NCLEX RN Practice Questions often require students to prioritize nursing interventions based on the client's condition and needs.
NCLEX Urinary System Questions - NCLEX Questions on Urinary System
Urinary System NCLEX Questions Test Strategies
NGN Case Study:
Mr. Jones is a 50-year-old man who has recently been experiencing fatigue, nausea, and difficulty urinating. His healthcare provider orders a series of renal function tests to assess the functioning of his kidneys. The results of the tests are as follows:
- Blood urea nitrogen (BUN): 12 mg/dL
- Serum creatinine: 1.8 mg/dL
- BUN/creatinine ratio: 6
- Based on these test results, the healthcare provider suspects that Mr. Jones has kidney disease.
Question 1.
Which of the following is NOT a possible cause of an increased BUN/creatinine ratio?
(a) Decreased body fluid volume
(b) High protein diet
(c) Extreme muscle catabolism
(d) Obstruction in the urinary path
(e) Increased body fluid volume
Answer:
(a) Decreased body fluid volume
Explanation:
The BUN/creatinine ratio is a measure of the balance between nitrogenous waste products (BUN) and creatinine in the blood. An increase in the ratio suggests that there is an excess of nitrogenous waste products relative to creatinine, which may be due to an increase in body fluid volume. This could be caused by a variety of factors, including dehydration, kidney disease, or certain medications.
On the other hand, a decrease in the BUN/creatinine ratio may be caused by a decrease in body fluid volume, a high protein diet, extreme muscle catabolism, or an obstruction in the urinary path. It is important to interpret the BUN/creatinine ratio in the context of the patient's clinical presentation and other laboratory values to accurately assess renal function.
Rationale:
The normal range for the BUN/creatinine ratio is between 6 to 25. An increase in this ratio suggests an increase in body fluid volume. Options (b), (c). and (d) may all cause a decrease in the BUN/creatinine ratio. Option (a), decreased body fluid volume, is incorrect as it would cause a decrease in the BUN/creatinine ratio rather than an increase.
Urinary System NCLEX Practice Questions
Question 1.
Mrs. Agrima is a 67-year-old woman who has been receiving hemodialysis for the past 5 years. During her latest treatment, she suddenly complains of chest pains and becomes pale and clammy. The nurse immediately checks for a pulse and finds that it is weak and thready. The nurse also notes that there is a small amount of air in the dialysis tubing.
Which of the following is NOT a nursing intervention for air embolism during hemodialysis?
(a) Stop the dialysis
(b) Turn the patient's head to the right side
(c) Call the healthcare provider
(d) Administer oxygen and check other vital signs
Answer:
(b) Turn the patient's head to the right side
Rationale:
The correct nursing intervention for air embolism during hemodialysis is to turn the patient's head to the left side, which is lower than the feet. Option (b), turning the head to the right side, is incorrect as it is not a recommended intervention for air embolism. Options (a), (c), and (d) are all correct interventions for air embolism.
Explanation:
Air embolism during dialysis is a serious condition that requires immediate attention. The first step in managing air embolism is to stop the dialysis, as continuing the procedure may exacerbate the problem. The patient's head should then be turned to the left side, which is lower than the feet, to help prevent further air from entering the circulation.
The healthcare provider should also be called immediately, as they will be able to assess the patient's condition and provide further treatment as necessary. In addition to calling the healthcare provider, the nurse should administer oxygen to the patient and check their vital signs, as this will help to ensure that the patient is receiving adequate oxygenation and perfusion.
Question 2.
Mr. Miranda is a 50-year-old man who has been experiencing fatigue, weight loss, and difficulty urinating. His healthcare provider orders a series of renal function tests, including a blood urea nitrogen (BUN) test, a serum creatinine test, and a BUN/creatinine ratio test. The results of these tests are as follows: BUN: 15 mg/dL Serum creatinine: 2.0 mg/dL BUN/creatinine ratio: 7.5
What is the most likely diagnosis based on the renal function test results for Mr. Miranda?
(a) Decreased body fluid volume
(b) High protein diet
(c) Extreme muscle catabolism
(d) Kidney disease
Answer:
(d) Kidney disease
Explanation:
Blood urea nitrogen (BUN) and serum creatinine are both markers of renal function. BUN is a byproduct of protein metabolism that is excreted by the kidneys, while creatinine is the end product of protein metabolism and is also excreted by the kidneys. Both BUN and creatinine levels can be elevated in the presence of kidney disease, as the kidneys are not functioning properly and are unable to effectively filter out these waste products.
The BUN/creatinine ratio can also be used to assess renal function and can indicate conditions such as decreased body fluid volume or extreme muscle catabolism. In the case of Mr. Miranda, the elevated BUN and creatinine levels, along with the low BUN/creatinine ratio, suggest that he has kidney disease.
Rationale:
The correct diagnosis based on the test results for Mr. Miranda is kidney disease. The BUN level is significantly elevated (15 mg/dL, compared to the normal range of 10-20 mg/dL), and the serum creatinine level is also elevated (2.0 mg/dL, compared to the normal range of 0.6-1.2 mg/dL in males). The BUN/'creatinine ratio is also low. at 7.5 (compared to the normal range of 6-25).
All of these findings suggest that Mr. Miranda has kidney disease, which is likely causing his symptoms of fatigue, weight loss, and difficulty urinating. Options (a), (b), and (c) are not consistent with the test results and are therefore not likely diagnoses.
Question 3.
Mr. Miranda is a 45-year-old man who has been experiencing symptoms of kidney disease, including fatigue, difficulty urinating, and swelling in his feet and ankles. His healthcare provider orders a series of renal function tests to assess the function of his kidneys. The results of the tests are as follows: Blood urea nitrogen (BUN): 8.5 mmol/L Serum creatinine: 1.3 mg/dL BUN/creatinine ratio: 12
Which of the following statements is NOT true about the results of Mr. Miranda's renal function tests?
(a) The BUN level is within the normal range
(b) The serum creatinine level is within the normal range
(c) The BUN/creatinine ratio is within the normal range
(d) The serum creatinine level suggests that Mr. Miranda's glomerular filtration rate is low
Answer:
(a) The BUN level is within the normal range
Explanation:
The renal function tests ordered for Mr. Miranda are used to assess the function of his kidneys and to diagnose any kidney disease or dysfunction. The BUN level measures the amount of urea nitrogen in the blood, which is a byproduct of protein metabolism and is eliminated by the kidneys. An elevated BUN level may indicate the presence of kidney disease or other conditions such as infection or gastrointestinal disorders. The serum creatinine level measures the amount of creatinine in the blood, which is also a byproduct of protein metabolism and is eliminated by the kidneys.
An elevated serum creatinine level is a sign of impaired kidney function and a reduced glomerular filtration rate. The BUN/creatinine ratio can be used to assess various body dysfunctions and changes in body fluid volume. An increase in this ratio may suggest an increase in body fluid volume, while a decrease may suggest a decrease in body fluid volume or other conditions such as a high protein diet or extreme muscle catabolism.
Rationale:
The correct statement is that the BUN level is not within the normal range. The normal range for BUN is 3.6 to 7.1 mmol/L, and Mr. Miranda's BUN level is 8.5 mmol/L. Option (b), stating that the serum creatinine level is within the normal range, is incorrect as the normal range for serum creatinine is 0.6 to 1.2 mg/dL in males and 0.5 to 1.1 mg/dL in females, and Mr. Miranda's serum creatinine level is 1.3 mg/dL.
Option (c), stating that the BUN/creatinine ratio is within the normal range, is also incorrect as the normal range for this ratio is 6 to 25, and Mr. Miranda's BUN/creatinine ratio is 12. Option (d), stating that the serum creatinine level suggests that Mr. Miranda's glomerular filtration rate is low, is correct as an elevated serum creatinine level is a sign of impaired kidney function and a reduced glomerular filtration rate.
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