NR 324 Adult Health II Exam 4 Study Guide 2026 |Chamberlain College
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Furosemide (Lasix)
Answer: B
Rationale: Calcium gluconate is used in hyperkalemia to stabilize the myocardium and
prevent life-threatening arrhythmias, although it does not lower the potassium level itself.
2. When assessing a patient’s arteriovenous (AV) fistula for hemodialysis, which
finding indicates the access is patent?
A. Presence of pitting edema in the extremity
B. Absence of a pulse distal to the site
C. Palpable thrill and audible bruit
D. Pulsatile mass over the incision line
Answer: C
Rationale: A palpable thrill (vibration) and an audible bruit (swishing sound) are normal
findings that indicate the fistula is patent and functioning.
,3. A patient with Chronic Kidney Disease (CKD) is prescribed Sevelamer
(Renagel). What is the primary purpose of this medication?
A. To increase red blood cell production
B. To lower serum potassium levels
C. To manage systemic hypertension
D. To bind dietary phosphorus in the GI tract
Answer: D
Rationale: Sevelamer is a phosphate binder given with meals to prevent the absorption of
phosphorus, which is often elevated in CKD patients due to reduced renal excretion.
4. A patient is in the oliguric phase of Acute Kidney Injury. Which clinical
manifestation should the nurse monitor for most closely?
A. Hypovolemia
B. Fluid volume excess
C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: During the oliguric phase, urine output decreases significantly, leading to fluid
retention, edema, hypertension, and potential pulmonary congestion.
5. Which GFR range is characteristic of Stage 3 Chronic Kidney Disease (CKD)?
A. Greater than 90 mL/min
B. 60 to 89 mL/min
C. 15 to 29 mL/min
D. 30 to 59 mL/min
Answer: D
Rationale: Stage 3 CKD is defined by a moderate decrease in GFR, ranging from 30 to 59
mL/min.
, 6. A patient undergoing peritoneal dialysis reports that the effluent (drainage) is
appearing cloudy. What is the nurse’s priority action?
A. Reposition the patient to improve drainage
B. Slow the infusion rate of the dialysate
C. Document the finding as a normal occurrence
D. Notify the healthcare provider of a possible infection
Answer: D
Rationale: Cloudy peritoneal effluent is the first sign of peritonitis, a serious complication
of peritoneal dialysis that requires immediate medical attention.
7. Which laboratory value is most indicative of the effectiveness of Epoetin alfa
(Epogen) therapy in a patient with CKD?
A. Increased serum iron
B. Decreased Creatinine
C. Increased Hemoglobin and Hematocrit
D. Decreased Blood Urea Nitrogen (BUN)
Answer: C
Rationale: Epoetin alfa is a synthetic form of erythropoietin used to stimulate red blood
cell production in CKD patients, so an increase in H&H indicates effectiveness.
8. A nurse is caring for a patient with a diagnosis of Pernicious Anemia. The
nurse understands this is caused by a deficiency in:
A. Intrinsic factor
B. Folic acid absorption
C. Dietary iron intake
D. Erythropoietin production
Answer: A
Rationale: Pernicious anemia is caused by a lack of intrinsic factor, which is necessary for
the absorption of Vitamin B12 in the small intestine.
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Furosemide (Lasix)
Answer: B
Rationale: Calcium gluconate is used in hyperkalemia to stabilize the myocardium and
prevent life-threatening arrhythmias, although it does not lower the potassium level itself.
2. When assessing a patient’s arteriovenous (AV) fistula for hemodialysis, which
finding indicates the access is patent?
A. Presence of pitting edema in the extremity
B. Absence of a pulse distal to the site
C. Palpable thrill and audible bruit
D. Pulsatile mass over the incision line
Answer: C
Rationale: A palpable thrill (vibration) and an audible bruit (swishing sound) are normal
findings that indicate the fistula is patent and functioning.
,3. A patient with Chronic Kidney Disease (CKD) is prescribed Sevelamer
(Renagel). What is the primary purpose of this medication?
A. To increase red blood cell production
B. To lower serum potassium levels
C. To manage systemic hypertension
D. To bind dietary phosphorus in the GI tract
Answer: D
Rationale: Sevelamer is a phosphate binder given with meals to prevent the absorption of
phosphorus, which is often elevated in CKD patients due to reduced renal excretion.
4. A patient is in the oliguric phase of Acute Kidney Injury. Which clinical
manifestation should the nurse monitor for most closely?
A. Hypovolemia
B. Fluid volume excess
C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: During the oliguric phase, urine output decreases significantly, leading to fluid
retention, edema, hypertension, and potential pulmonary congestion.
5. Which GFR range is characteristic of Stage 3 Chronic Kidney Disease (CKD)?
A. Greater than 90 mL/min
B. 60 to 89 mL/min
C. 15 to 29 mL/min
D. 30 to 59 mL/min
Answer: D
Rationale: Stage 3 CKD is defined by a moderate decrease in GFR, ranging from 30 to 59
mL/min.
, 6. A patient undergoing peritoneal dialysis reports that the effluent (drainage) is
appearing cloudy. What is the nurse’s priority action?
A. Reposition the patient to improve drainage
B. Slow the infusion rate of the dialysate
C. Document the finding as a normal occurrence
D. Notify the healthcare provider of a possible infection
Answer: D
Rationale: Cloudy peritoneal effluent is the first sign of peritonitis, a serious complication
of peritoneal dialysis that requires immediate medical attention.
7. Which laboratory value is most indicative of the effectiveness of Epoetin alfa
(Epogen) therapy in a patient with CKD?
A. Increased serum iron
B. Decreased Creatinine
C. Increased Hemoglobin and Hematocrit
D. Decreased Blood Urea Nitrogen (BUN)
Answer: C
Rationale: Epoetin alfa is a synthetic form of erythropoietin used to stimulate red blood
cell production in CKD patients, so an increase in H&H indicates effectiveness.
8. A nurse is caring for a patient with a diagnosis of Pernicious Anemia. The
nurse understands this is caused by a deficiency in:
A. Intrinsic factor
B. Folic acid absorption
C. Dietary iron intake
D. Erythropoietin production
Answer: A
Rationale: Pernicious anemia is caused by a lack of intrinsic factor, which is necessary for
the absorption of Vitamin B12 in the small intestine.
