MedSurg Comprehensive Final with
Rationales 2026 Exam Questions and
Correct Answers | New Update
A client admitted for acute pyelonephritis is about to start antibiotic therapy.
Which symptom would be expected in this client?
1) Hypertension
2) Flank pain on the affected side
3) Pain that radiates toward the unaffected side
4) No tenderness with deep palpation over the
,CVA - 🧠 ANSWER ✔✔RATIONAL: 2) The client may complain of pain on
the affected side because the kidney is enlarged and might have formed an
abscess.
Hypertension is associated with chronic pyelonephritis. Pain may radiate
down the ureters or to the epigastrium. The client would have tenderness
with deep palpation over the CVA.
Discharge instructions for a client treated for acute pyelonephritis should
include which statement?
- 1. Avoid taking any dairy products.
- 2. Return for follow-up urine cultures.
- 3. Stop taking the prescribed antibiotics when the symptoms subside.
- 4. Recurrence is unlikely because you've been treated with
antibiotics. - 🧠 ANSWER ✔✔RATIONALE: 2) The client needs to return for
follow-up urine cultures because bacteriuria may be present but
asymptomatic. Intake of dairy products won't contribute to pyelonephritis.
Antibiotics need to be taken for the full course of therapy regardless of the
symptoms. Pyelonephritis typically recurs as a relapse or new infection and
frequently recurs within 2 weeks of completing therapy.
,A client is complaining of severe flank and abdominal pain. A flat plate of
the abdomen shows urolithiasis. Which intervention is important?
- 1. Strain all urine
- 2. Limit fluid intake
- 3. Enforce strict bed rest.
- 4. Encourage a high-calcium diet - 🧠 ANSWER ✔✔RATIONALE: 1) Urine
should be strained for calculi and sent to the laboratory for analysis. Fluid
intake of 3 to 4 qt. 3 to 4 L/day is encouraged to flush the urinary tract and
prevent further calculi formation. Ambulation is encouraged to help pass
the calculi through gravity. A low-calcium formation of calcium calculi.
During a health history, which statement by a client indicates a risk of renal
calculi?
- 1. "I've been drinking a lot of cola soft drinks lately."
- 2. "I've been jogging more than usual."
- 3. "I've had more stress since we adopted a child last
year."
- 4. "I'm a vegetarian and eat cheese two or three times each
day." - 🧠 ANSWER ✔✔RATIONALE: 4) Renal calculi are commonly
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, composed of calcium. Diets high in calcium may predispose a person to
renal calculi. Milk and milk products are high in calcium. Cola soft drinks
don't contain ingredients that would increase the risk of renal calculi.
Jogging and increased stress aren't considered risk factors for renal calculi
formation.
A nurse is instructing a client with oxalate renal calculi. What foods should
the nurse urge the client to eliminate from his diet?
1) Citrus fruits, molasses, and dried apricots
2) Milk, cheese, and ice cream
3) Sardines, liver and kidney
4) Spinach rhubarb and asparagus - 🧠 ANSWER ✔✔RATIONALE: 4) To
reduce the formation of oxalate calculi, urge the client to avoid foods high in
oxalate, such as spinach, rhubarb, and asparagus. Other oxalate- rich
foods to avoid include tomatoes, beets, chocolate, cocoa, celery, and
parsley.
Citrus fruits, molasses, dried apricots, milk, cheese, ice cream, sardines
and organ meats do NOT produce oxalate and do NOT need to be omitted
from the client's diet.
Rationales 2026 Exam Questions and
Correct Answers | New Update
A client admitted for acute pyelonephritis is about to start antibiotic therapy.
Which symptom would be expected in this client?
1) Hypertension
2) Flank pain on the affected side
3) Pain that radiates toward the unaffected side
4) No tenderness with deep palpation over the
,CVA - 🧠 ANSWER ✔✔RATIONAL: 2) The client may complain of pain on
the affected side because the kidney is enlarged and might have formed an
abscess.
Hypertension is associated with chronic pyelonephritis. Pain may radiate
down the ureters or to the epigastrium. The client would have tenderness
with deep palpation over the CVA.
Discharge instructions for a client treated for acute pyelonephritis should
include which statement?
- 1. Avoid taking any dairy products.
- 2. Return for follow-up urine cultures.
- 3. Stop taking the prescribed antibiotics when the symptoms subside.
- 4. Recurrence is unlikely because you've been treated with
antibiotics. - 🧠 ANSWER ✔✔RATIONALE: 2) The client needs to return for
follow-up urine cultures because bacteriuria may be present but
asymptomatic. Intake of dairy products won't contribute to pyelonephritis.
Antibiotics need to be taken for the full course of therapy regardless of the
symptoms. Pyelonephritis typically recurs as a relapse or new infection and
frequently recurs within 2 weeks of completing therapy.
,A client is complaining of severe flank and abdominal pain. A flat plate of
the abdomen shows urolithiasis. Which intervention is important?
- 1. Strain all urine
- 2. Limit fluid intake
- 3. Enforce strict bed rest.
- 4. Encourage a high-calcium diet - 🧠 ANSWER ✔✔RATIONALE: 1) Urine
should be strained for calculi and sent to the laboratory for analysis. Fluid
intake of 3 to 4 qt. 3 to 4 L/day is encouraged to flush the urinary tract and
prevent further calculi formation. Ambulation is encouraged to help pass
the calculi through gravity. A low-calcium formation of calcium calculi.
During a health history, which statement by a client indicates a risk of renal
calculi?
- 1. "I've been drinking a lot of cola soft drinks lately."
- 2. "I've been jogging more than usual."
- 3. "I've had more stress since we adopted a child last
year."
- 4. "I'm a vegetarian and eat cheese two or three times each
day." - 🧠 ANSWER ✔✔RATIONALE: 4) Renal calculi are commonly
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, composed of calcium. Diets high in calcium may predispose a person to
renal calculi. Milk and milk products are high in calcium. Cola soft drinks
don't contain ingredients that would increase the risk of renal calculi.
Jogging and increased stress aren't considered risk factors for renal calculi
formation.
A nurse is instructing a client with oxalate renal calculi. What foods should
the nurse urge the client to eliminate from his diet?
1) Citrus fruits, molasses, and dried apricots
2) Milk, cheese, and ice cream
3) Sardines, liver and kidney
4) Spinach rhubarb and asparagus - 🧠 ANSWER ✔✔RATIONALE: 4) To
reduce the formation of oxalate calculi, urge the client to avoid foods high in
oxalate, such as spinach, rhubarb, and asparagus. Other oxalate- rich
foods to avoid include tomatoes, beets, chocolate, cocoa, celery, and
parsley.
Citrus fruits, molasses, dried apricots, milk, cheese, ice cream, sardines
and organ meats do NOT produce oxalate and do NOT need to be omitted
from the client's diet.
