NURSING · 2026/2027 LATEST UPDATE
NCLEX-RN Renal & Urinary
Nursing Concept Exam 2026
AKI, CKD, Dialysis, UTI Management
- Complete Study Guide
85+ Verified Exam Questions · Rated A+ · Guaranteed Results
V Acute Kidney Injury (AKI) & V Urinary Tract Infections (UTI)
Chronic Kidney Disease (CKD) & Pyelonephritis
V Dialysis (Hemodialysis & V Glomerulonephritis &
Peritoneal) Nephrotic Syndrome
V Fluid & Electrolyte Management in Renal Disease
85 Questions · 5 Sections · Passing Score: pass/fail
Instant PDF Download · 100% Verified Answers · Score 90%+
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 1 of 48
, BEST SELLER · NURSING
NCLEX-RN Renal & Urinary
Nursing Concept Exam 2026
AKI, CKD, Dialysis, UTI
Management 2026/2027 - Q&A
with Verified Answers
Every section. Every topic. 100% correct answers guaranteed.
Used by 5,000+ nursing students to pass on their first attempt.
AKI & CKD Dialysis UTI & Pyelonephritis
Glomerulonephritis & Nephrotic Syndrome Fluid & Electrolyte Management
A+
Rated
Used by 5,000+ students · 100% Verified Answers · 2026/2027 Latest Update
Instant PDF Download
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 2 of 48
,SECTION 1 | Acute Kidney Injury (AKI) & Chronic Kidney Disease (CKD) | Q1-Q18 | NCLEX-RN Renal & Urinary Nursing Concept
Q1 Question 1 of 85
Q1. A 68-year-old male with a history of benign prostatic hyperplasia presents to the emergency
department with oliguria, confusion, and a serum creatinine of 4.2 mg/dL, up from his baseline of 1.1
mg/dL over the past 48 hours. His blood pressure is 162/94 mmHg and he has 2+ pitting edema in
the lower extremities. The nurse recognizes these findings are most consistent with which stage of
acute kidney injury?
A. Stage 3 AKI based on the serum creatinine increase to more than 3 times baseline
B. Stage 2 AKI based on the serum creatinine increase to more than 2-3 times baseline
C. Stage 1 AKI based on the serum creatinine increase of more than 0.3 mg/dL from baseline
D. Prerenal azotemia that will resolve with intravenous fluid resuscitation
Correct Answer: A
Rationale:
The patient's creatinine has increased to approximately 3.8 times his baseline (4.2/1.1), which classifies
him as Stage 3 AKI per KDIGO criteria. Stage 1 requires a rise of 0.3 mg/dL or 1.5-1.9 times baseline,
and Stage 2 requires 2.0-2.9 times baseline. The oliguria and confusion further support severe AKI rather
than simple prerenal azotemia.
Q2 Question 2 of 85
Q2. A 55-year-old female with type 2 diabetes mellitus and hypertension has an estimated GFR of 28
mL/min/1.73m2 and persistent albuminuria. The nurse is educating the patient about her chronic
kidney disease stage. According to the KDIGO classification, which CKD stage does this patient
have?
A. CKD Stage 3a because the GFR is between 30-44 mL/min/1.73m2
B. CKD Stage 3b because the GFR is between 15-29 mL/min/1.73m2
C. CKD Stage 4 because the GFR is between 15-29 mL/min/1.73m2 with albuminuria
D. CKD Stage 2 because the albuminuria indicates moderate damage with preserved GFR
Correct Answer: B
Rationale:
KDIGO classifies CKD Stage 3b as GFR 15-29 mL/min/1.73m2, and this patient's GFR of 28 falls in that
range. Stage 3a is GFR 30-44, Stage 4 is GFR 15-29 with the same GFR range but the albuminuria
modifies risk rather than stage, and Stage 2 requires GFR 60-89.
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 3 of 48
, Q3 Question 3 of 85
Q3. A 72-year-old male with CKD Stage 4 is admitted with worsening fatigue, nausea, and metallic
taste in his mouth. Laboratory results show BUN 85 mg/dL, creatinine 6.8 mg/dL, potassium 5.9
mEq/L, and metabolic acidosis with a bicarbonate of 16 mEq/L. The nurse identifies these symptoms
and lab values as most indicative of which condition?
A. Hyperkalemia alone that can be managed with sodium polystyrene sulfonate
B. Acute kidney injury superimposed on chronic kidney disease
C. Uremia requiring evaluation for renal replacement therapy
D. Diabetic nephropathy progression that needs glycemic control adjustment
Correct Answer: C
Rationale:
The constellation of fatigue, nausea, metallic taste, elevated BUN and creatinine, hyperkalemia, and
metabolic acidosis are classic signs of uremia, which indicates the need for renal replacement therapy
evaluation. While AKI on CKD is possible, the progressive CKD Stage 4 with uremic symptoms is the
primary concern. Hyperkalemia and acidosis are components of uremia, not standalone issues.
Q4 Question 4 of 85
Q4. A 45-year-old female is admitted with rhabdomyolysis after a severe crush injury. Her creatinine
kinase is 28,000 U/L and her urine is tea-colored. The nurse anticipates which priority intervention to
prevent acute kidney injury in this patient?
A. Aggressive intravenous fluid resuscitation with normal saline to maintain urine output above 200
mL/hr
B. Administration of mannitol for osmotic diuresis to flush the renal tubules
C. Immediate initiation of continuous renal replacement therapy to remove myoglobin
D. Administration of sodium bicarbonate to alkalinize the urine and prevent myoglobin
precipitation
Correct Answer: D
Rationale:
Aggressive IV fluid resuscitation is the priority intervention to prevent AKI in rhabdomyolysis by
maintaining renal perfusion and diluting tubular myoglobin. Sodium bicarbonate is controversial and
secondary to volume resuscitation. CRRT is initiated only if AKI has already developed, and mannitol is
not a first-line intervention.
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 4 of 48
NCLEX-RN Renal & Urinary
Nursing Concept Exam 2026
AKI, CKD, Dialysis, UTI Management
- Complete Study Guide
85+ Verified Exam Questions · Rated A+ · Guaranteed Results
V Acute Kidney Injury (AKI) & V Urinary Tract Infections (UTI)
Chronic Kidney Disease (CKD) & Pyelonephritis
V Dialysis (Hemodialysis & V Glomerulonephritis &
Peritoneal) Nephrotic Syndrome
V Fluid & Electrolyte Management in Renal Disease
85 Questions · 5 Sections · Passing Score: pass/fail
Instant PDF Download · 100% Verified Answers · Score 90%+
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 1 of 48
, BEST SELLER · NURSING
NCLEX-RN Renal & Urinary
Nursing Concept Exam 2026
AKI, CKD, Dialysis, UTI
Management 2026/2027 - Q&A
with Verified Answers
Every section. Every topic. 100% correct answers guaranteed.
Used by 5,000+ nursing students to pass on their first attempt.
AKI & CKD Dialysis UTI & Pyelonephritis
Glomerulonephritis & Nephrotic Syndrome Fluid & Electrolyte Management
A+
Rated
Used by 5,000+ students · 100% Verified Answers · 2026/2027 Latest Update
Instant PDF Download
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 2 of 48
,SECTION 1 | Acute Kidney Injury (AKI) & Chronic Kidney Disease (CKD) | Q1-Q18 | NCLEX-RN Renal & Urinary Nursing Concept
Q1 Question 1 of 85
Q1. A 68-year-old male with a history of benign prostatic hyperplasia presents to the emergency
department with oliguria, confusion, and a serum creatinine of 4.2 mg/dL, up from his baseline of 1.1
mg/dL over the past 48 hours. His blood pressure is 162/94 mmHg and he has 2+ pitting edema in
the lower extremities. The nurse recognizes these findings are most consistent with which stage of
acute kidney injury?
A. Stage 3 AKI based on the serum creatinine increase to more than 3 times baseline
B. Stage 2 AKI based on the serum creatinine increase to more than 2-3 times baseline
C. Stage 1 AKI based on the serum creatinine increase of more than 0.3 mg/dL from baseline
D. Prerenal azotemia that will resolve with intravenous fluid resuscitation
Correct Answer: A
Rationale:
The patient's creatinine has increased to approximately 3.8 times his baseline (4.2/1.1), which classifies
him as Stage 3 AKI per KDIGO criteria. Stage 1 requires a rise of 0.3 mg/dL or 1.5-1.9 times baseline,
and Stage 2 requires 2.0-2.9 times baseline. The oliguria and confusion further support severe AKI rather
than simple prerenal azotemia.
Q2 Question 2 of 85
Q2. A 55-year-old female with type 2 diabetes mellitus and hypertension has an estimated GFR of 28
mL/min/1.73m2 and persistent albuminuria. The nurse is educating the patient about her chronic
kidney disease stage. According to the KDIGO classification, which CKD stage does this patient
have?
A. CKD Stage 3a because the GFR is between 30-44 mL/min/1.73m2
B. CKD Stage 3b because the GFR is between 15-29 mL/min/1.73m2
C. CKD Stage 4 because the GFR is between 15-29 mL/min/1.73m2 with albuminuria
D. CKD Stage 2 because the albuminuria indicates moderate damage with preserved GFR
Correct Answer: B
Rationale:
KDIGO classifies CKD Stage 3b as GFR 15-29 mL/min/1.73m2, and this patient's GFR of 28 falls in that
range. Stage 3a is GFR 30-44, Stage 4 is GFR 15-29 with the same GFR range but the albuminuria
modifies risk rather than stage, and Stage 2 requires GFR 60-89.
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 3 of 48
, Q3 Question 3 of 85
Q3. A 72-year-old male with CKD Stage 4 is admitted with worsening fatigue, nausea, and metallic
taste in his mouth. Laboratory results show BUN 85 mg/dL, creatinine 6.8 mg/dL, potassium 5.9
mEq/L, and metabolic acidosis with a bicarbonate of 16 mEq/L. The nurse identifies these symptoms
and lab values as most indicative of which condition?
A. Hyperkalemia alone that can be managed with sodium polystyrene sulfonate
B. Acute kidney injury superimposed on chronic kidney disease
C. Uremia requiring evaluation for renal replacement therapy
D. Diabetic nephropathy progression that needs glycemic control adjustment
Correct Answer: C
Rationale:
The constellation of fatigue, nausea, metallic taste, elevated BUN and creatinine, hyperkalemia, and
metabolic acidosis are classic signs of uremia, which indicates the need for renal replacement therapy
evaluation. While AKI on CKD is possible, the progressive CKD Stage 4 with uremic symptoms is the
primary concern. Hyperkalemia and acidosis are components of uremia, not standalone issues.
Q4 Question 4 of 85
Q4. A 45-year-old female is admitted with rhabdomyolysis after a severe crush injury. Her creatinine
kinase is 28,000 U/L and her urine is tea-colored. The nurse anticipates which priority intervention to
prevent acute kidney injury in this patient?
A. Aggressive intravenous fluid resuscitation with normal saline to maintain urine output above 200
mL/hr
B. Administration of mannitol for osmotic diuresis to flush the renal tubules
C. Immediate initiation of continuous renal replacement therapy to remove myoglobin
D. Administration of sodium bicarbonate to alkalinize the urine and prevent myoglobin
precipitation
Correct Answer: D
Rationale:
Aggressive IV fluid resuscitation is the priority intervention to prevent AKI in rhabdomyolysis by
maintaining renal perfusion and diluting tubular myoglobin. Sodium bicarbonate is controversial and
secondary to volume resuscitation. CRRT is initiated only if AKI has already developed, and mannitol is
not a first-line intervention.
NCLEX-RN Renal & Urinary Nursing Concept Exam 2026 AKI, CKD, Dialysis, UTI Management - 2026/2027 | Passing Score: pass/fail | Page 4 of 48
