Free Renal and Urological Nursing MCQs with Answers

• A. Collect the first urine passed after waking
• B. Clean the perineum and collect the midstream urine
• C. Insert an indwelling catheter before collecting urine
• D. Collect urine from the drainage bag of a catheter

Explanation: Cleaning the perineum and collecting midstream urine reduces contamination from skin and urethral organisms.

• A. Mild periorbital edema
• B. Urine that appears tea coloured
• C. Blood pressure of 170/100 mmHg
• D. Reduced appetite during breakfast

Explanation: Severe hypertension can cause complications such as encephalopathy, heart failure, or seizures, so it requires prompt reporting.

• A. Heavy proteinuria with low serum albumin
• B. Mild proteinuria with high serum albumin
• C. Glucosuria with low serum creatinine
• D. Hematuria with high serum calcium

Explanation: Damage to the glomerular filtration barrier causes heavy protein loss in urine, leading to hypoalbuminemia and edema.

• A. Prerenal injury caused by reduced renal perfusion
• B. Intrinsic injury caused by glomerular inflammation
• C. Postrenal injury caused by ureteric obstruction
• D. Chronic injury caused by long-term nephron loss

Explanation: Fluid loss reduces circulating volume and renal perfusion, producing prerenal acute kidney injury.

• A. Measure blood pressure on the fistula arm
• B. Apply a tight dressing over the fistula daily
• C. Check for a thrill and bruit each shift
• D. Use the fistula arm for routine venipuncture

Explanation: A palpable thrill and audible bruit indicate blood flow through the fistula.

• A. Normal urine output
• B. Polyuria
• C. Oliguria
• D. Urinary frequency

Explanation: Adult urine output below 400 mL in 24 hours is commonly described as oliguria.

• A. Red blood cell casts in the urine
• B. Clear urine with no formed elements
• C. Large glucose loss without ketones
• D. Many calcium crystals without blood

Explanation: Red blood cell casts form in damaged renal tubules after bleeding from the glomeruli and strongly support glomerulonephritis.

• A. Encourage vigorous oral fluids immediately
• B. Apply a warm compress and reassess later
• C. Report possible infected urinary obstruction promptly
• D. Ask the patient to walk until the stone passes

Explanation: Fever with obstruction suggests an infected, obstructed urinary tract, which can rapidly progress to sepsis and requires urgent medical…

• A. Place the patient supine and assess vital signs
• B. Offer a high-potassium fruit drink
• C. Ask the patient to stand and walk slowly
• D. Increase the prescribed ultrafiltration rate

Explanation: Hypotension during dialysis may result from excessive or rapid fluid removal, so the immediate priority is to support circulation and…

• A. I will drink extra water whenever my ankles swell
• B. I will record drinks, soup, ice, and other liquid foods
• C. I can ignore my daily weight if I have no thirst
• D. I will stop counting fluids on days when urine increases

Explanation: All liquid sources, including soup, ice, and liquid medicines, contribute to the daily fluid allowance and should be recorded.

• A. Prerenal kidney injury from reduced renal perfusion
• B. Intrinsic kidney injury from tubular damage
• C. Postrenal kidney injury from urinary obstruction
• D. Chronic kidney disease from gradual nephron loss

Explanation: The enlarged prostate obstructs urine flow, causing pressure to build above the obstruction and impairing kidney function.

• A. Reduced production of erythropoietin by the kidneys
• B. Increased production of erythropoietin by the liver
• C. Excessive destruction of platelets in the spleen
• D. Increased absorption of iron from the intestine

Explanation: Diseased kidneys produce less erythropoietin, so the bone marrow receives less stimulation to make red blood cells.

• A. Slow the next exchange and reassess the drainage
• B. Report suspected peritonitis promptly to the health-care provider
• C. Encourage the patient to walk to improve drainage
• D. Add extra fluid to the next dialysis exchange

Explanation: Cloudy dialysate with abdominal pain and fever strongly suggests peritonitis, a serious complication of peritoneal dialysis.

• A. Discard it after measuring the urine output
• B. Place it in a specimen container for laboratory analysis
• C. Flush it with tap water before returning it to the patient
• D. Store it in the medication refrigerator until discharge

Explanation: Stone analysis can identify its composition and guide prevention of recurrence.

• A. Stop the medicine once the urine becomes clear
• B. Take the medicine for the prescribed course even if symptoms improve
• C. Save the remaining medicine for the next urinary infection
• D. Take the medicine only when urinary pain returns

Explanation: The full prescribed course helps eradicate the infection and reduces treatment failure and resistance.

• A. A negative balance of 600 mL
• B. A positive balance of 600 mL
• C. A positive balance of 2,400 mL
• D. A negative balance of 2,400 mL

Explanation: Fluid balance equals intake minus output: 1,500 mL minus 900 mL equals a positive 600 mL.

• A. Apply gentle skin care and reposition the patient regularly
• B. Restrict all movement to prevent loss of body protein
• C. Massage the swollen areas vigorously every four hours
• D. Place the patient in a dependent position for prolonged periods

Explanation: Severe edema stretches the skin and increases the risk of pressure injury and infection.

• A. Irrigate the catheter routinely with sterile water
• B. Check the tubing for kinks and dependent loops
• C. Remove the catheter immediately without assessment
• D. Increase the patient’s fluid intake without checking the system

Explanation: A blocked or kinked drainage system is a common and correctable cause of absent urine flow.

• A. Place the patient on cardiac monitoring and notify the provider
• B. Offer a high-potassium fruit snack for additional energy
• C. Encourage ambulation to improve muscle strength
• D. Administer a potassium-containing intravenous fluid

Explanation: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias, so cardiac monitoring and urgent reporting are the priority.

• A. It binds dietary phosphate in the intestine
• B. It directly increases erythropoietin production
• C. It dissolves urinary stones in the renal pelvis
• D. It prevents all bacterial infections of the urinary tract

Explanation: Calcium carbonate acts as a phosphate binder when taken with meals, reducing intestinal phosphate absorption.