NSG 3800 Exam 3: Renal Disorders ACTUAL
2026
1. A nurse is reviewing the pathophysiology of Acute Kidney Injury (AKI). Which statement best describes
the primary mechanism of Prerenal AKI?
A. Obstruction to urine flow
B. Actual damage to the kidney tissue
C. Abnormal hypoperfusion of the kidney
D. Inflammation of the renal glomeruli
ANSWER: C
Rationale A: Incorrect. Obstruction to urine flow characterizes Postrenal AKI.
Rationale B: Incorrect. Actual damage to kidney tissue characterizes Intrarenal AKI.
Rationale C: Correct. Prerenal AKI is caused by abnormal hypoperfusion of the kidney (e.g., HF,
hemorrhage, shock).
Rationale D: Incorrect. Inflammation of glomeruli is related to Glomerulonephritis.
2. Which of the following conditions presents the greatest risk for AKI combined with hemorrhage?
A. Hypertension and Diabetes
B. Heart Failure, Hemorrhage, GI loss, Sepsis, Shock
C. Benign Prostatic Hyperplasia (BPH)
D. Nephrotic Syndrome
ANSWER: B
Rationale A: Incorrect. While DM and HTN cause CKD, they are not the primary "greatest risk" cluster for
acute hemorrhage-related AKI listed in the notes.
Rationale B: Correct. The notes list HF, hemorrhage, GI loss, sepsis, shock, and renal losses as causes of
Prerenal AKI with the greatest risk for hemorrhage.
,Rationale C: Incorrect. BPH causes Postrenal AKI due to obstruction.
Rationale D: Incorrect. Nephrotic syndrome is a glomerular disorder.
3. A patient is prescribed Gentamicin. The nurse monitors renal function closely because this drug is a
known cause of which type of AKI?
A. Prerenal
B. Intrarenal
C. Postrenal
D. Chronic
ANSWER: B
Rationale A: Incorrect. Prerenal is caused by hypoperfusion.
Rationale B: Correct. Gentamicin, tobramycin, lead, mercury, and ethylene are nephrotoxic agents
causing Intrarenal AKI (actual damage).
Rationale C: Incorrect. Postrenal is caused by obstruction.
Rationale D: Incorrect. This is an acute cause.
4. Which of the following is a cause of Postrenal AKI?
A. Sepsis
B. Lead poisoning
C. Blood clots
D. Heart Failure
ANSWER: C
Rationale A: Incorrect. Sepsis causes Prerenal AKI (hypoperfusion).
Rationale B: Incorrect. Lead causes Intrarenal AKI (nephrotoxic).
Rationale C: Correct. Blood clots, tumors, stones, and BPH cause obstruction to urine flow (Postrenal).
Rationale D: Incorrect. Heart Failure causes Prerenal AKI.
5. During the Oliguria phase of AKI, the nurse expects to see which of the following laboratory changes?
A. Decreased BUN and Creatinine
B. Increased Potassium (Hyperkalemia)
C. Increased Calcium
D. Decreased Phosphorus
,ANSWER: B
Rationale A: Incorrect. BUN and Creatinine increase (↑) during oliguria.
Rationale B: Correct. Hyperkalemia develops during the oliguria phase due to decreased excretion.
Rationale C: Incorrect. Calcium levels typically decrease (Ca ↓) in this phase.
Rationale D: Incorrect. Phosphorus levels typically increase (Phos ↑) due to retention.
6. A patient with AKI enters the Diuresis phase. What is the primary concern for the nurse during this
phase?
A. Fluid overload
B. Hyperkalemia
C. Dehydration
D. Metabolic Alkalosis
ANSWER: C
Rationale A: Incorrect. Fluid overload is a concern in the oliguria phase.
Rationale B: Incorrect. Hyperkalemia is a concern in the oliguria phase.
Rationale C: Correct. The diuresis phase is characterized by increased urine output, leading to a risk of
dehydration.
Rationale D: Incorrect. Metabolic acidosis is more common in renal failure; dehydration is the specific
risk noted for diuresis.
7. The nurse is educating a patient about the Recovery phase of AKI. How long might this phase take?
A. 1-2 weeks
B. 3-12 months
C. 24-48 hours
D. 6-12 months
ANSWER: B
Rationale A: Incorrect. Recovery takes longer.
Rationale B: Correct. The recovery phase (normal output/normal lab values) may take 3-12 months.
Rationale C: Incorrect. This is too short.
Rationale D: Incorrect. While possible, the specific range in notes is 3-12m.
8. In the Recovery phase of AKI, the nurse expects the potassium level to return to normal. What is the
normal value?
, A. 2.5 mEq/L
B. 3.5 mEq/L
C. 5.5 mEq/L
D. 6.0 mEq/L
ANSWER: B
Rationale A: Incorrect. This is hypokalemia.
Rationale B: Correct. The notes specify expecting 3.5 potassium = Normal.
Rationale C: Incorrect. This is hyperkalemia.
Rationale D: Incorrect. This is dangerous hyperkalemia.
9. Which manifestation is associated with AKI?
A. Increased energy
B. Seizures
C. Hypertension only
D. Polyuria
ANSWER: B
Rationale A: Incorrect. Drowsiness is a manifestation.
Rationale B: Correct. Manifestations include Drowsy, HA, Muscle aches, and Seizures.
Rationale C: Incorrect. While HTN can occur, seizures are a specific neurological manifestation listed.
Rationale D: Incorrect. Oliguria (low output) is typical in the early phases.
10. Which diagnostic test is contraindicated or should be used with caution (no contrast) in a patient
with AKI?
A. Renal sonogram
B. CT w/ contrast
C. MRI
D. Ultrasonography
ANSWER: B
Rationale A: Incorrect. Renal sonogram is safe.
Rationale B: Correct. CT w/ no contrast is listed; contrast agents should be avoided (nephrotoxic).
Rationale C: Incorrect. MRI, GFR, Metabolic acidosis labs are part of DX/TX, but contrast is the issue.
2026
1. A nurse is reviewing the pathophysiology of Acute Kidney Injury (AKI). Which statement best describes
the primary mechanism of Prerenal AKI?
A. Obstruction to urine flow
B. Actual damage to the kidney tissue
C. Abnormal hypoperfusion of the kidney
D. Inflammation of the renal glomeruli
ANSWER: C
Rationale A: Incorrect. Obstruction to urine flow characterizes Postrenal AKI.
Rationale B: Incorrect. Actual damage to kidney tissue characterizes Intrarenal AKI.
Rationale C: Correct. Prerenal AKI is caused by abnormal hypoperfusion of the kidney (e.g., HF,
hemorrhage, shock).
Rationale D: Incorrect. Inflammation of glomeruli is related to Glomerulonephritis.
2. Which of the following conditions presents the greatest risk for AKI combined with hemorrhage?
A. Hypertension and Diabetes
B. Heart Failure, Hemorrhage, GI loss, Sepsis, Shock
C. Benign Prostatic Hyperplasia (BPH)
D. Nephrotic Syndrome
ANSWER: B
Rationale A: Incorrect. While DM and HTN cause CKD, they are not the primary "greatest risk" cluster for
acute hemorrhage-related AKI listed in the notes.
Rationale B: Correct. The notes list HF, hemorrhage, GI loss, sepsis, shock, and renal losses as causes of
Prerenal AKI with the greatest risk for hemorrhage.
,Rationale C: Incorrect. BPH causes Postrenal AKI due to obstruction.
Rationale D: Incorrect. Nephrotic syndrome is a glomerular disorder.
3. A patient is prescribed Gentamicin. The nurse monitors renal function closely because this drug is a
known cause of which type of AKI?
A. Prerenal
B. Intrarenal
C. Postrenal
D. Chronic
ANSWER: B
Rationale A: Incorrect. Prerenal is caused by hypoperfusion.
Rationale B: Correct. Gentamicin, tobramycin, lead, mercury, and ethylene are nephrotoxic agents
causing Intrarenal AKI (actual damage).
Rationale C: Incorrect. Postrenal is caused by obstruction.
Rationale D: Incorrect. This is an acute cause.
4. Which of the following is a cause of Postrenal AKI?
A. Sepsis
B. Lead poisoning
C. Blood clots
D. Heart Failure
ANSWER: C
Rationale A: Incorrect. Sepsis causes Prerenal AKI (hypoperfusion).
Rationale B: Incorrect. Lead causes Intrarenal AKI (nephrotoxic).
Rationale C: Correct. Blood clots, tumors, stones, and BPH cause obstruction to urine flow (Postrenal).
Rationale D: Incorrect. Heart Failure causes Prerenal AKI.
5. During the Oliguria phase of AKI, the nurse expects to see which of the following laboratory changes?
A. Decreased BUN and Creatinine
B. Increased Potassium (Hyperkalemia)
C. Increased Calcium
D. Decreased Phosphorus
,ANSWER: B
Rationale A: Incorrect. BUN and Creatinine increase (↑) during oliguria.
Rationale B: Correct. Hyperkalemia develops during the oliguria phase due to decreased excretion.
Rationale C: Incorrect. Calcium levels typically decrease (Ca ↓) in this phase.
Rationale D: Incorrect. Phosphorus levels typically increase (Phos ↑) due to retention.
6. A patient with AKI enters the Diuresis phase. What is the primary concern for the nurse during this
phase?
A. Fluid overload
B. Hyperkalemia
C. Dehydration
D. Metabolic Alkalosis
ANSWER: C
Rationale A: Incorrect. Fluid overload is a concern in the oliguria phase.
Rationale B: Incorrect. Hyperkalemia is a concern in the oliguria phase.
Rationale C: Correct. The diuresis phase is characterized by increased urine output, leading to a risk of
dehydration.
Rationale D: Incorrect. Metabolic acidosis is more common in renal failure; dehydration is the specific
risk noted for diuresis.
7. The nurse is educating a patient about the Recovery phase of AKI. How long might this phase take?
A. 1-2 weeks
B. 3-12 months
C. 24-48 hours
D. 6-12 months
ANSWER: B
Rationale A: Incorrect. Recovery takes longer.
Rationale B: Correct. The recovery phase (normal output/normal lab values) may take 3-12 months.
Rationale C: Incorrect. This is too short.
Rationale D: Incorrect. While possible, the specific range in notes is 3-12m.
8. In the Recovery phase of AKI, the nurse expects the potassium level to return to normal. What is the
normal value?
, A. 2.5 mEq/L
B. 3.5 mEq/L
C. 5.5 mEq/L
D. 6.0 mEq/L
ANSWER: B
Rationale A: Incorrect. This is hypokalemia.
Rationale B: Correct. The notes specify expecting 3.5 potassium = Normal.
Rationale C: Incorrect. This is hyperkalemia.
Rationale D: Incorrect. This is dangerous hyperkalemia.
9. Which manifestation is associated with AKI?
A. Increased energy
B. Seizures
C. Hypertension only
D. Polyuria
ANSWER: B
Rationale A: Incorrect. Drowsiness is a manifestation.
Rationale B: Correct. Manifestations include Drowsy, HA, Muscle aches, and Seizures.
Rationale C: Incorrect. While HTN can occur, seizures are a specific neurological manifestation listed.
Rationale D: Incorrect. Oliguria (low output) is typical in the early phases.
10. Which diagnostic test is contraindicated or should be used with caution (no contrast) in a patient
with AKI?
A. Renal sonogram
B. CT w/ contrast
C. MRI
D. Ultrasonography
ANSWER: B
Rationale A: Incorrect. Renal sonogram is safe.
Rationale B: Correct. CT w/ no contrast is listed; contrast agents should be avoided (nephrotoxic).
Rationale C: Incorrect. MRI, GFR, Metabolic acidosis labs are part of DX/TX, but contrast is the issue.
