ask? A. “Have you noticed any blood in your urine?” B. “Have you experienced a decrease in your urinary output?” C. “Do you have pain when urinating?” D. “Do you find you are experiencing dribbling at the end of urinating?” 10. The nurse monitors an increased incidence of stress incontinence in a client during which of the following activities? A. Eating C. Walking B. Sleeping D. Laughing 11. After inserting a catheter, you inflate the balloon and the client complains of pain. Which of the following would be your PRIORITY action? A. Aspirate back solution from the balloon and remove the catheter B. Insert the remainder of the solution in the balloon and pull back gently until resistance is felt C. Aspirate back solution from the balloon and advance the catheter further D. Withdraw the catheter slightly and insert an additional 1 mL into the balloon 12. Which of the following principles of catheter care should the nurse consider before catheterizing a client? A. Place a urinary catheter in a client who is geriatric to prevent urinary incontinence B. Use catheterization as a last resort C. Keep the catheter bag on the bed and at the level of the bladder D. Sprinkle powder in the perineal area and around the catheter insertion site 13. The nurse should INCLUDE which of the following in the procedure for female urinary catheterization? A. Expose the urinary meatus with the dominant hand B. Lubricate 3 inches of the catheter C. Insert the catheter 8 inches with the sterile gloved hand D. Allow the labia to relax after the meatus is cleansed
NURSES LICENSURE EXAMINATION (NLE) Controlled Copy 2023 Rev. 00 14. The nurse evaluates a client with a diagnosis of dehydration to have which of the following specific gravity readings? A. 1.000 C. 1.023 B. 1.017 D. 1.035 15. The nurse is reviewing the normal limits for a urinalysis. Which of the following findings would indicate to the nurse the need for additional investigation? A. Dark, amber-colored urine B. Faint, aromatic odor C. Specific gravity of 1.015 D. pH of 6.0 16. The patient who has potassium level of 6.5 mEq/L is to receive sodium polystyrene sulfonate (Kayexalate) orally. After administering the drug, the PRIORITY nursing action is to monitor: A. Urine output B. Blood pressure C. Bowel movements D. ECG for tall, peaked T waves 17. The nurse is caring for a client who has been in good health up to the present and is admitted with cellulitis of the hand. The client’s serum potassium level was 4.5 mEq/L yesterday. Today the level is 7 mEq/L. Which of the following is the next APPROPRIATE nursing action? A. Call the physician and report results B. Question the results and redraw the specimen C. Encourage the client to increase the intake of bananas D. Initiate seizure precautions 18. A client is receiving an intravenous magnesium infusion to correct a serum level of 1.4 mEq/L. Which of the following assessments would alert the nurse to immediately stop the infusion? A. Absent patellar reflex B. Diarrhea C. Premature ventricular contractions D. Increase in blood pressure 19. The nurse is caring for a bedridden client admitted with multiple myeloma and a serum calcium level of 13 mg/dL. Which of the following is the MOST appropriate nursing action? A. Provide passive range-of-motion exercises and encourage fluid intake B. Teach the client to increase intake of whole grains and nuts C. Place a tracheostomy tray at the bedside D. Administer calcium gluconate IM as ordered 20. An older adult client admitted with heart failure and a sodium level of 113 mEq/L is behaving aggressively toward staff and does not recognize family members. When the family expresses concern about the client’s behavior, the nurse would respond MOST appropriately by stating which of the following? A. “The client may be suffering from dementia, and the hospitalization has worsened the confusion.” B. “Most older adults get confused in the hospital.” C. “The sodium level is low, and the confusion will resolve as the levels normalize.” D. “The sodium level is high, and the behavior is a result of dehydration.” 21. A client with a serum sodium of 125 mEq/L has been receiving 3% NS at 50 mL/hr for 16 hours. This morning the client feels tired and short of breath. Which of the following interventions is a PRIORITY? A. Turn down the infusion B. Check the latest sodium level C. Assess for signs of fluid overload D. Place a call to the physician 22. A client with chronic renal failure receiving dialysis complains of frequent constipation. When performing discharge teaching, which over-the-counter products should the nurse instruct the client to avoid at home? A. Bisacodyl (Dulcolax) suppository B. Fiber supplements C. Docusate sodium D. Milk of magnesia 23. The nurse should monitor for clinical manifestations of hypophosphatemia in which of the following clients? A. A client with osteoporosis taking vitamin D and calcium supplements B. A client who is alcoholic receiving total parenteral nutrition C. A client with chronic renal failure awaiting the first dialysis run D. A client with hypoparathyroidism secondary to thyroid surgery 24. The nurse should include which of the following instructions to assist in controlling phosphorus levels for a client in renal failure? A. Increase intake of dairy products and nuts B. Take aluminum-based antacids such as aluminum hydroxide (Amphojel) with or after meals C. Reduce intake of chocolate, meats, and whole grains D. Avoid calcium supplements 25. A client with pneumonia presents with the following arterial blood gases: pH of 7.28, PaCO2 of 74, HCO3 of 28 mEq/L, and PO2 of 45. Which of the following is the MOST appropriate nursing intervention? A. Administer a sedative B. Place client in left lateral position C. Place client in high-Fowler’s position D. Assist the client to breathe into a paper bag 26. A client with a recent thyroidectomy complains of numbness and tingling around the mouth. Which of the following findings indicates the serum calcium is low? A. Bone pain B. Depressed deep tendon reflexes C. Positive Chvostek’s sign D. Nausea 27. A client recently diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) complains of headache, weight gain, and nausea. Which of the following is an APPROPRIATE nursing diagnosis for this client? A. Deficient fluid volume related to decreased fluid intake B. Excess fluid volume related to increased water retention C. Deficient fluid volume related to excessive fluid loss D. Risk for injury related to fluid volume loss