The renal system, also known as the urinary system, plays a crucial role in maintaining homeostasis by filtering blood, removing waste, and balancing electrolytes. Understanding the renal system is essential for nursing professionals, as it is a frequent topic on the NCLEX exam. This article provides 11 in-depth NCLEX-style questions on the renal system, complete with detailed explanations to enhance your understanding and preparation.
1. Question: Acute Kidney Injury (AKI)
Question: A patient is admitted with acute kidney injury (AKI) following severe dehydration. Which of the following lab values would the nurse expect to find?
A. Decreased serum creatinine
B. Increased blood urea nitrogen (BUN)
C. Decreased potassium
D. Increased glomerular filtration rate (GFR)
Answer: B. Increased blood urea nitrogen (BUN)
Explanation: Acute kidney injury often results in the accumulation of waste products in the blood due to impaired kidney function. BUN and serum creatinine levels typically increase in AKI. Potassium levels may also rise due to reduced excretion, and GFR usually decreases.
2. Question: Chronic Kidney Disease (CKD)
Question: A patient with chronic kidney disease (CKD) is being educated on dietary restrictions. Which of the following should the nurse include in the teaching?
A. Increase protein intake
B. Limit sodium intake
C. Increase potassium intake
D. Limit calcium intake
Answer: B. Limit sodium intake
Explanation: Patients with CKD should limit sodium intake to help control blood pressure and reduce fluid retention. Protein intake should be moderated, potassium may need to be restricted depending on serum levels, and calcium intake should be monitored but not necessarily limited.
3. Question: Urinary Tract Infection (UTI)
Question: A patient presents with symptoms of a urinary tract infection (UTI). Which of the following is the most common causative organism?
A. Staphylococcus aureus
B. Escherichia coli
C. Pseudomonas aeruginosa
D. Klebsiella pneumoniae
Answer: B. Escherichia coli
Explanation: Escherichia coli (E. coli) is the most common causative organism of UTIs, accounting for approximately 80-90% of cases. It typically originates from the gastrointestinal tract and can ascend the urinary tract to cause infection.
4. Question: Nephrotic Syndrome
Question: A child is diagnosed with nephrotic syndrome. Which of the following findings is characteristic of this condition?
A. Hematuria
B. Proteinuria
C. Hypernatremia
D. Hypokalemia
Answer: B. Proteinuria
Explanation: Nephrotic syndrome is characterized by significant proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Hematuria is not a primary feature, and electrolyte imbalances such as hypernatremia and hypokalemia are not typically associated with nephrotic syndrome.
5. Question: Hemodialysis
Question: A patient undergoing hemodialysis is at risk for which of the following complications?
A. Hypercalcemia
B. Hypotension
C. Hyperglycemia
D. Hypokalemia
Answer: B. Hypotension
Explanation: Hypotension is a common complication of hemodialysis due to the rapid removal of fluid from the bloodstream. Other potential complications include muscle cramps, nausea, and headaches. Hypercalcemia and hyperglycemia are not typically associated with hemodialysis.
6. Question: Pyelonephritis
Question: Which of the following symptoms is most indicative of acute pyelonephritis?
A. Dysuria
B. Flank pain
C. Urinary frequency
D. Hematuria
Answer: B. Flank pain
Explanation: Acute pyelonephritis, an infection of the kidney, often presents with flank pain, fever, chills, and nausea. Dysuria, urinary frequency, and hematuria can occur but are more commonly associated with lower urinary tract infections.
7. Question: Renal Calculi
Question: A patient with renal calculi is advised to increase fluid intake. What is the primary reason for this recommendation?
A. To dilute urine
B. To decrease urine pH
C. To increase calcium excretion
D. To reduce sodium levels
Answer: A. To dilute urine
Explanation: Increasing fluid intake helps to dilute the urine, reducing the concentration of substances that can form stones. This can help prevent the formation of new calculi and facilitate the passage of existing stones.
8. Question: Glomerulonephritis
Question: A patient with post-streptococcal glomerulonephritis is likely to exhibit which of the following symptoms?
A. Polyuria
B. Hypertension
C. Hypercalcemia
D. Hypotension
Answer: B. Hypertension
Explanation: Post-streptococcal glomerulonephritis often leads to hypertension due to fluid retention and decreased kidney function. Other symptoms may include hematuria, proteinuria, and edema.
9. Question: Polycystic Kidney Disease (PKD)
Question: Which of the following is a common complication of polycystic kidney disease (PKD)?
A. Hypotension
B. Liver cysts
C. Hyperglycemia
D. Hypocalcemia
Answer: B. Liver cysts
Explanation: Polycystic kidney disease (PKD) is often associated with the development of cysts in other organs, particularly the liver. Hypertension is also a common complication, while hyperglycemia and hypocalcemia are not typically related to PKD.
10. Question: Renal Failure and Anemia
Question: Why are patients with chronic renal failure at risk for anemia?
A. Increased erythropoietin production
B. Decreased erythropoietin production
C. Increased red blood cell lifespan
D. Decreased red blood cell destruction
Answer: B. Decreased erythropoietin production
Explanation: The kidneys produce erythropoietin, a hormone that stimulates red blood cell production. In chronic renal failure, the kidneys' ability to produce erythropoietin is diminished, leading to anemia.
11. Question: Renal Transplant
Question: A patient who has undergone a renal transplant is at risk for which of the following complications?
A. Hyperkalemia
B. Rejection
C. Hypotension
D. Hypercalcemia
Answer: B. Rejection
Explanation: Rejection is a significant risk following a renal transplant, as the immune system may recognize the new kidney as foreign and attack it. Immunosuppressive medications are used to reduce this risk. Hyperkalemia, hypotension, and hypercalcemia are not primary concerns specific to renal transplantation.
Understanding the renal system and its associated conditions is vital for nursing professionals. These questions and explanations provide a comprehensive review to help you prepare for the NCLEX exam. Remember, thorough knowledge and critical thinking are key to success on the exam and in your nursing practice.
