NCLEXQUESTIONS LATEST UPDATE 2024/2025 WITH 100% DETAILED ANSWERS., Exams of Health sciences

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NCLEX QUESTIONS LATEST UPDATE 2024/2025 WITH

100% DETAILED ANSWERS.

1. Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis? A. Jaundice and flank pain B. Costovertebral angle tenderness and chills C. Burning sensation on urination D. Polyuria and nocturia Answer: Costovertebral angle tenderness and chills Costovertebral angle tenderness, flank pain, and chills are symptoms of acute pyelonephritis. Jaundice indicates gallbladder or liver obstruction. A burning sensation on urination is a sign of lower urinary tract infection.
2. You have a patient who might have a urinary tract infection (UTI). Which statement by the patient suggests that a UTI is likely? A. "I pee a lot." B. "It burns when I pee." C. "I go hours without the urge to pee." D. "My pee smells sweet." Answer: "It burns when I pee." A common symptom of a UTI is dysuria. A patient with a UTI often reports frequent voiding of small amounts and the urgency to void. Urine that smells sweet is often associated with diabetic ketoacidosis.
3. Which patient is at greatest risk for developing a urinary tract infection (UTI)? A. A 35 y.o. woman with a fractured wrist B. A 20 y.o. woman with asthma C. A 50 y.o. postmenopausal woman D. A 28 y.o. with angina Answer: A 50 y.o. postmenopausal woman Women are more prone to UTI's after menopause due to reduced estrogen levels. Reduced estrogen

levels lead to reduced levels of vaginal Lactobacilli bacteria, which protect against infection. Angina, asthma and fractures don't increase the risk of UTI.

4. Which intervention do you plan to include with a patient who has renal calculi? A. Maintain bed rest B. Increase dietary purines C. Restrict fluids D. Strain all urine Answer: Strain all urine All urine should be strained through gauze or a urine strainer to catch stones that are passed. The stones are then analyzed for composition. Ambulation may help the movement of the stone down the urinary tract. Encourage fluid to help flush the stones out.
5. An 18 y.o. student is admitted with dark urine, fever, and flank pain and is diagnosed with acute glomerulonephritis. Which would most likely be in this student's health history? A. Renal calculi B. Renal trauma C. Recent sore throat D. Family history of acute glomerulonephritis Answer: Recent sore throat The most common form of acute glomerulonephritis is caused by goup A beta-hemolytic streptococcal infection elsewhere in the body. Which of the following causes the majority of UTI's in hospitalized patients? Lack of fluid intake Inadequate perineal care Invasive procedures Immunosuppression Answer: Invasive procedures Invasive procedures such as catheterization can introduce bacteria into the urinary tract. A lack of fluid intake could cause concentration of urine, but wouldn't necessarily cause infection. Clinical manifestations of acute glomerulonephritis include which of the following? Chills and flank pain Oliguria and generalized edema

Hematuria and proteinuria Dysuria and hypotension Answer: Hematuria and proteinuria Hematuria and proteinuria indicate acute glomerulonephritis. These finding result from increased permeability of the glomerular membrane due to the antigen-antibody reaction. Generalized edema is seen most often in nephrosis. The most common early sign of kidney disease is: Sodium retention Elevated BUN level Development of metabolic acidosis Inability to dilute or concentrate urine Answer: Elevated BUN Increased BUN is usually an early indicator of decreased renal function A 22 y.o. patient with diabetic nephropathy says, "I have two kidneys and I'm still young. If I stick to my insulin schedule, I don't have to worry about kidney damage, right?" Which of the following statements is the best response? "You have little to worry about as long as your kidneys keep making urine." "You should talk to your doctor because statistics show that you're being unrealistic." "You would be correct if your diabetes could be managed with insulin." "Even with insulin, kidney damage is still a concern." Answer: "Even with insulin, kidney damage is still a concern." Kidney damage is still a concern. Microavascular changes occur in both of the patient's kidneys as a complication of the diabetes. Diabetic nephropathy is the leading cause of end-stage renal disease. The kidneys continue to produce urine until the end stage. Nephropathy occurs even with insulin management. A patient diagnosed with sepsis from a UTI is being discharged. What do you plan to include in her discharge teaching? Take cool baths Avoid tampon use Avoid sexual activity Drink 8 to 10 eight-oz glasses of water daily

Answer: Drink 8 to 10 eight-oz glasses of water daily Drinking 2 - 3L of water daily inhibits bacterial growth in the bladder and helps flush the bacteria from the bladder. The patient should be instructed to void after sexual activity. Which finding leads you to suspect acute glomerulonephritis in your 32 y.o. patient? Dysuria, frequency, and urgency Back pain, nausea, and vomiting Hypertension, oliguria, and fatigue Fever, chills, and right upper quadrant pain radiating to the back Answer: Hypertension, oliguria, and fatigue Mild to moderate HTN may result from sodium or water retention and inappropriate rennin release from the kidneys. Oliguria and fatigue also may be seen. Other signs are proteinuria and azotemia. What is the priority nursing diagnosis with your patient diagnosed with end-stage renal disease? Activity intolerance Fluid volume excess Knowledge deficit Pain Answer: Fluid volume excess Fluid volume excess because the kidneys aren't removing fluid and wastes. The other diagnoses may apply, but they don't take priority. Your 60 y.o. patient with pyelonephritis and possible septicemia has had five UTIs over the past two years. She is fatigued from lack of sleep, has lost weight, and urinates frequently even in the night. Her labs show: sodium, 154 mEq/L; osmolarity 340 mOsm/L; glucose, 127 mg/dl; and potassium, 3. mEq/L. Which nursing diagnosis is priority? Fluid volume deficit related to osmotic diuresis induced by hyponatremia Fluid volume deficit related to inability to conserve water Altered nutrition: Less than body requirements related to hypermetabolic state Altered nutrition: Less than body requirements related to catabolic effects of insulin deficiency Answer: Fluid volume deficit related to inability to conserve water Which sign indicated the second phase of acute renal failure? Daily doubling of urine output (4 to 5 L/day) Urine output less than 400 ml/day

Urine output less than 100 ml/day Stabilization of renal function Answer: Daily doubling of urine output (4 to 5 L/day) Daily doubling of the urine output indicates that the nephrons are healing. This means the patient is passing into the second phase (dieresis) of acute renal failure. A patient with diabetes mellitus and renal failure begins hemodialysis. Which diet is best on days between dialysis treatments? Low-protein diet with unlimited amounts of water Low-protein diet with a prescribed amount of water No protein in the diet and use of a salt substitute No restrictions Answer: Low-protein diet with a prescribed amount of water The patient should follow a low-protein diet with a prescribed amount of water. The patient requires some protein to meet metabolic needs. Salt substitutes shouldn't be used without a doctor's order because it may contain potassium, which could make the patient hyperkalemic. Fluid and protein restrictions are needed. A patient with diabetes has had many renal calculi over the past 20 years and now has chronic renal failure. Which substance must be reduced in this patient's diet? Carbohydrates Fats Protein Vitamin C Answer: Protein Because of damage to the nephrons, the kidney can't excrete all the metabolic wastes of protein, so this patient's protein intake must be restricted. A higher intake of carbs, fats, and vitamin supplements is needed to ensure the growth and maintenance of the patient's tissues. You have a paraplegic patient with renal calculi. Which factor contributes to the development of calculi? Increased calcium loss from the bones Decreased kidney function Decreased calcium intake High fluid intake

Answer: Increased calcium loss from the bones Bones lose calcium when a patient can no longer bear weight. The calcium lost from bones form calculi, a concentration of mineral salts also known as a stone, in the renal system. What is the most important nursing diagnosis for a patient in end-stage renal disease? Risk for injury Fluid volume excess Altered nutrition: less than body requirements Activity intolerance Answer: Fluid volume excess Kidneys are unable to rid the body of excess fluids which results in fluid volume excess during ESRD. Which cause of hypertension is the most common in acute renal failure? Pulmonary edema Hypervolemia Hypovolemia Anemia Answer: Hypervolemia Acute renal failure causes hypervolemia as a result of overexpansion of extracellular fluid and plasma volume with the hypersecretion of rennin. Therefore, hypervolemia causes hypertension. What change indicates recovery in a patient with nephritic syndrome? Disappearance of protein from the urine Decrease in blood pressure to normal Increase in serum lipid levels Gain in body weight Answer: Disappearance of protein from the urine With nephrotic syndrome, the glomerular basement membrane of the kidney becomes more porous, leading to loss of protein in the urine. As the patient recovers, less protein is found in the urine. Which statement correctly distinguishes renal failure from prerenal failure? A. With prerenal failure, vasoactive substances such as dopamine (Intropin) increase blood pressure B. With prerenal failure, there is less response to such diuretics as furosemide (Lasix)

C. With prerenal failure, an IV isotonic saline infusion increases urine output D. With prerenal failure, hemodialysis reduces the BUN level Answer: With prerenal failure, an IV isotonic saline infusion increases urine output Prerenal failure is caused by such conditions as hypovolemia that impairs kidney perfusion; giving isotonic fluids improves urine output. Vasoactive substances can increase blood pressure in both conditions. Your patient has complaints of severe right-sided flank pain, nausea, vomiting and restlessness. He appears slightly pale and is diaphoretic. Vital signs are BP 140/90 mmHg, Pulse 118 beats/min., respirations 33 breaths/minute, and temperature, 98.0F. Which subjective data supports a diagnosis of renal calculi? Pain radiating to the right upper quadrant History of mild flu symptoms last week Dark-colored coffee-ground emesis Dark, scant urine output Answer: Dark, scant urine output Patients with renal calculi commonly have blood in the urine caused by the stone's passage through the urinary tract. The urine appears dark, tests positive for blood, and is typically scant.