HESI RN RENAL NURSING ACCURATE
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. A client with chronic kidney disease (CKD) has a
serum potassium level of 6.2 mEq/L. Which
electrocardiographic (ECG) change should the nurse
expect to observe?
A. Prominent U waves
B. Tall, peaked T waves
C. ST segment depression
D. Prolonged PR interval
B. Tall, peaked T waves
Rationale: Hyperkalemia, defined as a serum
,potassium level greater than 5.0 mEq/L, is a critical
electrolyte disturbance in CKD. The classic early ECG
manifestation is tall, peaked, and narrow T waves.
Prominent U waves are associated with
hypokalemia. ST segment depression and prolonged
PR interval can occur with hyperkalemia but are not
the earliest or most specific findings; peaked T
waves are the hallmark. Early recognition allows for
timely intervention such as calcium gluconate
administration to stabilize the cardiac membrane.
2. A client is diagnosed with acute
glomerulonephritis. Which assessment finding is
most consistent with this diagnosis?
A. Polyuria and polydipsia
B. Hypotension and bradycardia
C. Periorbital edema and cola-colored urine
D. Flank pain radiating to the groin
C. Periorbital edema and cola-colored urine
Rationale: Acute glomerulonephritis is an
inflammatory condition of the glomeruli often
following a streptococcal infection. The classic
presentation includes periorbital edema due to fluid
,retention and hematuria, which gives urine a smoky
or cola-colored appearance. Polyuria and polydipsia
are associated with diabetes insipidus. Hypotension
is not typical; hypertension is more common due to
fluid overload. Flank pain radiating to the groin
suggests a renal stone. These findings guide the
nurse in prioritizing assessment and interventions
for fluid and electrolyte balance.
3. The nurse is caring for a client who received a
kidney transplant 24 hours ago. Which assessment
finding requires immediate notification of the
healthcare provider?
A. Urine output of 45 mL/hr
B. Mild incisional pain
C. Temperature of 99.8°F (37.7°C)
D. Absence of bowel sounds
D. Absence of bowel sounds
Rationale: After kidney transplantation, the absence
of bowel sounds can indicate an ileus or a more
severe complication such as peritonitis or graft-
related issues. While a urine output of 45 mL/hr is
acceptable (typically >30 mL/hr) and mild pain and
, low-grade fever are expected postoperatively, the
absence of bowel sounds suggests a disruption in
gastrointestinal function that requires prompt
evaluation. This finding could indicate a surgical
complication that may compromise the graft or
patient safety, necessitating immediate provider
notification.
4. A client with end-stage renal disease (ESRD) is
scheduled for hemodialysis. Which medication
should the nurse withhold on the morning of
dialysis?
A. Multivitamin
B. Iron supplement
C. Antihypertensive agent
D. Phosphate binder
C. Antihypertensive agent
Rationale: Antihypertensive medications are often
withheld before hemodialysis to prevent
intradialytic hypotension, a common complication
during fluid removal. The reduction in blood volume
during dialysis can potentiate the effects of these
drugs, leading to severe hypotension. Multivitamins,
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
1. A client with chronic kidney disease (CKD) has a
serum potassium level of 6.2 mEq/L. Which
electrocardiographic (ECG) change should the nurse
expect to observe?
A. Prominent U waves
B. Tall, peaked T waves
C. ST segment depression
D. Prolonged PR interval
B. Tall, peaked T waves
Rationale: Hyperkalemia, defined as a serum
,potassium level greater than 5.0 mEq/L, is a critical
electrolyte disturbance in CKD. The classic early ECG
manifestation is tall, peaked, and narrow T waves.
Prominent U waves are associated with
hypokalemia. ST segment depression and prolonged
PR interval can occur with hyperkalemia but are not
the earliest or most specific findings; peaked T
waves are the hallmark. Early recognition allows for
timely intervention such as calcium gluconate
administration to stabilize the cardiac membrane.
2. A client is diagnosed with acute
glomerulonephritis. Which assessment finding is
most consistent with this diagnosis?
A. Polyuria and polydipsia
B. Hypotension and bradycardia
C. Periorbital edema and cola-colored urine
D. Flank pain radiating to the groin
C. Periorbital edema and cola-colored urine
Rationale: Acute glomerulonephritis is an
inflammatory condition of the glomeruli often
following a streptococcal infection. The classic
presentation includes periorbital edema due to fluid
,retention and hematuria, which gives urine a smoky
or cola-colored appearance. Polyuria and polydipsia
are associated with diabetes insipidus. Hypotension
is not typical; hypertension is more common due to
fluid overload. Flank pain radiating to the groin
suggests a renal stone. These findings guide the
nurse in prioritizing assessment and interventions
for fluid and electrolyte balance.
3. The nurse is caring for a client who received a
kidney transplant 24 hours ago. Which assessment
finding requires immediate notification of the
healthcare provider?
A. Urine output of 45 mL/hr
B. Mild incisional pain
C. Temperature of 99.8°F (37.7°C)
D. Absence of bowel sounds
D. Absence of bowel sounds
Rationale: After kidney transplantation, the absence
of bowel sounds can indicate an ileus or a more
severe complication such as peritonitis or graft-
related issues. While a urine output of 45 mL/hr is
acceptable (typically >30 mL/hr) and mild pain and
, low-grade fever are expected postoperatively, the
absence of bowel sounds suggests a disruption in
gastrointestinal function that requires prompt
evaluation. This finding could indicate a surgical
complication that may compromise the graft or
patient safety, necessitating immediate provider
notification.
4. A client with end-stage renal disease (ESRD) is
scheduled for hemodialysis. Which medication
should the nurse withhold on the morning of
dialysis?
A. Multivitamin
B. Iron supplement
C. Antihypertensive agent
D. Phosphate binder
C. Antihypertensive agent
Rationale: Antihypertensive medications are often
withheld before hemodialysis to prevent
intradialytic hypotension, a common complication
during fluid removal. The reduction in blood volume
during dialysis can potentiate the effects of these
drugs, leading to severe hypotension. Multivitamins,
