RENAL & URINARY MED-SURG EXAM LATEST 2026
UPDATE 100 QUESTIONS AND DETAILED VERIFIED
ANSWERS FROM ACTUAL EXAMS TEST GRADE A+
1. A patient with acute kidney injury (AKI) has a rising serum creatinine. What is
the priority nursing assessment?
A. Skin integrity
B. Urine output
C. Dietary intake
D. Bowel sounds
Answer: B. Urine output
Rationale: Urine output is the most sensitive indicator of kidney function and
perfusion in AKI.
2. Which finding is most consistent with chronic kidney disease (CKD)?
A. Sudden flank pain
B. Elevated BUN and creatinine over months
C. High-grade fever
D. Hematuria after trauma
Answer: B. Elevated BUN and creatinine over months
Rationale: CKD is a progressive decline in renal function reflected by persistently
elevated labs.
3. A patient with nephrotic syndrome is most likely to have:
,A. Hypoalbuminemia
B. Hypercalcemia
C. Polyuria
D. Hypoglycemia
Answer: A. Hypoalbuminemia
Rationale: Protein loss in urine leads to low serum albumin.
4. Which symptom is an early sign of urinary tract infection (UTI)?
A. Chest pain
B. Dysuria
C. Jaundice
D. Bradycardia
Answer: B. Dysuria
Rationale: Painful urination is a hallmark early symptom of UTI.
5. The nurse should monitor for which complication of hemodialysis?
A. Hyperglycemia
B. Disequilibrium syndrome
C. Hypothermia
D. Hearing loss
Answer: B. Disequilibrium syndrome
Rationale: Rapid fluid and solute shifts during dialysis can cause neurological
symptoms.
6. Which diet is appropriate for a patient with CKD?
A. High potassium, high protein
B. Low sodium, controlled protein
,C. High sodium, low fluid
D. High carbohydrate, high potassium
Answer: B. Low sodium, controlled protein
Rationale: CKD requires restriction of sodium and careful protein management.
7. Which electrolyte imbalance is most common in renal failure?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia unrelated to phosphate
D. Hypomagnesemia only
Answer: A. Hyperkalemia
Rationale: Reduced renal excretion leads to potassium retention.
8. A patient on dialysis should report immediately:
A. Mild fatigue
B. Muscle cramps during treatment
C. Shortness of breath and chest pain
D. Dry mouth
Answer: C. Shortness of breath and chest pain
Rationale: These may indicate fluid overload or cardiac complications.
9. Which drug is commonly used to treat anemia in CKD?
A. Insulin
B. Erythropoietin
C. Furosemide
D. Heparin
, Answer: B. Erythropoietin
Rationale: It stimulates red blood cell production in renal failure.
10. The most reliable indicator of fluid status in kidney disease is:
A. Skin turgor
B. Daily weight
C. Blood pressure only
D. Temperature
Answer: B. Daily weight
Rationale: Daily weight reflects true fluid gain or loss.
11. Which urine characteristic is expected in UTI?
A. Clear and odorless
B. Cloudy with foul odor
C. Pale and diluted
D. Blue-green color
Answer: B. Cloudy with foul odor
Rationale: Bacterial infection causes cloudy, foul-smelling urine.
12. A patient with renal colic likely has:
A. Kidney infection
B. Kidney stones
C. Bladder cancer
D. Liver failure
Answer: B. Kidney stones
Rationale: Renal colic is caused by obstruction from calculi.
UPDATE 100 QUESTIONS AND DETAILED VERIFIED
ANSWERS FROM ACTUAL EXAMS TEST GRADE A+
1. A patient with acute kidney injury (AKI) has a rising serum creatinine. What is
the priority nursing assessment?
A. Skin integrity
B. Urine output
C. Dietary intake
D. Bowel sounds
Answer: B. Urine output
Rationale: Urine output is the most sensitive indicator of kidney function and
perfusion in AKI.
2. Which finding is most consistent with chronic kidney disease (CKD)?
A. Sudden flank pain
B. Elevated BUN and creatinine over months
C. High-grade fever
D. Hematuria after trauma
Answer: B. Elevated BUN and creatinine over months
Rationale: CKD is a progressive decline in renal function reflected by persistently
elevated labs.
3. A patient with nephrotic syndrome is most likely to have:
,A. Hypoalbuminemia
B. Hypercalcemia
C. Polyuria
D. Hypoglycemia
Answer: A. Hypoalbuminemia
Rationale: Protein loss in urine leads to low serum albumin.
4. Which symptom is an early sign of urinary tract infection (UTI)?
A. Chest pain
B. Dysuria
C. Jaundice
D. Bradycardia
Answer: B. Dysuria
Rationale: Painful urination is a hallmark early symptom of UTI.
5. The nurse should monitor for which complication of hemodialysis?
A. Hyperglycemia
B. Disequilibrium syndrome
C. Hypothermia
D. Hearing loss
Answer: B. Disequilibrium syndrome
Rationale: Rapid fluid and solute shifts during dialysis can cause neurological
symptoms.
6. Which diet is appropriate for a patient with CKD?
A. High potassium, high protein
B. Low sodium, controlled protein
,C. High sodium, low fluid
D. High carbohydrate, high potassium
Answer: B. Low sodium, controlled protein
Rationale: CKD requires restriction of sodium and careful protein management.
7. Which electrolyte imbalance is most common in renal failure?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia unrelated to phosphate
D. Hypomagnesemia only
Answer: A. Hyperkalemia
Rationale: Reduced renal excretion leads to potassium retention.
8. A patient on dialysis should report immediately:
A. Mild fatigue
B. Muscle cramps during treatment
C. Shortness of breath and chest pain
D. Dry mouth
Answer: C. Shortness of breath and chest pain
Rationale: These may indicate fluid overload or cardiac complications.
9. Which drug is commonly used to treat anemia in CKD?
A. Insulin
B. Erythropoietin
C. Furosemide
D. Heparin
, Answer: B. Erythropoietin
Rationale: It stimulates red blood cell production in renal failure.
10. The most reliable indicator of fluid status in kidney disease is:
A. Skin turgor
B. Daily weight
C. Blood pressure only
D. Temperature
Answer: B. Daily weight
Rationale: Daily weight reflects true fluid gain or loss.
11. Which urine characteristic is expected in UTI?
A. Clear and odorless
B. Cloudy with foul odor
C. Pale and diluted
D. Blue-green color
Answer: B. Cloudy with foul odor
Rationale: Bacterial infection causes cloudy, foul-smelling urine.
12. A patient with renal colic likely has:
A. Kidney infection
B. Kidney stones
C. Bladder cancer
D. Liver failure
Answer: B. Kidney stones
Rationale: Renal colic is caused by obstruction from calculi.
