NCLEX Renal & Genitourinary Practice Questions

15 free NCLEX-RN renal & genitourinary questions with answers and rationales — perfect for renal nclex questions practice. Want them as an interactive timed quiz?

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1. A 65-year-old male with chronic kidney disease (CKD) presents with fatigue, pallor, and dyspnea on exertion. Which laboratory finding is most consistent with these symptoms?
- A. Decreased hemoglobin level ✓
- B. Elevated creatinine level
- C. Increased blood urea nitrogen (BUN)
- D. Elevated potassium level
Answer: A. Decreased hemoglobin level — Fatigue, pallor, and dyspnea on exertion in CKD are often due to anemia, which is indicated by a decreased hemoglobin level.
2. A patient with benign prostatic hyperplasia (BPH) is experiencing urinary retention. What is the most appropriate initial nursing action?
- A. Catheterize the patient to relieve retention ✓
- B. Administer prescribed tamsulosin (Flomax)
- C. Encourage the patient to attempt double voiding
- D. Apply a warm compress to the lower abdomen
Answer: A. Catheterize the patient to relieve retention — Immediate relief of urinary retention can be achieved through catheterization, preventing potential complications such as bladder damage.
3. A patient undergoing hemodialysis complains of muscle cramps during the procedure. What is the best nursing action?
- A. Stop the dialysis treatment immediately
- B. Administer prescribed saline bolus ✓
- C. Increase the ultrafiltration rate
- D. Apply warm compresses to the affected areas
Answer: B. Administer prescribed saline bolus — Muscle cramps during dialysis can be caused by rapid fluid removal; administering a saline bolus can help alleviate the cramps by restoring fluid balance.
4. A patient with a history of recurrent urinary tract infections (UTIs) is being educated on prevention strategies. Which of the following should the nurse include in the teaching plan?
- A. Wipe from back to front after using the toilet
- B. Increase fluid intake to at least 2-3 liters per day ✓
- C. Take a hot bath daily to maintain hygiene
- D. Use douches regularly to cleanse the urinary tract
Answer: B. Increase fluid intake to at least 2-3 liters per day — Increasing fluid intake helps to flush bacteria out of the urinary tract, reducing the risk of infection.
5. A patient with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. What is the priority nursing intervention?
- A. Administer sodium polystyrene sulfonate (Kayexalate)
- B. Prepare the patient for dialysis
- C. Administer IV calcium gluconate ✓
- D. Encourage a potassium-restricted diet
Answer: C. Administer IV calcium gluconate — IV calcium gluconate is used as an immediate intervention to stabilize cardiac membranes and prevent dysrhythmias in the presence of hyperkalemia.
6. A patient with chronic kidney disease is prescribed erythropoietin. What laboratory value should the nurse monitor to evaluate the effectiveness of this medication?
- A. Serum creatinine
- B. Hemoglobin level ✓
- C. Serum potassium
- D. Blood urea nitrogen (BUN)
Answer: B. Hemoglobin level — Erythropoietin stimulates red blood cell production, and its effectiveness is evaluated by monitoring hemoglobin levels.
7. Which statement by a patient with renal calculi indicates a need for further teaching?
- A. I should drink plenty of fluids to help pass the stone
- B. I will limit my intake of calcium-rich foods ✓
- C. I should avoid foods high in oxalates like spinach
- D. I can take over-the-counter pain medication as needed
Answer: B. I will limit my intake of calcium-rich foods — Patients often mistakenly believe they should limit calcium intake, but adequate calcium can help bind oxalates in the gut, reducing stone formation.
8. A patient is receiving peritoneal dialysis. The nurse notes the outflow is less than the inflow. What is the best initial nursing action?
- A. Reposition the patient on their side ✓
- B. Flush the peritoneal catheter with saline
- C. Clamp the catheter and notify the healthcare provider
- D. Increase the dwell time of the dialysis solution
Answer: A. Reposition the patient on their side — Repositioning the patient can help facilitate drainage by ensuring proper catheter placement and flow.
9. A patient with end-stage renal disease is admitted with fluid overload. Which assessment finding is the priority for the nurse to address?
- A. Peripheral edema
- B. Jugular vein distention
- C. Crackles in the lungs ✓
- D. Hypertension
Answer: C. Crackles in the lungs — Crackles in the lungs indicate pulmonary edema and are a sign of fluid overload affecting respiratory function, requiring immediate intervention.
10. A patient with AKI is on a potassium-restricted diet. Which fruit should the patient avoid?
- A. Apple
- B. Banana ✓
- C. Blueberry
- D. Grapes
Answer: B. Banana — Bananas are high in potassium and should be avoided in patients on a potassium-restricted diet due to their risk of hyperkalemia.
11. A patient with CKD has developed metabolic acidosis. Which laboratory result supports this diagnosis?
- A. Decreased serum bicarbonate level ✓
- B. Elevated serum albumin level
- C. Increased blood pH level
- D. Decreased serum phosphate level
Answer: A. Decreased serum bicarbonate level — Metabolic acidosis in CKD is often due to a decreased serum bicarbonate level as the kidneys are unable to excrete enough acids or conserve bicarbonate.
12. A patient with a history of kidney stones is advised to increase fluid intake. What is the recommended daily fluid intake to prevent stone formation?
- A. 1 liter
- B. 1.5 liters
- C. 2 liters
- D. 3 liters ✓
Answer: D. 3 liters — Increasing fluid intake to approximately 3 liters per day helps dilute the urine, reducing the risk of stone formation.
13. During a health fair, a nurse is educating participants about the risk factors for BPH. Which individual is at greatest risk?
- A. A 45-year-old man with a family history of prostate cancer
- B. A 50-year-old man who smokes and has hypertension
- C. A 65-year-old man with obesity and a sedentary lifestyle ✓
- D. A 70-year-old man with a high-fat diet
Answer: C. A 65-year-old man with obesity and a sedentary lifestyle — BPH is more common in older men, with risk increasing with age, obesity, and a lack of physical activity.
14. A patient with CKD is experiencing severe itching. What is the best nursing intervention to help relieve this symptom?
- A. Encourage the patient to take a hot shower
- B. Apply a moisturizing lotion to the skin
- C. Increase the patient's dietary phosphorus intake
- D. Administer an oral antihistamine as prescribed ✓
Answer: D. Administer an oral antihistamine as prescribed — Pruritus in CKD is often related to elevated phosphate levels; antihistamines can help relieve itching, although controlling phosphorus is crucial.
15. A nurse is teaching a patient with recurrent UTIs about dietary modifications. Which food should be limited to reduce the risk of UTIs?
- A. Cranberries
- B. Blueberries
- C. Spicy foods
- D. Caffeine ✓
Answer: D. Caffeine — Caffeine can irritate the bladder, potentially increasing the risk of UTIs, so it is recommended to limit its intake.

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NCLEX Renal & Genitourinary Practice Questions

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