RENAL NCLEX PRACTICE EXAM 2026 | QUESTIONS
VERIFIED ANSWERS & DETAILED RATIONALES |
LATEST UPDATED HIGH-YIELD TEST & A+ STUDY GUIDE
Questions 1-10: Kidney Function & Diagnostic Tests
1. A nurse is teaching a client scheduled for an intravenous pyelogram (IVP). Which statement
by the client indicates a need for further teaching?
a) "I will need to empty my bladder right before the procedure."
b) "I should not eat or drink anything after midnight."
c) "I might feel a warm, flushed sensation when the dye is injected."
d) "I need to tell the doctor if I'm allergic to shellfish or iodine."
-Answer💜💜-: d) Allergy to shellfish/iodine is a contraindication for contrast dyes. The other
statements are correct.
2. A client with diabetes mellitus is scheduled for a CT scan with IV contrast. Which
medication order requires the nurse to question and potentially clarify with the healthcare
provider?
a) Metformin
b) Lisinopril
c) Furosemide
d) Insulin glargine
-Answer💜💜-: a) Metformin should be held for 48 hours after contrast administration due to
the risk of contrast-induced nephropathy and subsequent metformin-induced lactic acidosis.
3. A nurse is reviewing a client's urinalysis results. Which findings are most indicative of a
urinary tract infection (UTI)?
,a) Clear color with a pH of 6.0
b) Trace protein and few hyaline casts
c) Positive leukocyte esterase and nitrates
d) 0-2 RBCs and 0-1 WBCs per high-power field
-Answer💜💜-: c) Leukocyte esterase indicates WBCs, and nitrites indicate bacteria. These are
hallmark signs of a UTI.
4. A client has a 24-hour urine collection ordered for creatinine clearance. Which nursing
action is essential for accurate test results?
a) Keeping the urine collection container on ice at all times.
b) Discarding the first voided specimen and timing the collection from that point.
c) Shaking the collection container vigorously every time urine is added.
d) Obtaining a random urine sample at the end of the 24 hours to compare.
-Answer💜💜-: b) Discarding the first void and starting the timer ensures the collection period is
exactly 24 hours. All urine for that period must be saved.
5. A client asks the nurse why an ultrasound of the kidneys was ordered instead of an IVP. On
what understanding should the nurse base the response?
a) An ultrasound is the preferred test to evaluate kidney function.
b) An ultrasound can differentiate a solid mass from a fluid-filled cyst without dye.
c) An ultrasound is more cost-effective than an IVP.
d) An ultrasound provides a detailed view of the ureters and bladder.
-Answer💜💜-: b) Ultrasound is non-invasive and excellent for distinguishing between solid
tumors and benign, fluid-filled cysts without using contrast dye.
6. The nurse is reviewing lab results for a client at risk for renal impairment. Which estimated
glomerular filtration rate (eGFR) result would be most concerning?
a) 115 mL/min/1.73 m²
b) 90 mL/min/1.73 m²
, c) 55 mL/min/1.73 m²
d) 120 mL/min/1.73 m²
-Answer💜💜-: c) An eGFR of 55 mL/min indicates Stage 3 CKD (moderate decrease). Values >90
are considered normal.
7. A client with hypertension is scheduled for a captopril renal scan. Which post-procedure
assessment is most important for the nurse to perform?
a) Assess for hypertension.
b) Monitor for orthostatic hypotension.
c) Encourage a high-fluid intake.
d) Assess the injection site for urticaria.
-Answer💜💜-: b) Captopril is an ACE inhibitor that can cause vasodilation and orthostatic
hypotension. The nurse must monitor for this post-procedure.
8. A nurse is caring for a client immediately after a kidney biopsy. Which assessment finding is
the highest priority?
a) Complaints of pain at the biopsy site rated 4 on a 0-10 scale.
b) Frank bleeding on the pressure dressing.
c) Pink-tinged urine.
d) Client lying supine and reporting they are "thirsty."
-Answer💜💜-: b) The greatest risk after a kidney biopsy is hemorrhage. Frank bleeding on the
dressing is a sign of active bleeding and requires immediate intervention.
9. The nurse is providing discharge instructions to a client who had a cystoscopy. Which
statement by the client indicates correct understanding of the teaching?
a) "I should expect my urine to be bloody for the next week."
b) "I can take my usual aspirin for any discomfort."
c) "I will drink plenty of fluids to help prevent infection."
d) "A fever up to 101°F (38.3°C) is normal for the next day."
VERIFIED ANSWERS & DETAILED RATIONALES |
LATEST UPDATED HIGH-YIELD TEST & A+ STUDY GUIDE
Questions 1-10: Kidney Function & Diagnostic Tests
1. A nurse is teaching a client scheduled for an intravenous pyelogram (IVP). Which statement
by the client indicates a need for further teaching?
a) "I will need to empty my bladder right before the procedure."
b) "I should not eat or drink anything after midnight."
c) "I might feel a warm, flushed sensation when the dye is injected."
d) "I need to tell the doctor if I'm allergic to shellfish or iodine."
-Answer💜💜-: d) Allergy to shellfish/iodine is a contraindication for contrast dyes. The other
statements are correct.
2. A client with diabetes mellitus is scheduled for a CT scan with IV contrast. Which
medication order requires the nurse to question and potentially clarify with the healthcare
provider?
a) Metformin
b) Lisinopril
c) Furosemide
d) Insulin glargine
-Answer💜💜-: a) Metformin should be held for 48 hours after contrast administration due to
the risk of contrast-induced nephropathy and subsequent metformin-induced lactic acidosis.
3. A nurse is reviewing a client's urinalysis results. Which findings are most indicative of a
urinary tract infection (UTI)?
,a) Clear color with a pH of 6.0
b) Trace protein and few hyaline casts
c) Positive leukocyte esterase and nitrates
d) 0-2 RBCs and 0-1 WBCs per high-power field
-Answer💜💜-: c) Leukocyte esterase indicates WBCs, and nitrites indicate bacteria. These are
hallmark signs of a UTI.
4. A client has a 24-hour urine collection ordered for creatinine clearance. Which nursing
action is essential for accurate test results?
a) Keeping the urine collection container on ice at all times.
b) Discarding the first voided specimen and timing the collection from that point.
c) Shaking the collection container vigorously every time urine is added.
d) Obtaining a random urine sample at the end of the 24 hours to compare.
-Answer💜💜-: b) Discarding the first void and starting the timer ensures the collection period is
exactly 24 hours. All urine for that period must be saved.
5. A client asks the nurse why an ultrasound of the kidneys was ordered instead of an IVP. On
what understanding should the nurse base the response?
a) An ultrasound is the preferred test to evaluate kidney function.
b) An ultrasound can differentiate a solid mass from a fluid-filled cyst without dye.
c) An ultrasound is more cost-effective than an IVP.
d) An ultrasound provides a detailed view of the ureters and bladder.
-Answer💜💜-: b) Ultrasound is non-invasive and excellent for distinguishing between solid
tumors and benign, fluid-filled cysts without using contrast dye.
6. The nurse is reviewing lab results for a client at risk for renal impairment. Which estimated
glomerular filtration rate (eGFR) result would be most concerning?
a) 115 mL/min/1.73 m²
b) 90 mL/min/1.73 m²
, c) 55 mL/min/1.73 m²
d) 120 mL/min/1.73 m²
-Answer💜💜-: c) An eGFR of 55 mL/min indicates Stage 3 CKD (moderate decrease). Values >90
are considered normal.
7. A client with hypertension is scheduled for a captopril renal scan. Which post-procedure
assessment is most important for the nurse to perform?
a) Assess for hypertension.
b) Monitor for orthostatic hypotension.
c) Encourage a high-fluid intake.
d) Assess the injection site for urticaria.
-Answer💜💜-: b) Captopril is an ACE inhibitor that can cause vasodilation and orthostatic
hypotension. The nurse must monitor for this post-procedure.
8. A nurse is caring for a client immediately after a kidney biopsy. Which assessment finding is
the highest priority?
a) Complaints of pain at the biopsy site rated 4 on a 0-10 scale.
b) Frank bleeding on the pressure dressing.
c) Pink-tinged urine.
d) Client lying supine and reporting they are "thirsty."
-Answer💜💜-: b) The greatest risk after a kidney biopsy is hemorrhage. Frank bleeding on the
dressing is a sign of active bleeding and requires immediate intervention.
9. The nurse is providing discharge instructions to a client who had a cystoscopy. Which
statement by the client indicates correct understanding of the teaching?
a) "I should expect my urine to be bloody for the next week."
b) "I can take my usual aspirin for any discomfort."
c) "I will drink plenty of fluids to help prevent infection."
d) "A fever up to 101°F (38.3°C) is normal for the next day."
