Nclex Questions On Uti — I Hate CBT's

Question: 1

Fever, chills, and costovertebral pain are symptoms of a urinary tract infection (acute pyelonephritis), which requires a urine culture ﬁrst to conﬁrm the diagnosis.

Answer: The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe ﬁrst?

1.A midstream urine for culture.
2.A sonogram of the kidney.
3.An intravenous pyelogram for renal calculi.
4.A CT scan of the kidneys.

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Question: 4

Coffee, tea, cola, and alcoholic beverages are urinary tract irritants.

Answer: The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI?

1.Clean the perineum from back to front after a bowel movement.
2.Take warm tub baths instead of hot showers daily.
3.Void immediately preceding sexual intercourse.
4.Avoid coffee, tea, colas, and alcoholic beverages.

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Question: 3

The client should be taught to take all the prescribed medication anytime a prescription is written for antibiotics.

Answer: The nurse is discharging a client with a health-care facility acquired urinary tract infection. Which information should the nurse include in the discharge teaching?

1.Limit ﬂuid intake so the urinary tract can heal.
2.Collect a routine urine specimen for culture.
3.Take all the antibiotics as prescribed.
4.Tell the client to void every ﬁve (5) to six (6) hours.

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Question: 3

A long-term complication of glomerulonephritis is it can become chronic if unresponsive to treatment,and this can lead to end-stage renal disease. Maintaining renal function is an appropriate long-term goal.

Answer: The nurse is preparing a plan of care for the client diagnosed with acute glomerulonephritis. Which statement is an appropriate long-term goal?

1.The client will have a blood pressure within normal limits.
2.The client will show no protein in the urine.
3.The client will maintain normal renal function.
4.The client will have clear lung sounds.

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Question: 3

Glomerular ﬁltration rate (GFR) is approximately 120 mL/min. If the GFR is decreased to 40 mL/min, the kidneys are functioning at about one-third ﬁltration capacity.

Answer: The elderly client is diagnosed with chronic glomerulonephritis. Which laboratory value indicates to the nurse the condition has become worse?

1.The blood urea nitrogen is 15 mg/dL.
2.The creatinine level is 1.2 mg/dL.
3.The glomerular ﬁltration rate is 40 mL/min.
4.The 24-hour creatinine clearance is 100 mL/min.

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Question: 1.

Blood urea nitrogen (BUN) levels reﬂect the balance between the production and excretion of urea from the kidneys. Creatinine is a by-product of the metabolism of the muscles and is excreted by the kidneys. Creatinine is the ideal sub-stance for determining renal clearance because it is relatively constant in the body and is the laboratory value most signiﬁcant in diagnosing renal failure.

Answer: The nurse is caring for a client diagnosed with ARF. Which laboratory values are most signiﬁcant for diagnosing ARF?

1.BUN and creatinine.
2.WBC and hemoglobin.
3.Potassium and sodium.
4.Bilirubin and ammonia level.

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Question: 2.

Hypotension, which causes a decreased blood supply to the kidney, is one of the most common causes of pre-renal failure(before the kidney).

Answer: The nurse is caring for a client diagnosed with rule-out ARF. Which condition predisposes the client to developing prerenal failure?

1.Diabetes mellitus.
2.Hypotension.
3.Aminoglycosides.
4.Benign prostatic hypertrophy

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Question: 4.

Normal potassium level is 3.5 to5.5 mEq/L. A level of 6.8 mEq/L is life threatening and could lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to decrease the potassium level quickly. This requires a health-careprovider order, so it is a collaborative intervention.

Answer: The client diagnosed with ARF has a serum potassium level of 6.8 mEq/L. Which collaborative treatment should the nurse anticipate for the client?

1.Administer a phosphate binder.
2.Type and crossmatch for whole blood.
3.Assess the client for leg cramps.
4.Prepare the client for dialysis.

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Question: 3.

Carbohydrates are increased to provide for the client's caloric intake and protein is restricted to minimize protein breakdown and to prevent accumulation of toxic waste products.

Answer: The client diagnosed with ARF is admitted to the intensive care unit and placed on a therapeutic diet. Which diet is most appropriate for the client?

1.A high-potassium and low-calcium diet.
2.A low-fat and low-cholesterol diet.
3.A high-carbohydrate and restricted-protein diet.
4.A regular diet with six (6) small feedings a day.

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Question: 2.

Bed rest reduces exertion and the metabolic rate, thereby reducing catabolism and subsequent release of potassium and accumulation of endogenous waste products (urea and creatinine).

Answer: The client diagnosed with ARF is placed on bed rest. The client asks the nurse, "Why do I have to stay in bed? I don't feel bad." Which scientiﬁc rationale supports the nurse's response?

1.Bed rest helps increase the blood return to the renal circulation.
2.Bed rest reduces the metabolic rate during the acute stage.
3.Bed rest decreases the workload of the left side of the heart.
4.Bed rest aids in reduction of peripheral and sacral edema.

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Question: 2.

These crystals are uremic frost resulting from irritating toxins deposited in the client's tissues. Bathing in cool water will remove the crystals, promote client comfort, and decrease the itching resulting from uremic frost.

Answer: The UAP tells the nurse the client with ARF has a white crystal-like layer on top of the skin. Which intervention should the nurse implement?

1.Have the assistant apply a moisture barrier cream to the skin.
2.Instruct the UAP to bathe the client in cool water.
3.Tell the UAP not to turn the client in this condition.
4.Explain this is normal and do not do anything for the client.

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Question: 3.

Regular insulin, along with glucose, will drive potassium into the cells,thereby lowering serum potassium levels temporarily.

Answer: The client diagnosed with ARF is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level?

1.Erythropoietin.
2.Calcium gluconate.
3.Regular insulin.
4.Osmotic diuretic.

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Question: 2.

This client's dialysis access is compromised and he or she should be assessed ﬁrst.

Answer: The nurse in the dialysis center is initiating the morning dialysis run. Which client should the nurse assess ﬁrst?

1.The client who has hemoglobin of 9.8 g/dL and hematocrit of 30%.
2.The client who does not have a palpable thrill or auscultated bruit.
3.The client who is complaining of being exhausted and is sleeping.
4.The client who did not take antihypertensive medication this morning.

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Question: 1.

The nurse should place the client's chair with the head lower than thebody, which will shunt blood to the brain; this is the Trendelenburg position.

Answer: The client receiving dialysis is complaining of being dizzy and light-headed. Which action should the nurse implement ﬁrst?

1.Place the client in the Trendelenburg position.
2.Turn off the dialysis machine immediately.
3.Bolus the client with 500 mL of normal saline.
4.Notify the health-care provider as soon as possible.

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Question: 3.

Dehydration results in concentrated serum, causing laboratory values to increase because the blood has normal constituents but not enough volume to dilute the values to within normal range or possibly lower.

Answer: The client is admitted to a nursing unit from a long-term care facility with a hematocrit of 56% and a serum sodium level of 152 mEq/L. Which condition is a cause for these ﬁndings?

1.Overhydration.
2.Anemia.
3.Dehydration.
4.Renal failure.

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Question: 1.

A client with a peaked T wave could be experiencing hyperkalemia. Changes in potassium levels can initiate cardiac dysrhythmias and instability.

Answer: The telemetry monitor technician notiﬁes the nurse of the morning telemetry readings. Which client should the nurse assess ﬁrst?

1.The client in normal sinus rhythm with a peaked T wave.
2.The client diagnosed with atrial ﬁbrillation with a rate of 100.
3.The client diagnosed with a myocardial infarction who has occasional PVCs.
4.The client with a ﬁrst-degree atrioventricular block and a rate of 92.

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Question: 2.

Increasing the irrigation ﬂuid will ﬂush out the clots and blood.

Answer: The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement?

1.Remove the indwelling catheter.
2.Titrate the NS irrigation to run faster.
3.Administer protamine sulfate IVP.
4.Administer vitamin K slowly.

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Question: 4.

Clients with acute bacterial prostatitis will frequently experience a sudden onset of fever and chills. Clients with chronic prostatitis have milder symptoms.

Answer: Which data support to the nurse the client's diagnosis of acute bacterial prostatitis?

1.Terminal dribbling.
2.Urinary frequency.
3.Stress incontinence.
4.Sudden fever and chills.

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Question: 4.

This is a potentially life-threatening problem.

Answer: Which nursing diagnosis is priority for the client who has undergone a TURP?

1.Potential for sexual dysfunction.
2.Potential for an altered body image.
3.Potential for chronic infection.
4.Potential for hemorrhage.

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Question: 2.

Elevating the scrotum on a towel for support is a task which can be delegated to the UAP.

Answer: The client is one (1) day postoperative TURP. Which task should the nurse delegate to the UAP?

1.Increase the irrigation ﬂuid to clear clots from the tubing.
2.Elevate the scrotum on a towel roll for support.
3.Change the dressing on the ﬁrst postoperative day.
4.Teach the client how to care for the continuous irrigation catheter.

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Question: 4.

The nurse should always assess any complaint before dismissing it as a commonly occurring problem.

Answer: The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement ﬁrst?

1.Call the surgeon to inform the HCP of the client's complaint.
2.Administer the client a narcotic medication for pain.
3.Explain to the client this sensation happens frequently.
4.Assess the continuous irrigation catheter for patency.

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Question: 3.

This is usually the length of time clients need to wait prior to having sexual intercourse; this is the information the client wants to know.

Answer: The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse?

1."You seem anxious about your surgery."
2."Tell me about your fears of impotency."
3."Potency can return in six (6) to eight (8) weeks."
4."Did you ask your doctor about your concern?"

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Question: 1.

An elevated PSA can be from urinary retention, BPH, prostate cancer, or prostate infarct.

Answer: The client asks, "What does an elevated PSA test mean?" On which scientiﬁc rationale should the nurse base the response?

1.An elevated PSA can result from several different causes.
2.An elevated PSA can be only from prostate cancer.
3.An elevated PSA can be diagnostic for testicular cancer.
4.An elevated PSA is the only test used to diagnose BPH.

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Question: 1, 3, 4

The nurse should assess the drain postoperatively.

The head of the bed should be lowered and the foot should be elevated to shunt blood to the central circulating system.

The surgeon needs to be notiﬁed of the change in condition.

Answer: The client returned from surgery after having a TURP and has a P 110, R 24, BP90/40, and cool and clammy skin. Which interventions should the nurse implement?Select all that apply.

1.Assess the urine in the continuous irrigation drainage bag.
2.Decrease the irrigation ﬂuid in the continuous irrigation catheter.
3.Lower the head of the bed while raising the foot of the bed.
4.Contact the surgeon to give an update on the client's condition.
5.Check the client's postoperative creatinine and BUN.

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Question: 2.

Bladder spasms are common, but being relieved with medication indicates the condition is improving.

Answer: The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving?

1.The client is using the maximum amount allowed by the PCA pump.
2.The client's bladder spasms are relieved by medication.
3.The client's scrotum is swollen and tender with movement.
4.The client has passed a large, hard, brown stool this morning.

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Question: 4.

The white blood cell count is elevated;normal is 5,000 to 10,000/mm3.

Answer: The client had surgery to remove a kidney stone. Which laboratory assessment data warrant immediate intervention by the nurse?

1.A serum potassium level of 3.8 mEq/L.
2.A urinalysis shows microscopic hematuria.
3.A creatinine level of 0.8 mg/100 mL.
4.A white blood cell count of 14,000/mm3.

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Question: 3.

Venison, sardines, goose, organ meats,and herring are high-purine foods, which should be eliminated from the diet to help prevent uric acid stones.

Answer: The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent re-occurrence?

1.Beer and colas.
2.Asparagus and cabbage.
3.Venison and sardines.
4.Cheese and eggs.

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Question: 1.

Clients who have urinary incontinenceare often embarrassed, so it is the responsibility of the nurse to approach this subject with respect and consideration.

Answer: The elderly client being seen in the clinic has complaints of urinary frequency,urgency, and "leaking." Which priority intervention should the nurse implement when interviewing the client?

1.Ensure communication is nonjudgmental and respectful.
2.Set the temperature for comfort in the examination room.
3.Speak loudly to ensure the client understands the nurse.
4.Ensure the examining room has adequate lighting.

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Question: 4.

Use of the bladder training drill is helpful in stress incontinence. The client is instructed to void at scheduled intervals. After consistently being dry, the interval is increased by 15 minutes until the client reaches an acceptable interval.

Answer: The elderly client recovering from a prostatectomy has been experiencing stress incontinence. Which independent nursing intervention should the nurse discuss with the client?

1.Establish a set voiding frequency of every two (2) hours while awake.
2.Encourage a family member to assist the client to the bathroom to void.
3.Apply a transurethral electrical stimulator to relieve symptoms of urinary urgency.
4.Discuss the use of a "bladder drill," including a timed voiding schedule.

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Question: 2.

When an elderly client's mental status changes to confused and irritable, the nurse should seek the etiology, which may be a UTI secondary to an indwelling catheter. Elderly client soften do not present with classic signs and symptoms of infection.

Answer: The nurse is caring for an elderly client who has an indwelling catheter. Which data warrant further investigation?

1.The client's temperature is 98.0˚F.
2.The client has become confused and irritable.
3.The client's urine is clear and light yellow.
4.The client feels the need to urinate.

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Question: 3.

The drainage bag should be kept below the level of the bladder to prevent reﬂux of urine into the renal system; it should not be placed on the bed.

Answer: The nurse is observing the UAP providing direct care to a client with an indwelling catheter. Which data warrant immediate intervention by the nurse?

1.The UAP secures the tubing to the client's leg with tape.
2.The UAP provides catheter care with the client's bath.
3.The UAP puts the collection bag on the client's bed.
4.The UAP cares for the catheter after washing the hands.

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Question: 4.

The nephrostomy tube should never be clamped or have kinks because an obstruction can cause pyelonephritis.

Answer: Which intervention should the nurse implement when caring for the client with a nephrostomy tube?

1.Change the dressing only if soiled by urine.
2.Clean the end of the connecting tubing with Betadine.
3.Clean the drainage system every day with bleach and water.
4.Assess the tube for kinks to prevent obstruction.

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