Renal Failure NCLEX Questions (1-5)

Try answering the following Renal Failure NCLEX Questions and review the rationale afterwards.

1. A client with acute pyelonephritis is scheduled for a voiding cystourethrogram. The client is very shy and modest. The nurse determines that this client would benefit from increased support and teaching about the procedure because:

a) radioactive material is inserted into the bladder
b) radiopaque contrast is injected into the bloodstream
c) the client must void while the voiding process is filmed
d) the client must lie on x-ray table in a cold, barren room

2. Renal Failure NCLEX Questions about a client who has been diagnosed with chronic renal failure has been told that hemodialysis will be required. The client becomes angry and states, “I’ll never be the same now.” The nurse formulates which nursing diagnosis for the client?

a) anxiety
b) noncompliance
c) disturbed body image
d) disturbed thought process

3. A 22-year old female client has recently been diagnosed with polycystic kidney disease. The nurse has a series of discussions with the client that are intended to help the client adjust to the disorder. The nurse plans to include which item as a part of one of these discussions?

a) ongoing fluid restriction
b) the need for genetic counseling
c) the risk of hypotensive episodes
d) depression regarding massive edema

4. Renal Failure NCLEX Questions about the nurse who is admitting a client to the hospital who is to undergo ureterolithomy for urinal calculi removal. The nurse understands that it is unnecessary to assess which of the following to determine the client’s readiness for surgery?

a) the need for a visit from a support group
b) the knowledge of postoperative activities
c) an understanding of the surgical procedure
d) feelings or anxieties about the surgical procedure

5. A client diagnosed with cancer of the bladder has a nursing diagnosis of Fear related to the uncertain outcome of an upcoming cystectomy and urinary diversion. The nurse assesses that this diagnosis still applies if the client makes which of the following statements?

a) I wish I’d never gone to the doctor at all
b) I’m so afraid that I won’t live through all this
c) I’ll never feel like myself if I can’t go to the bathroom
d) What if I have no help at home after going through this awful surgery

Renal Failure NCLEX Questions
Answers and Rationale

1) C
- Having to void in the presence of others can be very embarrassing for clients, and it may actually interfere with the client's ability to void. The nurse teaches the client about the procedure to try to minimize stress from a lack of preparation and gives the client encouragement and emotional support. Screens may be used in the radiology department to try to provide an element of privacy during this procedure. Options A, B, and D are incorrect and do not address the subject of support.

2) C
- A client with a renal disorder such as renal failure may become angry in response to the permanence of the condition. Because of the physical changes and the change in lifestyle that may be required to manage a severe renal condition, the client may experience Disturbed body image. Anxiety is not appropriate, because the client is able to identify the cause of concern. The client is not stating a refusal to undergo therapy (option B) and is not cognitively impaired (option D).

3) B
- Renal Failure NCLEX Questions Rationale: Adult polycystic kidney disease is a hereditary disorder that is inherited as an autosomal-dominant trait. Because of this, the client and his or her extended family should have genetic counseling. Ongoing fluid restriction is unnecessary. The client is likely to have hypertension rather than hypotension. Massive edema is not part of the clinical picture of this disorder.

4) A
- Ureterolithotomy is the removal of a calculus from the ureter using either a flank or abdominal incision. Because no urinary diversion is created during this procedure, the client has no need for a visit from a member of a support group. The client should have an understanding of the same items as are required for any surgery, including knowledge of the procedures, the expected outcome, the postoperative routines, and any expected discomfort. The client should also be assessed for any concerns or anxieties before surgery.

5) B
- For Fear to be an actual diagnosis, the client must be able to identify the object of fear. In this question, the client is expressing a fear of an uncertain outcome related to cancer and possibly a fear of death. Option A is vague and nonspecific. Option C reflects a disturbed body image. The statement in option D reflects a risk for impaired home maintenance. Further exploration would be required to associate this statement with a nursing diagnosis.

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