1
NCLEX PN Exam Bank Renal and Urinary Disorders
and Fluid Management
Table of Contents
Subtopic 1: Assessment and Common Symptoms of Renal and Urinary Disorders ............ 2
Subtopic 2: Fluid and Electrolyte Balance in Renal Disorders ........................................... 9
Subtopic 3: Infections and Inflammatory Conditions of the Renal and Urinary System ..... 16
Subtopic 4: Acute and Chronic Kidney Injury ................................................................. 23
Subtopic 5: Electrolyte Imbalances and Fluid Volume Disturbances ............................... 31
Subtopic 6: Gastrointestinal Disorders – Diagnostic Procedures and Interpretation ......... 38
Subtopic 7: Inflammatory Bowel Diseases (IBD) and Nursing Interventions ..................... 44
Subtopic 8: Gastrointestinal Diagnostic Procedures and Pre/Post Care ........................... 52
Subtopic 9: Gastrointestinal Surgical Procedures and Postoperative Nursing Care .......... 60
Subtopic 10: Collaborative Care, Patient Education, and Discharge Planning for Renal and
Gastrointestinal Conditions ......................................................................................... 68
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Subtopic 1: Assessment and Common Symptoms of
Renal and Urinary Disorders
(Questions 1–20)
1. A client presents with dark-colored urine, periorbital edema, and hypertension. Which
condition should the nurse suspect?
A. Urinary tract infection
B. Acute glomerulonephritis
C. Nephrolithiasis
D. Interstitial cystitis
Rationale: Acute glomerulonephritis is commonly associated with dark or tea-colored
urine, facial/periorbital edema, and elevated blood pressure due to fluid retention and
glomerular inflammation.
2. Which clinical manifestation indicates possible nephrotic syndrome in a pediatric
patient?
A. Hematuria and urinary frequency
B. Flank pain and fever
C. Proteinuria and generalized edema
D. Burning sensation during urination
Rationale: Nephrotic syndrome is marked by massive proteinuria, hypoalbuminemia, and
generalized edema due to fluid shifts caused by decreased oncotic pressure.
3. The nurse is assessing a client with pyelonephritis. Which finding would be most
expected?
, 3
A. Suprapubic pain
B. Cloudy urine without fever
C. Flank pain and fever
D. Oliguria and dysuria
Rationale: Pyelonephritis is a kidney infection that presents with systemic signs such as
flank pain, fever, and chills due to the infection ascending to the kidneys.
4. A client with benign prostatic hyperplasia (BPH) reports difficulty starting urination and a
weak stream. What is the most likely cause?
A. Urinary tract infection
B. Urethral compression due to prostate enlargement
C. Bladder infection
D. Renal calculi
Rationale: BPH leads to urethral narrowing or compression, causing voiding symptoms
such as hesitancy, weak stream, and incomplete bladder emptying.
5. Which laboratory value is most specific for evaluating kidney function?
A. Hematocrit
B. Serum creatinine
C. Potassium
D. Hemoglobin
Rationale: Serum creatinine is the most specific indicator of renal function because it
reflects the kidney’s ability to excrete waste products.
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6. The presence of which substance in urine is most concerning and requires further
evaluation?
A. Urobilinogen
B. Trace ketones
C. Small amount of glucose
D. Protein
Rationale: Protein in urine is abnormal and can indicate glomerular damage, especially in
diseases like glomerulonephritis or nephrotic syndrome.
7. Which symptom differentiates cystitis from pyelonephritis?
A. Dysuria
B. Urinary frequency
C. Costovertebral angle tenderness
D. Cloudy urine
Rationale: Costovertebral angle tenderness is specific to pyelonephritis, indicating kidney
involvement, while cystitis is limited to the bladder.
8. What is the most appropriate initial nursing action when a patient reports no urine output
for 6 hours post-op?
A. Increase IV fluid rate
B. Assess for bladder distension
C. Notify the physician
D. Document the findings and continue monitoring
NCLEX PN Exam Bank Renal and Urinary Disorders
and Fluid Management
Table of Contents
Subtopic 1: Assessment and Common Symptoms of Renal and Urinary Disorders ............ 2
Subtopic 2: Fluid and Electrolyte Balance in Renal Disorders ........................................... 9
Subtopic 3: Infections and Inflammatory Conditions of the Renal and Urinary System ..... 16
Subtopic 4: Acute and Chronic Kidney Injury ................................................................. 23
Subtopic 5: Electrolyte Imbalances and Fluid Volume Disturbances ............................... 31
Subtopic 6: Gastrointestinal Disorders – Diagnostic Procedures and Interpretation ......... 38
Subtopic 7: Inflammatory Bowel Diseases (IBD) and Nursing Interventions ..................... 44
Subtopic 8: Gastrointestinal Diagnostic Procedures and Pre/Post Care ........................... 52
Subtopic 9: Gastrointestinal Surgical Procedures and Postoperative Nursing Care .......... 60
Subtopic 10: Collaborative Care, Patient Education, and Discharge Planning for Renal and
Gastrointestinal Conditions ......................................................................................... 68
, 2
Subtopic 1: Assessment and Common Symptoms of
Renal and Urinary Disorders
(Questions 1–20)
1. A client presents with dark-colored urine, periorbital edema, and hypertension. Which
condition should the nurse suspect?
A. Urinary tract infection
B. Acute glomerulonephritis
C. Nephrolithiasis
D. Interstitial cystitis
Rationale: Acute glomerulonephritis is commonly associated with dark or tea-colored
urine, facial/periorbital edema, and elevated blood pressure due to fluid retention and
glomerular inflammation.
2. Which clinical manifestation indicates possible nephrotic syndrome in a pediatric
patient?
A. Hematuria and urinary frequency
B. Flank pain and fever
C. Proteinuria and generalized edema
D. Burning sensation during urination
Rationale: Nephrotic syndrome is marked by massive proteinuria, hypoalbuminemia, and
generalized edema due to fluid shifts caused by decreased oncotic pressure.
3. The nurse is assessing a client with pyelonephritis. Which finding would be most
expected?
, 3
A. Suprapubic pain
B. Cloudy urine without fever
C. Flank pain and fever
D. Oliguria and dysuria
Rationale: Pyelonephritis is a kidney infection that presents with systemic signs such as
flank pain, fever, and chills due to the infection ascending to the kidneys.
4. A client with benign prostatic hyperplasia (BPH) reports difficulty starting urination and a
weak stream. What is the most likely cause?
A. Urinary tract infection
B. Urethral compression due to prostate enlargement
C. Bladder infection
D. Renal calculi
Rationale: BPH leads to urethral narrowing or compression, causing voiding symptoms
such as hesitancy, weak stream, and incomplete bladder emptying.
5. Which laboratory value is most specific for evaluating kidney function?
A. Hematocrit
B. Serum creatinine
C. Potassium
D. Hemoglobin
Rationale: Serum creatinine is the most specific indicator of renal function because it
reflects the kidney’s ability to excrete waste products.
, 4
6. The presence of which substance in urine is most concerning and requires further
evaluation?
A. Urobilinogen
B. Trace ketones
C. Small amount of glucose
D. Protein
Rationale: Protein in urine is abnormal and can indicate glomerular damage, especially in
diseases like glomerulonephritis or nephrotic syndrome.
7. Which symptom differentiates cystitis from pyelonephritis?
A. Dysuria
B. Urinary frequency
C. Costovertebral angle tenderness
D. Cloudy urine
Rationale: Costovertebral angle tenderness is specific to pyelonephritis, indicating kidney
involvement, while cystitis is limited to the bladder.
8. What is the most appropriate initial nursing action when a patient reports no urine output
for 6 hours post-op?
A. Increase IV fluid rate
B. Assess for bladder distension
C. Notify the physician
D. Document the findings and continue monitoring
