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I-HUMAN GENITOURINARY/RENAL CASES LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
i-Human Genitourinary/Renal Cases: 70 Questions with Rationales
DOMAIN 1: HISTORY OF PRESENT ILLNESS & OLD CARTS FRAMEWORK (15
Questions)
1. The nurse is interviewing an i-Human patient with renal symptoms. Which of the
following is the MOST appropriate question to assess the "Character" of the
patient's nausea?
A) "When did your nausea start?"
B) "Is your nausea associated with vomiting?"
C) "Does anything make your nausea worse?"
D) "How often do you feel nauseated?"
Answer: B) "Is your nausea associated with vomiting?"
Rationale: In the OLD CARTS framework, Character describes the quality or nature of
the symptom—in this case, whether the nausea is associated with vomiting. Onset (A),
Aggravating factors (C), and Timing (D) are separate components. In i-Human cases,
characterizing associated symptoms helps differentiate the etiology of renal
impairment.
2. In the OLD CARTS framework, a patient reports that their nausea started "about 3
days ago." This corresponds to which component?
A) Location
B) Duration
C) Onset
D) Timing
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Answer: C) Onset
Rationale: Onset in OLD CARTS refers to when the symptom first started. In i-Human
cases like Ken Fowler, accurate determination of onset is critical for differentiating
prerenal AKI from intrinsic renal disease.
3. An i-Human patient with renal impairment reports that symptoms are "worse
when I haven't eaten anything." The nurse should document this under which OLD
CARTS component?
A) Aggravating factors
B) Alleviating factors
C) Timing
D) Associated symptoms
Answer: A) Aggravating factors
Rationale: Aggravating factors are conditions that make the symptom worse. In the Ken
Fowler i-Human case, the patient reported nausea and vomiting that started with
decreased oral intake, which is an important aggravating factor.
4. In the Ken Fowler i-Human case, the patient reports, "I went to see my doctor this
morning because I have been feeling bad for the past few days. I'm tired, with
nausea & vomiting." Which question is MOST important to ask NEXT regarding the
renal symptoms?
A) "Do you have any difficulty breathing?"
B) "Have you noticed a change in your urination frequency?"
C) "Do you have any pain anywhere?"
D) "Have you had any fever or chills?"
Answer: B) "Have you noticed a change in your urination frequency?"
Rationale: In a patient with suspected renal impairment, changes in urination
(frequency, color, amount) are critical for assessing kidney function. Ken Fowler
reported peeing less recently, which was a key finding .
5. A 70-year-old i-Human patient with suspected AKI reports nausea, vomiting, and
fatigue for 3 days. The nurse should ask which of the following to assess for
dehydration?
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A) "Have you had any fever or chills?"
B) "When did you last urinate, and what color was it?"
C) "Do you have any blood in your stool?"
D) "Have you had any recent travel?"
Answer: B) "When did you last urinate, and what color was it?"
Rationale: In a patient with renal impairment, decreased urine output is a key sign of
dehydration and acute kidney injury. In i-Human cases, the patient often reports "I have
been peeing less recently" and "I am barely peeing at all."
6. A patient reports a creatinine level of 3.2 mg/dL, compared to 1.1 mg/dL one
month ago. This change is MOST concerning for:
A) Chronic kidney disease
B) Acute kidney injury (AKI)
C) Normal age-related change
D) Laboratory error
Answer: B) Acute kidney injury (AKI)
Rationale: A rapid rise in creatinine from 1.1 to 3.2 mg/dL over one month indicates
acute kidney injury (AKI). In the Ken Fowler i-Human case, this significant change
prompted the PCP to send the patient to the ED.
7. In an i-Human renal case, a patient reports using naproxen for back pain. This is
significant because:
A) NSAIDs are safe for patients with kidney disease
B) NSAIDs can cause or worsen kidney injury
C) NSAIDs treat kidney disease
D) NSAIDs are only for acute pain
Answer: B) NSAIDs can cause or worsen kidney injury
Rationale: NSAIDs can cause prerenal AKI by reducing renal blood flow. In the Ken
Fowler case, the patient had recently taken naproxen for back pain, which is a key
finding in the history.
8. A patient reports taking lisinopril, metoprolol, and hydrochlorothiazide for
hypertension but has not taken them for the last 24 hours because they feel sick.
This is significant because:
I-HUMAN GENITOURINARY/RENAL CASES LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
i-Human Genitourinary/Renal Cases: 70 Questions with Rationales
DOMAIN 1: HISTORY OF PRESENT ILLNESS & OLD CARTS FRAMEWORK (15
Questions)
1. The nurse is interviewing an i-Human patient with renal symptoms. Which of the
following is the MOST appropriate question to assess the "Character" of the
patient's nausea?
A) "When did your nausea start?"
B) "Is your nausea associated with vomiting?"
C) "Does anything make your nausea worse?"
D) "How often do you feel nauseated?"
Answer: B) "Is your nausea associated with vomiting?"
Rationale: In the OLD CARTS framework, Character describes the quality or nature of
the symptom—in this case, whether the nausea is associated with vomiting. Onset (A),
Aggravating factors (C), and Timing (D) are separate components. In i-Human cases,
characterizing associated symptoms helps differentiate the etiology of renal
impairment.
2. In the OLD CARTS framework, a patient reports that their nausea started "about 3
days ago." This corresponds to which component?
A) Location
B) Duration
C) Onset
D) Timing
, Page 2 of 25
Answer: C) Onset
Rationale: Onset in OLD CARTS refers to when the symptom first started. In i-Human
cases like Ken Fowler, accurate determination of onset is critical for differentiating
prerenal AKI from intrinsic renal disease.
3. An i-Human patient with renal impairment reports that symptoms are "worse
when I haven't eaten anything." The nurse should document this under which OLD
CARTS component?
A) Aggravating factors
B) Alleviating factors
C) Timing
D) Associated symptoms
Answer: A) Aggravating factors
Rationale: Aggravating factors are conditions that make the symptom worse. In the Ken
Fowler i-Human case, the patient reported nausea and vomiting that started with
decreased oral intake, which is an important aggravating factor.
4. In the Ken Fowler i-Human case, the patient reports, "I went to see my doctor this
morning because I have been feeling bad for the past few days. I'm tired, with
nausea & vomiting." Which question is MOST important to ask NEXT regarding the
renal symptoms?
A) "Do you have any difficulty breathing?"
B) "Have you noticed a change in your urination frequency?"
C) "Do you have any pain anywhere?"
D) "Have you had any fever or chills?"
Answer: B) "Have you noticed a change in your urination frequency?"
Rationale: In a patient with suspected renal impairment, changes in urination
(frequency, color, amount) are critical for assessing kidney function. Ken Fowler
reported peeing less recently, which was a key finding .
5. A 70-year-old i-Human patient with suspected AKI reports nausea, vomiting, and
fatigue for 3 days. The nurse should ask which of the following to assess for
dehydration?
, Page 3 of 25
A) "Have you had any fever or chills?"
B) "When did you last urinate, and what color was it?"
C) "Do you have any blood in your stool?"
D) "Have you had any recent travel?"
Answer: B) "When did you last urinate, and what color was it?"
Rationale: In a patient with renal impairment, decreased urine output is a key sign of
dehydration and acute kidney injury. In i-Human cases, the patient often reports "I have
been peeing less recently" and "I am barely peeing at all."
6. A patient reports a creatinine level of 3.2 mg/dL, compared to 1.1 mg/dL one
month ago. This change is MOST concerning for:
A) Chronic kidney disease
B) Acute kidney injury (AKI)
C) Normal age-related change
D) Laboratory error
Answer: B) Acute kidney injury (AKI)
Rationale: A rapid rise in creatinine from 1.1 to 3.2 mg/dL over one month indicates
acute kidney injury (AKI). In the Ken Fowler i-Human case, this significant change
prompted the PCP to send the patient to the ED.
7. In an i-Human renal case, a patient reports using naproxen for back pain. This is
significant because:
A) NSAIDs are safe for patients with kidney disease
B) NSAIDs can cause or worsen kidney injury
C) NSAIDs treat kidney disease
D) NSAIDs are only for acute pain
Answer: B) NSAIDs can cause or worsen kidney injury
Rationale: NSAIDs can cause prerenal AKI by reducing renal blood flow. In the Ken
Fowler case, the patient had recently taken naproxen for back pain, which is a key
finding in the history.
8. A patient reports taking lisinopril, metoprolol, and hydrochlorothiazide for
hypertension but has not taken them for the last 24 hours because they feel sick.
This is significant because:
