Tiêu đề 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

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
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.” 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 TOP RANK REVIEW ACADEMY, INC. Page 4 | 7