Renal Failure Nursing 2026 AKI & CKD Guidelines

1. A patient presents with sudden decreased urine output, elevated creatinine, and recent hypotension. What condition is most likely? A. Chronic kidney disease B. Acute kidney injury C. Nephrotic syndrome D. Urinary tract infection Correct Answer: B. Acute kidney injury Rationale: AKI is characterized by rapid decline in kidney function, often after hypoperfusion or injury. 2. Which lab value is most indicative of renal failure progression? A. Hemoglobin B. Creatinine C. Platelets D. Sodium only Correct Answer: B. Creatinine Rationale: Creatinine rises as glomerular filtration decreases. 3. Which urine output is considered oliguria? A. B. C. 1000 mL/day 2000 mL/day 400–500 mL/day D. 1500 mL/day Correct Answer: C. 400–500 mL/day Rationale: Oliguria indicates reduced kidney perfusion or function. 4. Which condition is the most common cause of prerenal AKI? A. Hypertension B. Dehydration or hypovolemia C. Diabetes insipidus D. Hyperthyroidism Correct Answer: B. Dehydration or hypovolemia Rationale: Reduced renal perfusion leads to kidney injury. 5. Which nursing action is priority in suspected AKI? A. Increase fluid intake immediately without assessment B. Assess fluid balance and vital signs C. Give diuretics immediately D. Restrict monitoring Correct Answer: B. Assess fluid balance and vital signs Rationale: Determines severity and guides treatment. 6. Which electrolyte imbalance is most dangerous in AKI? A. Hypokalemia B. Hyperkalemia C. Hypocalcemia only D. Low sodium only Correct Answer: B. Hyperkalemia Rationale: Can cause fatal cardiac arrhythmias. 7. Which ECG change is associated with hyperkalemia? A. Tall peaked T waves B. ST elevation C. U waves only D. Short PR interval only Correct Answer: A. Tall peaked T waves Rationale: Classic ECG sign of elevated potassium. 8. Which intervention is priority for severe hyperkalemia? A. IV calcium gluconate B. Oral fluids only C. Vitamin D D. Iron supplementation Correct Answer: A. IV calcium gluconate Rationale: Stabilizes cardiac membranes immediately. 9. Which symptom is most consistent with uremia? A. Confusion and nausea B. Increased appetite C. Weight gain muscle D. Improved alertness Correct Answer: A. Confusion and nausea Rationale: Uremia affects CNS and GI system. 10. Which condition defines chronic kidney disease (CKD)? A. Sudden kidney failure within hours B. Kidney damage lasting 3 months C. Temporary dehydration D. Acute infection only Correct Answer: B. Kidney damage lasting 3 months Rationale: CKD is long-term progressive loss of kidney function. 11. Which dietary restriction is most important in CKD? A. High potassium foods B. High sodium and fluid intake C. Protein moderation D. High phosphate foods Correct Answer: C. Protein moderation Rationale: Excess protein increases nitrogen waste burden. 12. Which complication is common in CKD patients? A. Anemia B. Hyperthyroidism C. Asthma D. Leukemia Correct Answer: A. Anemia Rationale: Reduced erythropoietin production causes anemia.