NR 325 EXAM 1 NEWEST ACTUAL EXAM COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS/NEWEST UPDATE!!!
Question 1
To assess whether there is any improvement in a patient's dysuria, which question will the nurse
ask?
A) "Do you have to urinate at night?"
B) "Do you have blood in your urine?"
C) "Do you have to urinate frequently?"
D) "Do you have pain when you urinate?"
E) "Do you have trouble starting your stream?"
Correct Answer: D) "Do you have pain when you urinate?"
Rationale: Dysuria is defined as painful or difficult urination. It is a common symptom of
urinary tract infections (UTIs) or inflammation. To assess improvement, the nurse must
ask directly about the presence or absence of pain during the act of voiding.
Question 2
When a patient's urine dipstick test indicates a small amount of protein, which of the following
should be the nurse's next action?
A) Send a urine specimen to the laboratory to test for ketones.
B) Obtain a clean-catch urine for culture and sensitivity testing.
C) Inquire about which medications the patient is currently taking.
D) Ask the patient about any family history of chronic renal failure.
E) Immediately initiate a 24-hour urine collection.
Correct Answer: C) inquire about which medications the patient is currently taking.
Rationale: While persistent proteinuria is a sign of glomerular damage, a single positive
dipstick for protein can be caused by various factors, including certain medications that
cause false-positive readings. The nurse should rule out these external factors first.
Question 3
A patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a
creatinine clearance test. Which equipment will the nurse need to obtain?
A) Urinary catheter kit
B) Cleaning towelettes for midstream collection
C) Large container for 24-hour urine collection
D) Sterile urine specimen cup
E) A bedside bladder scanner
Correct Answer: C) Large container for urine
Rationale: A creatinine clearance test requires a 24-hour urine specimen collection. The
nurse needs a large container (often orange and containing a preservative) to collect all
urine voided by the patient over exactly 24 hours to ensure accurate calculation of the
GFR.
, 2
Question 4
A 32-year-old patient who is employed as a hairdresser and has a 15 pack-year history of
cigarette smoking is at an significantly increased risk for which condition?
A) Chronic renal failure
B) Nephrolithiasis (Kidney stones)
C) Acute pyelonephritis
D) Bladder cancer
E) Renal artery stenosis
Correct Answer: D) bladder cancer.
Rationale: Bladder cancer risks include cigarette smoking and occupational exposure to
certain chemicals (dyes and aromatic amines) used in professions like hairdressing,
painting, and textile work. The nurse must prioritize teaching regarding these specific risk
factors.
Question 5
Which medication taken at home by a patient with decreased renal function is of the most
concern to the nurse due to its nephrotoxic potential?
A) Ibuprofen (Motrin)
B) Warfarin (Coumadin)
C) Folic acid (Vitamin B9)
) Penicillin (Bicillin LA)
E) Acetaminophen (Tylenol)
Correct Answer: A) ibuprofen (Motrin)
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit
prostaglandins that maintain renal blood flow. In patients with pre-existing renal
impairment, NSAIDs can cause acute kidney injury (AKI) and should be strictly avoided.
Question 6
A 79-year-old man is admitted with benign prostatic hyperplasia (BPH). Which intervention is
most appropriate to include in the nursing plan of care for safety?
A) Limit fluid intake to no more than 1000 mL/day to prevent bladder distention.
B) Leave a light on in the bathroom during the night.
C) Ask the patient to use a urinal only so that urine can be measured.
D) Pad the patient's bed to accommodate overflow incontinence.
E) Insert an indwelling catheter immediately upon admission.
Correct Answer: B) Leave a light on in the bathroom during the night.
Rationale: Elderly patients with BPH often experience nocturia (frequent nighttime
urination). Providing a light in the bathroom reduces the risk of falls during the night.
Restricting fluids is inappropriate as it can lead to dehydration and concentrated urine,
which irritates the bladder.
, 3
Question 7
During a physical assessment of a newly admitted male patient, the nurse is unable to palpate
either kidney. Which action should the nurse take next?
A) Obtain a urine specimen to check for microscopic hematuria.
B) Document the information on the assessment form.
C) Ask the patient about any history of a recent sore throat.
D) Request the health care provider to schedule a renal ultrasound.
E) Percuss the abdomen for shifting dullness.
Correct Answer: B) Document the information on the assessment form.
Rationale: Kidneys are located retroperitoneally and are protected by the ribs and back
muscles. In a healthy adult, they are often not palpable. Unless the patient is extremely thin
or the kidney is significantly enlarged (hydronephrosis or cysts), inability to palpate is a
normal finding.
Question 8
How will the nurse correctly assess for flank tenderness in a patient with suspected
pyelonephritis?
A) Palpate along both sides of the lumbar vertebral column with deep pressure.
B) Strike a flat hand covering the costovertebral angle (CVA) with the ulnar surface of the other
fist.
C) Push fingers upward into the two lowest intercostal spaces.
D) Percuss between the iliac crest and ribs along the midaxillary line.
E) Use light palpation over the suprapubic region.
Correct Answer: B) Strike a flat hand covering the costovertebral angle (CVA).
Rationale: CVA tenderness is assessed via "kidney punch" or blunt percussion. The nurse
places one hand over the 12th rib at the CVA on the back and strikes it with the other fist.
Pain during this maneuver indicates kidney inflammation, such as pyelonephritis.
Question 9
What Glomerular Filtration Rate (GFR) would the nurse estimate for a 30-year-old patient with a
creatinine clearance result of 60 mL/min?
A) 30 mL/min
B) 60 mL/min
C) 90 mL/min
D) 120 mL/min
E) 180 mL/min
Correct Answer: B) 60 mL/min
Rationale: Creatinine clearance is a clinical calculation that closely approximates the GFR.
Therefore, if the creatinine clearance is 60 mL/min, the estimated GFR is also
approximately 60 mL/min.
, 4
Question 10
The nurse assessing the urinary system of a 45-year-old female would use auscultation primarily
to:
A) Determine the exact position of the kidneys.
B) Identify renal artery bruits.
C) Check for the presence of ureteral peristalsis.
D) Assess for the degree of bladder distention.
E) Detect the presence of a kidney stone.
Correct Answer: B) identify renal artery bruits.
Rationale: Auscultation is performed over the costovertebral angles and upper abdominal
quadrants to listen for bruits (swishing sounds). A bruit indicates turbulent blood flow,
which may suggest renal artery stenosis or an aneurysm.
Question 11
A patient is scheduled for an intravenous pyelogram (IVP). Which piece of health information
has the most immediate implications for the patient's safety?
A) The patient has been NPO for 8 hours.
B) The patient lists allergies to shellfish and penicillin.
C) The patient complains of CVA tenderness.
D) The patient used a laxative (bisacodyl) the previous night.
E) The patient’s blood pressure is 140/90 mmHg.
Correct Answer: B) The patient lists allergies to shellfish and penicillin.
Rationale: IVP involves the injection of iodine-based contrast dye. An allergy to shellfish
often correlates with an iodine allergy. The nurse must notify the provider to determine if
the procedure should be cancelled or if the patient needs premedication with
steroids/antihistamines.
Question 12
A patient is Passsing bloody urine and is scheduled for a cystoscopy with cystogram. Which
description of the procedure by the nurse is accurate?
A) "The doctor will place a catheter into a groin artery to visualize the renal blood supply."
B) "The doctor will insert a lighted tube into the bladder to look at the kidneys directly."
C) "The doctor will insert a lighted tube into the bladder through the urethra, inspect the bladder,
and instill a dye to outline it on X-ray."
D) "The doctor will inject a radioactive isotope into your vein to check the distribution in your
kidneys."
E) "The doctor will use sound waves to create a picture of your bladder and prostate."
Correct Answer: C) "Your doctor will insert a lighted tube into the bladder through your
urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."
Rationale: Cystoscopy is direct visualization of the bladder via the urethra. A cystogram is
CORRECT DETAILED ANSWERS/NEWEST UPDATE!!!
Question 1
To assess whether there is any improvement in a patient's dysuria, which question will the nurse
ask?
A) "Do you have to urinate at night?"
B) "Do you have blood in your urine?"
C) "Do you have to urinate frequently?"
D) "Do you have pain when you urinate?"
E) "Do you have trouble starting your stream?"
Correct Answer: D) "Do you have pain when you urinate?"
Rationale: Dysuria is defined as painful or difficult urination. It is a common symptom of
urinary tract infections (UTIs) or inflammation. To assess improvement, the nurse must
ask directly about the presence or absence of pain during the act of voiding.
Question 2
When a patient's urine dipstick test indicates a small amount of protein, which of the following
should be the nurse's next action?
A) Send a urine specimen to the laboratory to test for ketones.
B) Obtain a clean-catch urine for culture and sensitivity testing.
C) Inquire about which medications the patient is currently taking.
D) Ask the patient about any family history of chronic renal failure.
E) Immediately initiate a 24-hour urine collection.
Correct Answer: C) inquire about which medications the patient is currently taking.
Rationale: While persistent proteinuria is a sign of glomerular damage, a single positive
dipstick for protein can be caused by various factors, including certain medications that
cause false-positive readings. The nurse should rule out these external factors first.
Question 3
A patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a
creatinine clearance test. Which equipment will the nurse need to obtain?
A) Urinary catheter kit
B) Cleaning towelettes for midstream collection
C) Large container for 24-hour urine collection
D) Sterile urine specimen cup
E) A bedside bladder scanner
Correct Answer: C) Large container for urine
Rationale: A creatinine clearance test requires a 24-hour urine specimen collection. The
nurse needs a large container (often orange and containing a preservative) to collect all
urine voided by the patient over exactly 24 hours to ensure accurate calculation of the
GFR.
, 2
Question 4
A 32-year-old patient who is employed as a hairdresser and has a 15 pack-year history of
cigarette smoking is at an significantly increased risk for which condition?
A) Chronic renal failure
B) Nephrolithiasis (Kidney stones)
C) Acute pyelonephritis
D) Bladder cancer
E) Renal artery stenosis
Correct Answer: D) bladder cancer.
Rationale: Bladder cancer risks include cigarette smoking and occupational exposure to
certain chemicals (dyes and aromatic amines) used in professions like hairdressing,
painting, and textile work. The nurse must prioritize teaching regarding these specific risk
factors.
Question 5
Which medication taken at home by a patient with decreased renal function is of the most
concern to the nurse due to its nephrotoxic potential?
A) Ibuprofen (Motrin)
B) Warfarin (Coumadin)
C) Folic acid (Vitamin B9)
) Penicillin (Bicillin LA)
E) Acetaminophen (Tylenol)
Correct Answer: A) ibuprofen (Motrin)
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit
prostaglandins that maintain renal blood flow. In patients with pre-existing renal
impairment, NSAIDs can cause acute kidney injury (AKI) and should be strictly avoided.
Question 6
A 79-year-old man is admitted with benign prostatic hyperplasia (BPH). Which intervention is
most appropriate to include in the nursing plan of care for safety?
A) Limit fluid intake to no more than 1000 mL/day to prevent bladder distention.
B) Leave a light on in the bathroom during the night.
C) Ask the patient to use a urinal only so that urine can be measured.
D) Pad the patient's bed to accommodate overflow incontinence.
E) Insert an indwelling catheter immediately upon admission.
Correct Answer: B) Leave a light on in the bathroom during the night.
Rationale: Elderly patients with BPH often experience nocturia (frequent nighttime
urination). Providing a light in the bathroom reduces the risk of falls during the night.
Restricting fluids is inappropriate as it can lead to dehydration and concentrated urine,
which irritates the bladder.
, 3
Question 7
During a physical assessment of a newly admitted male patient, the nurse is unable to palpate
either kidney. Which action should the nurse take next?
A) Obtain a urine specimen to check for microscopic hematuria.
B) Document the information on the assessment form.
C) Ask the patient about any history of a recent sore throat.
D) Request the health care provider to schedule a renal ultrasound.
E) Percuss the abdomen for shifting dullness.
Correct Answer: B) Document the information on the assessment form.
Rationale: Kidneys are located retroperitoneally and are protected by the ribs and back
muscles. In a healthy adult, they are often not palpable. Unless the patient is extremely thin
or the kidney is significantly enlarged (hydronephrosis or cysts), inability to palpate is a
normal finding.
Question 8
How will the nurse correctly assess for flank tenderness in a patient with suspected
pyelonephritis?
A) Palpate along both sides of the lumbar vertebral column with deep pressure.
B) Strike a flat hand covering the costovertebral angle (CVA) with the ulnar surface of the other
fist.
C) Push fingers upward into the two lowest intercostal spaces.
D) Percuss between the iliac crest and ribs along the midaxillary line.
E) Use light palpation over the suprapubic region.
Correct Answer: B) Strike a flat hand covering the costovertebral angle (CVA).
Rationale: CVA tenderness is assessed via "kidney punch" or blunt percussion. The nurse
places one hand over the 12th rib at the CVA on the back and strikes it with the other fist.
Pain during this maneuver indicates kidney inflammation, such as pyelonephritis.
Question 9
What Glomerular Filtration Rate (GFR) would the nurse estimate for a 30-year-old patient with a
creatinine clearance result of 60 mL/min?
A) 30 mL/min
B) 60 mL/min
C) 90 mL/min
D) 120 mL/min
E) 180 mL/min
Correct Answer: B) 60 mL/min
Rationale: Creatinine clearance is a clinical calculation that closely approximates the GFR.
Therefore, if the creatinine clearance is 60 mL/min, the estimated GFR is also
approximately 60 mL/min.
, 4
Question 10
The nurse assessing the urinary system of a 45-year-old female would use auscultation primarily
to:
A) Determine the exact position of the kidneys.
B) Identify renal artery bruits.
C) Check for the presence of ureteral peristalsis.
D) Assess for the degree of bladder distention.
E) Detect the presence of a kidney stone.
Correct Answer: B) identify renal artery bruits.
Rationale: Auscultation is performed over the costovertebral angles and upper abdominal
quadrants to listen for bruits (swishing sounds). A bruit indicates turbulent blood flow,
which may suggest renal artery stenosis or an aneurysm.
Question 11
A patient is scheduled for an intravenous pyelogram (IVP). Which piece of health information
has the most immediate implications for the patient's safety?
A) The patient has been NPO for 8 hours.
B) The patient lists allergies to shellfish and penicillin.
C) The patient complains of CVA tenderness.
D) The patient used a laxative (bisacodyl) the previous night.
E) The patient’s blood pressure is 140/90 mmHg.
Correct Answer: B) The patient lists allergies to shellfish and penicillin.
Rationale: IVP involves the injection of iodine-based contrast dye. An allergy to shellfish
often correlates with an iodine allergy. The nurse must notify the provider to determine if
the procedure should be cancelled or if the patient needs premedication with
steroids/antihistamines.
Question 12
A patient is Passsing bloody urine and is scheduled for a cystoscopy with cystogram. Which
description of the procedure by the nurse is accurate?
A) "The doctor will place a catheter into a groin artery to visualize the renal blood supply."
B) "The doctor will insert a lighted tube into the bladder to look at the kidneys directly."
C) "The doctor will insert a lighted tube into the bladder through the urethra, inspect the bladder,
and instill a dye to outline it on X-ray."
D) "The doctor will inject a radioactive isotope into your vein to check the distribution in your
kidneys."
E) "The doctor will use sound waves to create a picture of your bladder and prostate."
Correct Answer: C) "Your doctor will insert a lighted tube into the bladder through your
urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."
Rationale: Cystoscopy is direct visualization of the bladder via the urethra. A cystogram is
