GALEN ADVANCED MEDSURG
NUR265 EXAM 1 QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED +
Question: What are the primary clinical signs and symptoms of Acute Kidney
Injury (AKI), including fluid balance changes and vital signs?
✔✔ Answer:
Urine Output Changes: Oliguria (abnormally low urine production) and a
general decrease in overall fluid output.
Lab Markers: Azotemia (an accumulation of nitrogenous waste
compounds, like BUN and creatinine, in the blood).
Fluid Volume Overload: Manifesting as pulmonary crackles, peripheral
edema, mental confusion, a drop in oxygen saturation (e.g., $SpO_2$ around
88%), and tachycardia (rapid heart rate).
Hemodynamics: A Mean Arterial Pressure (MAP) falling below 65 mmHg.
Question: What classic diagnostic finding appears on a chest X-ray when an AKI
leads to systemic fluid back-up?
✔✔ Answer: Pulmonary infiltrates, which indicate fluid accumulation in the lung
fields due to volume overload.
Question: How might an Arterial Blood Gas (ABG) panel read if a patient with
AKI develops hyperventilation due to severe hypoxia ($SpO_2$ below 88%)?
✔✔ Answer: Respiratory alkalosis (often caused by the patient breathing rapidly
to compensate for poor oxygenation or fluid in the lungs).
Question: What are some common examples of prerenal factors that can cause
Acute Kidney Injury?
✔✔ Answer: Any condition that decreases systemic blood flow to the kidneys
before it reaches the renal tissue, such as severe dehydration, acute hemorrhage
(blood loss), drop in cardiac output, congestive heart failure, severe infection,
,excessive nasogastric (NG) tube suctioning, sepsis, or fluid loss from severe
vomiting and diarrhea.
Question: What are some common examples of intrarenal (intrinsic) factors that
can cause Acute Kidney Injury?
✔✔ Answer: Conditions that cause direct, structural damage to the internal kidney
tissue or filtering units, including myoglobinuria (from muscle breakdown), acute
tubular necrosis (ATN), nephrotoxicity (drug-induced kidney damage), severe
acute pyelonephritis, or exposure to diagnostic intravenous contrast dye.
Note: Benign Prostatic Hyperplasia (BPH) causes a physical blockage after the
kidney, meaning it is classified under postrenal AKI rather than intrarenal.
Example of post renal AKI -ANSWER ✔✔bladder neck obstruction, bladder
cancer; calculi; tumor
Duiretic phase (3rd phase) of AKI -ANSWER ✔✔Nurse should give 3L-6L per
day; place Foley
Asses I and O (output=1000-2000mL/day)
replace fluids and monitor electrolyes
dialysis may be required
Best Lab indicator of Kindey function (AKI and CKD) -ANSWER ✔✔creatine
(Normal 0.6-1.2)
AKI increased 1-2 every 24-48hrs
Normal urine output per hour -ANSWER ✔✔30 mL/hr
normal potassium levels -ANSWER ✔✔3.5-5.0 mEq/L
, Normal Sodium levels -ANSWER ✔✔135-145 mEq/L
Diet for AKI patients -ANSWER ✔✔mod protein
high carb
Complication of AKI -ANSWER ✔✔Preicarditis
Nephrotoxic agents include -ANSWER ✔✔contrast
mycin antibitics (peak and trough)
NSAIDS (celecoxib, ibuprophen, ketorolac, napraxon)
Diet : AKI patient w/ dialysis -ANSWER ✔✔protein 40 g/day
diet:AKI patient without dialysis -ANSWER ✔✔protein 1-1.5g/kg
Na 60-90 mEq/kg
K restriction 60-70 mEq/kg
Define oliguria -ANSWER ✔✔decreased urine production
400mL/day or less
How many stages of Kidney failure are there? -ANSWER ✔✔5 stages ( defined by
GFR)
stage 1 (GFR 90 and up)
Stage 5 (GFR 15 or less)
NUR265 EXAM 1 QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED +
Question: What are the primary clinical signs and symptoms of Acute Kidney
Injury (AKI), including fluid balance changes and vital signs?
✔✔ Answer:
Urine Output Changes: Oliguria (abnormally low urine production) and a
general decrease in overall fluid output.
Lab Markers: Azotemia (an accumulation of nitrogenous waste
compounds, like BUN and creatinine, in the blood).
Fluid Volume Overload: Manifesting as pulmonary crackles, peripheral
edema, mental confusion, a drop in oxygen saturation (e.g., $SpO_2$ around
88%), and tachycardia (rapid heart rate).
Hemodynamics: A Mean Arterial Pressure (MAP) falling below 65 mmHg.
Question: What classic diagnostic finding appears on a chest X-ray when an AKI
leads to systemic fluid back-up?
✔✔ Answer: Pulmonary infiltrates, which indicate fluid accumulation in the lung
fields due to volume overload.
Question: How might an Arterial Blood Gas (ABG) panel read if a patient with
AKI develops hyperventilation due to severe hypoxia ($SpO_2$ below 88%)?
✔✔ Answer: Respiratory alkalosis (often caused by the patient breathing rapidly
to compensate for poor oxygenation or fluid in the lungs).
Question: What are some common examples of prerenal factors that can cause
Acute Kidney Injury?
✔✔ Answer: Any condition that decreases systemic blood flow to the kidneys
before it reaches the renal tissue, such as severe dehydration, acute hemorrhage
(blood loss), drop in cardiac output, congestive heart failure, severe infection,
,excessive nasogastric (NG) tube suctioning, sepsis, or fluid loss from severe
vomiting and diarrhea.
Question: What are some common examples of intrarenal (intrinsic) factors that
can cause Acute Kidney Injury?
✔✔ Answer: Conditions that cause direct, structural damage to the internal kidney
tissue or filtering units, including myoglobinuria (from muscle breakdown), acute
tubular necrosis (ATN), nephrotoxicity (drug-induced kidney damage), severe
acute pyelonephritis, or exposure to diagnostic intravenous contrast dye.
Note: Benign Prostatic Hyperplasia (BPH) causes a physical blockage after the
kidney, meaning it is classified under postrenal AKI rather than intrarenal.
Example of post renal AKI -ANSWER ✔✔bladder neck obstruction, bladder
cancer; calculi; tumor
Duiretic phase (3rd phase) of AKI -ANSWER ✔✔Nurse should give 3L-6L per
day; place Foley
Asses I and O (output=1000-2000mL/day)
replace fluids and monitor electrolyes
dialysis may be required
Best Lab indicator of Kindey function (AKI and CKD) -ANSWER ✔✔creatine
(Normal 0.6-1.2)
AKI increased 1-2 every 24-48hrs
Normal urine output per hour -ANSWER ✔✔30 mL/hr
normal potassium levels -ANSWER ✔✔3.5-5.0 mEq/L
, Normal Sodium levels -ANSWER ✔✔135-145 mEq/L
Diet for AKI patients -ANSWER ✔✔mod protein
high carb
Complication of AKI -ANSWER ✔✔Preicarditis
Nephrotoxic agents include -ANSWER ✔✔contrast
mycin antibitics (peak and trough)
NSAIDS (celecoxib, ibuprophen, ketorolac, napraxon)
Diet : AKI patient w/ dialysis -ANSWER ✔✔protein 40 g/day
diet:AKI patient without dialysis -ANSWER ✔✔protein 1-1.5g/kg
Na 60-90 mEq/kg
K restriction 60-70 mEq/kg
Define oliguria -ANSWER ✔✔decreased urine production
400mL/day or less
How many stages of Kidney failure are there? -ANSWER ✔✔5 stages ( defined by
GFR)
stage 1 (GFR 90 and up)
Stage 5 (GFR 15 or less)
