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
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: 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 TOP RANK REVIEW ACADEMY, INC. Page 2 | 7

D. “You should take this medication with meals to avoid stomach ulcers.” 51. Nurse Rina evaluates which of the following arterial blood gases for normal values? Select all that apply: I. pH of 7.30 II. PaCO2 of 36 mm Hg III. HCO 3– of 20 mEq/L IV. P aO2 of 84 mm Hg V. P aCO2 of 30 mm Hg VI. pH of 7.43 A. 1, 2, 3, 4 B. 1, 4, 5 C. 2, 3, 6 D. 2, 4, 6 52. The nurse evaluates which of the following clients to be at risk for developing hypernatremia? A. Marina, 50-year-old with pneumonia, diaphoresis, and high fevers B. Malin, 62-year-old with congestive heart failure taking loop diuretics C. Hannah, 39-year-old with diarrhea and vomiting D. Lucing, 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone (SIADH) 53. Lena was admitted due to diabetic ketoacidosis and was treated accordingly. Currently, she has a normal blood glucose, pH, and serum osmolality. During assessment, the client complains of weakness in the legs. Which of the following is a priority nursing intervention? A. Request a physical therapy consult from the physician B. Ensure the client is safe from falls and check the most recent potassium level C. Allow uninterrupted rest periods throughout the day D. Encourage the client to increase intake of dairy products and green, leafy vegetables 54. Gretchen has a potassium level of 7 mEq/L and 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. 55. Nurse Paul is caring for Connie who was admitted for urinary tract infection. The infection has been resolved. 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 56. Linda, a 39 weeks AOG pregnant patient 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 57. Kelly is a patient with chronic renal failure reports a 10-pound weight loss over 3 months and has had difficulty taking calcium supplements. The total calcium is 6.9 mg/dl. Which of the following would be the first nursing action? A. Assess for depressed deep tendon reflexes B. Call the physician to report calcium level C. Place an intravenous catheter in anticipation of administering calcium gluconate D. Check to see if a serum albumin level is available 58. Aling Mila is a patient with heart failure who is complaining of nauseA. She has received IV furosemide (Lasix), and the urine output has been 2500 ml over the past 12 hours. The client’s home drugs include metoprolol (Lopressor), digoxin (Lanoxin), furosemide, and multivitamins. Which of the following are the appropriate nursing actions before administering the digoxin? Select all that apply: I. Administer an antiemetic prior to giving the digoxin II. Encourage the client to increase fluid intake III. Call the physician IV. Report the urine output V. Report indications of nausea VI. Monitor continuous ECG for peaked T waves and widened QRS A. 1, 2, 3 B. 2, 5, 6 C. 3, 4, 5 D. 2, 4, 6 59. Nurse Lea is caring for a Fivo, a client admitted with multiple myeloma and a serum calcium level of 15 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 60. Mang Tomas was admitted due to heart failure and has a sodium level of 111 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 behaviour is a result of dehydration.” 61. Benjamin with a serum sodium of 98 mEq/L has been receiving 3% NS at 30 ml/hr for 16 hours. This morning the client feels fatigued and breathless. 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 62. Harry has an end stage renal disease undergoing dialysis and 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 63. Paolo is receiving intravenous potassium supplementation in addition to maintenance fluids. The urine output has been 120 ml every 8 hours for the past 16 hours and the next dose is due. Before administering the next potassium dose, which of the following is the priority nursing action? A. Encourage the client to increase fluid intake B. Administer the dose as ordered C. Draw a potassium level and administer the dose if the level is low or normal D. Notify the physician of the urine output and hold the dose 64. Nurse Genna 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 TOP RANK REVIEW ACADEMY, INC. Page 4 | 7