NR 324 Adult Health II - Renal and Urinary Systems 2026
|Chamberlain College
1. A patient in the oliguric phase of acute kidney injury (AKI) has a 24-hour urine
output of 350 mL. What is the priority nursing diagnosis?
A. Excess fluid volume
B. Deficient fluid volume
C. Risk for infection
D. Imbalanced nutrition: less than body requirements
Answer: A
Rationale: In the oliguric phase of AKI, urine output drops significantly (less than 400
mL/day), leading to fluid retention, edema, and hypertension. Excess fluid volume is the
priority.
2. Which laboratory value is the best indicator of overall kidney function?
A. Glomerular filtration rate (GFR)
B. Blood urea nitrogen (BUN)
C. Serum creatinine
D. Urine specific gravity
Answer: A
Rationale: While serum creatinine is used to calculate it, GFR is the most accurate
indicator of kidney function as it reflects the rate at which the kidneys filter blood.
,3. A patient with chronic kidney disease (CKD) reports feeling extremely
fatigued. The nurse notes a hemoglobin level of 8.2 g/dL. Which medication
should the nurse anticipate administering?
A. Furosemide
B. Sodium polystyrene sulfonate
C. Calcium acetate
D. Epoetin alfa
Answer: D
Rationale: CKD patients often experience anemia because the kidneys fail to produce
erythropoietin; Epoetin alfa stimulates red blood cell production.
4. A nurse is caring for a patient receiving peritoneal dialysis. The nurse notices
the outflow drainage is cloudy. What is the nurse’s priority action?
A. Notify the healthcare provider immediately
B. Reposition the patient to improve flow
C. Continue the procedure as this is normal
D. Add heparin to the next dialysate bag
Answer: A
Rationale: Cloudy or opaque effluent is the first sign of peritonitis, a serious complication
of peritoneal dialysis that requires immediate medical attention.
5. Which clinical manifestation is characteristic of the diuretic phase of AKI?
A. Hypervolemia
B. Hypokalemia
C. Metabolic acidosis
D. Weight gain
Answer: B
, Rationale: During the diuretic phase, the kidneys can excrete waste but cannot
concentrate urine, leading to massive fluid loss and electrolyte depletion, such as
hypokalemia and hyponatremia.
6. A patient with CKD is prescribed calcium acetate (PhosLo). The nurse knows
this medication is effective if which lab value decreases?
A. Calcium
B. Potassium
C. Magnesium
D. Phosphorus
Answer: D
Rationale: Calcium acetate is a phosphate binder used to treat hyperphosphatemia in CKD
by binding phosphorus in the gut so it can be excreted in stool.
7. A patient is diagnosed with post-streptococcal glomerulonephritis. What is a
key clinical finding for this condition?
A. Painless hematuria
B. Polyuria
C. Hypotension
D. Periorbital edema
Answer: D
Rationale: Post-streptococcal glomerulonephritis typically presents with edema (starting
in the face/eyes), hypertension, and hematuria (cola-colored urine).
8. What is the primary cause of prerenal acute kidney injury?
A. Reduced blood flow to the kidneys
B. Direct damage to kidney tissue
C. Obstruction of urine outflow
D. Nephrotoxic medications
Answer: A
|Chamberlain College
1. A patient in the oliguric phase of acute kidney injury (AKI) has a 24-hour urine
output of 350 mL. What is the priority nursing diagnosis?
A. Excess fluid volume
B. Deficient fluid volume
C. Risk for infection
D. Imbalanced nutrition: less than body requirements
Answer: A
Rationale: In the oliguric phase of AKI, urine output drops significantly (less than 400
mL/day), leading to fluid retention, edema, and hypertension. Excess fluid volume is the
priority.
2. Which laboratory value is the best indicator of overall kidney function?
A. Glomerular filtration rate (GFR)
B. Blood urea nitrogen (BUN)
C. Serum creatinine
D. Urine specific gravity
Answer: A
Rationale: While serum creatinine is used to calculate it, GFR is the most accurate
indicator of kidney function as it reflects the rate at which the kidneys filter blood.
,3. A patient with chronic kidney disease (CKD) reports feeling extremely
fatigued. The nurse notes a hemoglobin level of 8.2 g/dL. Which medication
should the nurse anticipate administering?
A. Furosemide
B. Sodium polystyrene sulfonate
C. Calcium acetate
D. Epoetin alfa
Answer: D
Rationale: CKD patients often experience anemia because the kidneys fail to produce
erythropoietin; Epoetin alfa stimulates red blood cell production.
4. A nurse is caring for a patient receiving peritoneal dialysis. The nurse notices
the outflow drainage is cloudy. What is the nurse’s priority action?
A. Notify the healthcare provider immediately
B. Reposition the patient to improve flow
C. Continue the procedure as this is normal
D. Add heparin to the next dialysate bag
Answer: A
Rationale: Cloudy or opaque effluent is the first sign of peritonitis, a serious complication
of peritoneal dialysis that requires immediate medical attention.
5. Which clinical manifestation is characteristic of the diuretic phase of AKI?
A. Hypervolemia
B. Hypokalemia
C. Metabolic acidosis
D. Weight gain
Answer: B
, Rationale: During the diuretic phase, the kidneys can excrete waste but cannot
concentrate urine, leading to massive fluid loss and electrolyte depletion, such as
hypokalemia and hyponatremia.
6. A patient with CKD is prescribed calcium acetate (PhosLo). The nurse knows
this medication is effective if which lab value decreases?
A. Calcium
B. Potassium
C. Magnesium
D. Phosphorus
Answer: D
Rationale: Calcium acetate is a phosphate binder used to treat hyperphosphatemia in CKD
by binding phosphorus in the gut so it can be excreted in stool.
7. A patient is diagnosed with post-streptococcal glomerulonephritis. What is a
key clinical finding for this condition?
A. Painless hematuria
B. Polyuria
C. Hypotension
D. Periorbital edema
Answer: D
Rationale: Post-streptococcal glomerulonephritis typically presents with edema (starting
in the face/eyes), hypertension, and hematuria (cola-colored urine).
8. What is the primary cause of prerenal acute kidney injury?
A. Reduced blood flow to the kidneys
B. Direct damage to kidney tissue
C. Obstruction of urine outflow
D. Nephrotoxic medications
Answer: A
