Nu 310 Exam 2 Actual Exam Newest With Complete Questions And Correct Detailed Answers|
Brand New Version!
Question 1
A patient is diagnosed with oxalate renal calculi (kidney stones). Which nutritional guideline
should the nurse prioritize during health education?
A) Increase intake of spinach and rhubarb.
B) Restrict protein intake as prescribed.
C) Follow a strictly low-calcium diet.
D) Increase intake of sodium-rich snacks.
E) Limit fluid intake to 1,000 mL per day.
Correct Answer: B) Restrict protein intake as ordered.
Rationale: High protein intake increases urinary excretion of calcium, uric acid, and
oxalate, which promotes stone formation. While oxalate-rich foods (like spinach) should be
limited, calcium should generally be maintained at normal levels because low calcium can
actually increase oxalate absorption. Sodium should also be restricted, not increased.
Question 2
A patient underwent percutaneous lithotripsy earlier today. Which discharge instruction is most
important for the nurse to provide?
A) "It is normal for your urine to be cloudy for one week."
B) "Notify the physician immediately if your urine is foul-smelling or cloudy."
C) "Limit your oral fluid intake to 1,000 mL for the next 48 hours."
D) "Report the presence of sand-like particles in your urine as a complication."
E) "Expect your urine to be bright red for at least three days."
Correct Answer: B) Notify the physician about cloudy or foul-smelling urine.
Rationale: Cloudy or foul-smelling urine is a hallmark sign of a urinary tract infection
(UTI), a common risk after invasive urologic procedures. Sand-like particles are expected
as the stone fragments pass, and fluids should be increased, not limited.
Question 3
When teaching a patient with renal calculi about fluid intake, the nurse should explain that the
goal is to produce a daily urine output of at least:
A) 1,000 mL
B) 1,500 mL
C) 2,000 mL
D) 3,000 mL
E) 4,000 mL
Correct Answer: C) 2,000 mL
Rationale: High fluid intake is the most effective way to prevent the recurrence of kidney
stones. Patients are encouraged to drink enough to produce at least 2 liters (2,000 mL) of
urine every 24 hours to keep the urine dilute.
, 2
Question 4
A nurse is monitoring a patient's hourly urine output following a complicated prostate surgery. At
what threshold must the nurse notify the physician?
A) Less than 30 mL/hr
B) Less than 50 mL/hr
C) Less than 100 mL/hr
D) Exactly 60 mL/hr
E) More than 200 mL/hr
Correct Answer: A) 30 mL
Rationale: Urine output of at least 30 mL per hour is the standard indicator of adequate
renal perfusion. Anything less (oliguria) indicates potential dehydration, hemorrhage, or
acute kidney injury (AKI) and requires immediate medical notification.
Question 5
Following Extracorporeal Shock Wave Lithotripsy (ESWL), which nursing action is essential?
A) Place the patient on strict bed rest for 48 hours.
B) Strain all urine to collect stone fragments for analysis.
C) Administer a 2,000 mL bolus of normal saline.
D) Insert an indwelling urinary catheter to prevent spasms.
E) Restrict the patient's potassium intake.
Correct Answer: B) Strain the patient's urine following the procedure.
Rationale: The goal of ESWL is to break the stone into small pieces. Straining the urine
allows the laboratory to analyze the stone composition, which is critical for planning future
dietary and medical prevention strategies.
Question 6
A 43-year-old man has renal calculi causing a bladder outlet obstruction. The nurse should
monitor specifically for which complication?
A) Nephritic syndrome
B) Hydronephrosis
C) Glomerulonephritis
D) Nephrotoxicity
E) Bladder cancer
Correct Answer: B) Hydronephrosis
Rationale: When a stone obstructs the flow of urine at the bladder outlet or in the ureter,
urine backs up into the kidney. This causes the renal pelvis and calyces to distend, a
condition known as hydronephrosis, which can lead to permanent kidney damage.
Question 7
During an admission assessment for a patient with renal stones, which areas are priorities for the
nurse to address? (Select all that apply)
, 3
A. Dietary and nutritional history
B. Family history of renal calculi
C. Current medication history
D. Surgical history
E. Vaccination history
Correct Answer: A, B, C) Dietary history; Family history; Medication history
Rationale: Stones are often caused by specific dietary habits (high protein/oxalate), genetics
(family history), or certain medications (like calcium-based antacids). Vaccination and
surgical history are less directly related to the etiology of urolithiasis.
Question 8
A patient with active flank pain from kidney stones reports drinking 3 liters of water daily. How
should the nurse respond?
A) Tell the patient to stop to prevent water intoxication.
B) Recommend switching to a high-calorie diet.
C) Encourage the patient to continue this pattern of intake.
D) Request a high-sodium diet to balance the water.
E) Tell the patient they only need 1 liter daily.
Correct Answer: C) Encourage the patient to continue this pattern of fluid intake.
Rationale: Increased fluid intake (2.5 to 3 liters) is exactly what is needed to help move the
stone through the urinary tract and prevent the formation of new crystals.
Question 9
Which symptoms are characteristic of ureteral colic secondary to urolithiasis? (Select all that
apply)
A. Diarrhea
B. Hematuria
C. Urinary frequency
D. Acute, severe pain
E. Bradycardia
Correct Answer: B, C, D) Hematuria; Urinary frequency; Acute pain
Rationale: Ureteral colic (pain from a stone in the ureter) classically presents with
excruciating, radiating pain, blood in the urine (hematuria) from tissue trauma, and
frequency/urgency as the stone irritates the bladder wall.
Question 10
A nurse in the Emergency Department is caring for a patient with a new diagnosis of
nephrolithiasis. What is the priority nursing focus?
A) Inserting a Foley catheter
B) Pain management
) Aspiration of the stone via needle
Brand New Version!
Question 1
A patient is diagnosed with oxalate renal calculi (kidney stones). Which nutritional guideline
should the nurse prioritize during health education?
A) Increase intake of spinach and rhubarb.
B) Restrict protein intake as prescribed.
C) Follow a strictly low-calcium diet.
D) Increase intake of sodium-rich snacks.
E) Limit fluid intake to 1,000 mL per day.
Correct Answer: B) Restrict protein intake as ordered.
Rationale: High protein intake increases urinary excretion of calcium, uric acid, and
oxalate, which promotes stone formation. While oxalate-rich foods (like spinach) should be
limited, calcium should generally be maintained at normal levels because low calcium can
actually increase oxalate absorption. Sodium should also be restricted, not increased.
Question 2
A patient underwent percutaneous lithotripsy earlier today. Which discharge instruction is most
important for the nurse to provide?
A) "It is normal for your urine to be cloudy for one week."
B) "Notify the physician immediately if your urine is foul-smelling or cloudy."
C) "Limit your oral fluid intake to 1,000 mL for the next 48 hours."
D) "Report the presence of sand-like particles in your urine as a complication."
E) "Expect your urine to be bright red for at least three days."
Correct Answer: B) Notify the physician about cloudy or foul-smelling urine.
Rationale: Cloudy or foul-smelling urine is a hallmark sign of a urinary tract infection
(UTI), a common risk after invasive urologic procedures. Sand-like particles are expected
as the stone fragments pass, and fluids should be increased, not limited.
Question 3
When teaching a patient with renal calculi about fluid intake, the nurse should explain that the
goal is to produce a daily urine output of at least:
A) 1,000 mL
B) 1,500 mL
C) 2,000 mL
D) 3,000 mL
E) 4,000 mL
Correct Answer: C) 2,000 mL
Rationale: High fluid intake is the most effective way to prevent the recurrence of kidney
stones. Patients are encouraged to drink enough to produce at least 2 liters (2,000 mL) of
urine every 24 hours to keep the urine dilute.
, 2
Question 4
A nurse is monitoring a patient's hourly urine output following a complicated prostate surgery. At
what threshold must the nurse notify the physician?
A) Less than 30 mL/hr
B) Less than 50 mL/hr
C) Less than 100 mL/hr
D) Exactly 60 mL/hr
E) More than 200 mL/hr
Correct Answer: A) 30 mL
Rationale: Urine output of at least 30 mL per hour is the standard indicator of adequate
renal perfusion. Anything less (oliguria) indicates potential dehydration, hemorrhage, or
acute kidney injury (AKI) and requires immediate medical notification.
Question 5
Following Extracorporeal Shock Wave Lithotripsy (ESWL), which nursing action is essential?
A) Place the patient on strict bed rest for 48 hours.
B) Strain all urine to collect stone fragments for analysis.
C) Administer a 2,000 mL bolus of normal saline.
D) Insert an indwelling urinary catheter to prevent spasms.
E) Restrict the patient's potassium intake.
Correct Answer: B) Strain the patient's urine following the procedure.
Rationale: The goal of ESWL is to break the stone into small pieces. Straining the urine
allows the laboratory to analyze the stone composition, which is critical for planning future
dietary and medical prevention strategies.
Question 6
A 43-year-old man has renal calculi causing a bladder outlet obstruction. The nurse should
monitor specifically for which complication?
A) Nephritic syndrome
B) Hydronephrosis
C) Glomerulonephritis
D) Nephrotoxicity
E) Bladder cancer
Correct Answer: B) Hydronephrosis
Rationale: When a stone obstructs the flow of urine at the bladder outlet or in the ureter,
urine backs up into the kidney. This causes the renal pelvis and calyces to distend, a
condition known as hydronephrosis, which can lead to permanent kidney damage.
Question 7
During an admission assessment for a patient with renal stones, which areas are priorities for the
nurse to address? (Select all that apply)
, 3
A. Dietary and nutritional history
B. Family history of renal calculi
C. Current medication history
D. Surgical history
E. Vaccination history
Correct Answer: A, B, C) Dietary history; Family history; Medication history
Rationale: Stones are often caused by specific dietary habits (high protein/oxalate), genetics
(family history), or certain medications (like calcium-based antacids). Vaccination and
surgical history are less directly related to the etiology of urolithiasis.
Question 8
A patient with active flank pain from kidney stones reports drinking 3 liters of water daily. How
should the nurse respond?
A) Tell the patient to stop to prevent water intoxication.
B) Recommend switching to a high-calorie diet.
C) Encourage the patient to continue this pattern of intake.
D) Request a high-sodium diet to balance the water.
E) Tell the patient they only need 1 liter daily.
Correct Answer: C) Encourage the patient to continue this pattern of fluid intake.
Rationale: Increased fluid intake (2.5 to 3 liters) is exactly what is needed to help move the
stone through the urinary tract and prevent the formation of new crystals.
Question 9
Which symptoms are characteristic of ureteral colic secondary to urolithiasis? (Select all that
apply)
A. Diarrhea
B. Hematuria
C. Urinary frequency
D. Acute, severe pain
E. Bradycardia
Correct Answer: B, C, D) Hematuria; Urinary frequency; Acute pain
Rationale: Ureteral colic (pain from a stone in the ureter) classically presents with
excruciating, radiating pain, blood in the urine (hematuria) from tissue trauma, and
frequency/urgency as the stone irritates the bladder wall.
Question 10
A nurse in the Emergency Department is caring for a patient with a new diagnosis of
nephrolithiasis. What is the priority nursing focus?
A) Inserting a Foley catheter
B) Pain management
) Aspiration of the stone via needle
