NUR 425 Final Exam: Acute & Chronic Health Disruptions
In Adults II V1 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient with acute kidney injury (AKI) has a rising serum creatinine level. What is the most specific
indicator of renal function?
A. Serum creatinine
B. Blood urea nitrogen (BUN)
C. Urine specific gravity
D. Potassium level
Ans: A
Explanation: Serum creatinine is a waste product of muscle metabolism and is primarily excreted by the
kidneys. It is considered more specific than BUN because it is not significantly affected by diet or
hydration status. When the glomerular filtration rate decreases, the creatinine level rises proportionally
in the blood. Nurses monitor this value to determine the severity of renal impairment in clinical settings.
Stable creatinine levels usually indicate that the current renal management plan is effective for the
patient.
2. Which electrolyte imbalance is most commonly associated with the oliguric phase of acute kidney injury?
A. Hypokalemia
B. Hypomagnesemia
C. Hypernatremia
D. Hyperkalemia
Ans: D
,Explanation: In the oliguric phase of AKI, the kidneys fail to excrete potassium effectively, leading to high
serum levels. Hyperkalemia is a medical emergency because it can cause lethal cardiac dysrhythmias and
cardiac arrest. Unlike sodium imbalances, potassium changes have a direct and immediate impact on
myocardial electrical conduction. The nurse must prioritize monitoring the patient’s EKG for peaked T
waves or widened QRS complexes. Immediate interventions may include the administration of
polystyrene sulfonate or intravenous insulin with dextrose.
3. A patient is diagnosed with prerenal acute kidney injury. What is a common cause of this condition?
A. Bladder stones
B. Nephrotoxic drugs
C. Hypovolemia
D. Prostate cancer
Ans: C
Explanation: Prerenal AKI is caused by factors that reduce systemic blood flow and decrease glomerular
perfusion. Hypovolemia from hemorrhage or dehydration leads to decreased renal artery pressure and
reduced filtration. This differs from intrarenal causes which involve direct damage to the kidney tissues
themselves. Management typically involves restoring blood volume to improve kidney perfusion and
prevent permanent damage. Nurses must assess the patient’s blood pressure and intake and output
closely during resuscitation.
4. What is the primary purpose of the arterial-venous (AV) fistula in a hemodialysis patient?
A. To provide a site for medication administration
B. To prevent the development of blood clots
C. To monitor central venous pressure
, D. To allow for high-flow access to the patient’s blood
Ans: D
Explanation: An AV fistula is surgically created to allow high volumes of blood to be removed and
returned during dialysis. By connecting an artery to a vein, the vein becomes thicker and stronger over
time to handle the needles. This access point is essential for the efficient removal of toxins and excess
fluid from the body. Nurses must check for a palpable thrill and an audible bruit to ensure the fistula is
patent. No blood pressures or needle sticks should ever be performed on the arm containing the fistula.
5. A patient with chronic kidney disease (CKD) reports severe itching. This is most likely caused by:
A. Increased urea levels
B. Low calcium levels
C. Accumulation of uremic frost
D. Allergic reaction to dialysis
Ans: C
Explanation: Severe itching, or pruritus, occurs in CKD due to the accumulation of uremic waste
products in the skin. When urea levels are extremely high, they can crystallize on the skin surface,
forming what is known as uremic frost. This condition is a sign of advanced renal failure and inadequate
clearance of metabolic toxins. Nursing care focuses on skin integrity and keeping the patient’s skin
hydrated with specialized lotions. Dialysis remains the most effective way to lower these systemic toxin
levels and relieve the symptoms.
6. What is a major complication of peritoneal dialysis that the nurse should monitor for?
A. Air embolism
B. Hypotension
In Adults II V1 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient with acute kidney injury (AKI) has a rising serum creatinine level. What is the most specific
indicator of renal function?
A. Serum creatinine
B. Blood urea nitrogen (BUN)
C. Urine specific gravity
D. Potassium level
Ans: A
Explanation: Serum creatinine is a waste product of muscle metabolism and is primarily excreted by the
kidneys. It is considered more specific than BUN because it is not significantly affected by diet or
hydration status. When the glomerular filtration rate decreases, the creatinine level rises proportionally
in the blood. Nurses monitor this value to determine the severity of renal impairment in clinical settings.
Stable creatinine levels usually indicate that the current renal management plan is effective for the
patient.
2. Which electrolyte imbalance is most commonly associated with the oliguric phase of acute kidney injury?
A. Hypokalemia
B. Hypomagnesemia
C. Hypernatremia
D. Hyperkalemia
Ans: D
,Explanation: In the oliguric phase of AKI, the kidneys fail to excrete potassium effectively, leading to high
serum levels. Hyperkalemia is a medical emergency because it can cause lethal cardiac dysrhythmias and
cardiac arrest. Unlike sodium imbalances, potassium changes have a direct and immediate impact on
myocardial electrical conduction. The nurse must prioritize monitoring the patient’s EKG for peaked T
waves or widened QRS complexes. Immediate interventions may include the administration of
polystyrene sulfonate or intravenous insulin with dextrose.
3. A patient is diagnosed with prerenal acute kidney injury. What is a common cause of this condition?
A. Bladder stones
B. Nephrotoxic drugs
C. Hypovolemia
D. Prostate cancer
Ans: C
Explanation: Prerenal AKI is caused by factors that reduce systemic blood flow and decrease glomerular
perfusion. Hypovolemia from hemorrhage or dehydration leads to decreased renal artery pressure and
reduced filtration. This differs from intrarenal causes which involve direct damage to the kidney tissues
themselves. Management typically involves restoring blood volume to improve kidney perfusion and
prevent permanent damage. Nurses must assess the patient’s blood pressure and intake and output
closely during resuscitation.
4. What is the primary purpose of the arterial-venous (AV) fistula in a hemodialysis patient?
A. To provide a site for medication administration
B. To prevent the development of blood clots
C. To monitor central venous pressure
, D. To allow for high-flow access to the patient’s blood
Ans: D
Explanation: An AV fistula is surgically created to allow high volumes of blood to be removed and
returned during dialysis. By connecting an artery to a vein, the vein becomes thicker and stronger over
time to handle the needles. This access point is essential for the efficient removal of toxins and excess
fluid from the body. Nurses must check for a palpable thrill and an audible bruit to ensure the fistula is
patent. No blood pressures or needle sticks should ever be performed on the arm containing the fistula.
5. A patient with chronic kidney disease (CKD) reports severe itching. This is most likely caused by:
A. Increased urea levels
B. Low calcium levels
C. Accumulation of uremic frost
D. Allergic reaction to dialysis
Ans: C
Explanation: Severe itching, or pruritus, occurs in CKD due to the accumulation of uremic waste
products in the skin. When urea levels are extremely high, they can crystallize on the skin surface,
forming what is known as uremic frost. This condition is a sign of advanced renal failure and inadequate
clearance of metabolic toxins. Nursing care focuses on skin integrity and keeping the patient’s skin
hydrated with specialized lotions. Dialysis remains the most effective way to lower these systemic toxin
levels and relieve the symptoms.
6. What is a major complication of peritoneal dialysis that the nurse should monitor for?
A. Air embolism
B. Hypotension
