NSG 3800 Exam 3: Acute Kidney Injury,
Acute Tubular Necrosis, and Chronic
Kidney Disease Comprehensive
Examination 2026
1. A patient with acute kidney injury has a urine output of 400 mL over 24 hours. The nurse recognizes
this as which phase of AKI?
A. Initiation period
B. Oliguria period
C. Diuresis period
D. Recovery period
ANSWER✨✨✔-: B. Oliguria period
Rationale:
A. Incorrect: The initiation period is when the injury first occurs; urine output may still be normal during
this phase.
B. Correct: Oliguria is defined as urine output less than 500 mL in 24 hours. This patient's output of 400
mL meets the criteria for the oliguric phase of AKI, which is characterized by decreased urine output and
abnormal laboratory values.
C. Incorrect: The diuresis period is characterized by increased urine output, not decreased.
,D. Incorrect: The recovery period is when renal function returns to normal and laboratory values
normalize; urine output would be normal, not decreased.
2. A patient is diagnosed with prerenal acute kidney injury. Which of the following conditions most likely
contributed to this diagnosis?
A. Gentamicin toxicity
B. Benign prostatic hyperplasia
C. Hemorrhage
D. Mercury poisoning
ANSWER✨✨✔-: C. Hemorrhage
Rationale:
A. Incorrect: Gentamicin toxicity causes intrarenal AKI by directly damaging kidney tissue, not prerenal
injury.
B. Incorrect: Benign prostatic hyperplasia causes postrenal AKI by obstructing urine flow.
C. Correct: Hemorrhage leads to decreased blood volume, which reduces renal perfusion. This
hypoperfusion is the hallmark of prerenal AKI, as the kidney tissue itself remains intact but is
underperfused.
D. Incorrect: Mercury is a nephrotoxic agent that causes intrarenal damage to kidney tissue.
3. A patient's laboratory results show hyperkalemia during the oliguric phase of acute kidney injury. The
nurse understands that hyperkalemia in this phase is:
A. Usually benign and self-limiting
,B. The most life-threatening electrolyte imbalance
C. Treated with increased dietary potassium
D. A sign that the patient is entering the recovery phase
ANSWER✨✨✔-: B. The most life-threatening electrolyte imbalance
Rationale:
A. Incorrect: Hyperkalemia is not benign; it poses significant cardiac risks including dysrhythmias.
B. Correct: Hyperkalemia is considered the most life-threatening electrolyte imbalance seen during AKI
because it can cause fatal cardiac arrhythmias. The kidneys cannot excrete potassium effectively during
the oliguric phase.
C. Incorrect: Dietary potassium should be restricted, not increased, during hyperkalemia.
D. Incorrect: Hyperkalemia is characteristic of the oliguric phase, not the recovery phase.
4. Which of the following is classified as a nephrotoxic agent that can cause intrarenal acute kidney
injury?
A. Furosemide
B. Tobramycin
C. Normal saline
D. Acetaminophen
ANSWER✨✨✔-: B. Tobramycin
Rationale:
, A. Incorrect: Furosemide is a diuretic used to treat AKI, not a cause of nephrotoxic injury.
B. Correct: Tobramycin is an aminoglycoside antibiotic that is nephrotoxic. Along with gentamicin, it can
cause direct damage to kidney tissue resulting in intrarenal AKI.
C. Incorrect: Normal saline is a fluid replacement and not nephrotoxic.
D. Incorrect: Acetaminophen is not typically nephrotoxic; it is hepatotoxic in large doses.
5. The nurse is caring for a patient with postrenal acute kidney injury. Which of the following is the most
likely cause of this condition?
A. Heart failure
B. Sepsis
C. Benign prostatic hyperplasia
D. Lead poisoning
ANSWER✨✨✔-: C. Benign prostatic hyperplasia
Rationale:
A. Incorrect: Heart failure leads to decreased cardiac output and renal hypoperfusion, causing prerenal
AKI.
B. Incorrect: Sepsis can cause prerenal AKI due to hypotension and decreased renal perfusion.
C. Correct: Benign prostatic hyperplasia (BPH) can obstruct urine flow from the bladder, leading to
postrenal AKI. Other causes include blood clots, tumors, and stones.
D. Incorrect: Lead is a nephrotoxic agent that causes intrarenal AKI.
Acute Tubular Necrosis, and Chronic
Kidney Disease Comprehensive
Examination 2026
1. A patient with acute kidney injury has a urine output of 400 mL over 24 hours. The nurse recognizes
this as which phase of AKI?
A. Initiation period
B. Oliguria period
C. Diuresis period
D. Recovery period
ANSWER✨✨✔-: B. Oliguria period
Rationale:
A. Incorrect: The initiation period is when the injury first occurs; urine output may still be normal during
this phase.
B. Correct: Oliguria is defined as urine output less than 500 mL in 24 hours. This patient's output of 400
mL meets the criteria for the oliguric phase of AKI, which is characterized by decreased urine output and
abnormal laboratory values.
C. Incorrect: The diuresis period is characterized by increased urine output, not decreased.
,D. Incorrect: The recovery period is when renal function returns to normal and laboratory values
normalize; urine output would be normal, not decreased.
2. A patient is diagnosed with prerenal acute kidney injury. Which of the following conditions most likely
contributed to this diagnosis?
A. Gentamicin toxicity
B. Benign prostatic hyperplasia
C. Hemorrhage
D. Mercury poisoning
ANSWER✨✨✔-: C. Hemorrhage
Rationale:
A. Incorrect: Gentamicin toxicity causes intrarenal AKI by directly damaging kidney tissue, not prerenal
injury.
B. Incorrect: Benign prostatic hyperplasia causes postrenal AKI by obstructing urine flow.
C. Correct: Hemorrhage leads to decreased blood volume, which reduces renal perfusion. This
hypoperfusion is the hallmark of prerenal AKI, as the kidney tissue itself remains intact but is
underperfused.
D. Incorrect: Mercury is a nephrotoxic agent that causes intrarenal damage to kidney tissue.
3. A patient's laboratory results show hyperkalemia during the oliguric phase of acute kidney injury. The
nurse understands that hyperkalemia in this phase is:
A. Usually benign and self-limiting
,B. The most life-threatening electrolyte imbalance
C. Treated with increased dietary potassium
D. A sign that the patient is entering the recovery phase
ANSWER✨✨✔-: B. The most life-threatening electrolyte imbalance
Rationale:
A. Incorrect: Hyperkalemia is not benign; it poses significant cardiac risks including dysrhythmias.
B. Correct: Hyperkalemia is considered the most life-threatening electrolyte imbalance seen during AKI
because it can cause fatal cardiac arrhythmias. The kidneys cannot excrete potassium effectively during
the oliguric phase.
C. Incorrect: Dietary potassium should be restricted, not increased, during hyperkalemia.
D. Incorrect: Hyperkalemia is characteristic of the oliguric phase, not the recovery phase.
4. Which of the following is classified as a nephrotoxic agent that can cause intrarenal acute kidney
injury?
A. Furosemide
B. Tobramycin
C. Normal saline
D. Acetaminophen
ANSWER✨✨✔-: B. Tobramycin
Rationale:
, A. Incorrect: Furosemide is a diuretic used to treat AKI, not a cause of nephrotoxic injury.
B. Correct: Tobramycin is an aminoglycoside antibiotic that is nephrotoxic. Along with gentamicin, it can
cause direct damage to kidney tissue resulting in intrarenal AKI.
C. Incorrect: Normal saline is a fluid replacement and not nephrotoxic.
D. Incorrect: Acetaminophen is not typically nephrotoxic; it is hepatotoxic in large doses.
5. The nurse is caring for a patient with postrenal acute kidney injury. Which of the following is the most
likely cause of this condition?
A. Heart failure
B. Sepsis
C. Benign prostatic hyperplasia
D. Lead poisoning
ANSWER✨✨✔-: C. Benign prostatic hyperplasia
Rationale:
A. Incorrect: Heart failure leads to decreased cardiac output and renal hypoperfusion, causing prerenal
AKI.
B. Incorrect: Sepsis can cause prerenal AKI due to hypotension and decreased renal perfusion.
C. Correct: Benign prostatic hyperplasia (BPH) can obstruct urine flow from the bladder, leading to
postrenal AKI. Other causes include blood clots, tumors, and stones.
D. Incorrect: Lead is a nephrotoxic agent that causes intrarenal AKI.
