Nursing 354 Acute Kidney Injury Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. Which finding is most characteristic of acute kidney injury (AKI)?
A. Gradual loss of kidney function over several years
B. Sudden decline in kidney function with rising serum creatinine
C. Persistent hypoglycemia
D. Increased erythropoietin production
Answer: B. Sudden decline in kidney function with rising serum creatinine
Rationale: AKI is characterized by an abrupt decline in kidney function,
commonly reflected by an increase in serum creatinine and/or reduced urine
output.
2. Which patient is at greatest risk for prerenal AKI?
A. Patient with severe dehydration from prolonged vomiting
B. Patient with chronic kidney disease
C. Patient with polycystic kidney disease
D. Patient with nephrotic syndrome
Answer: A. Patient with severe dehydration from prolonged vomiting
,Rationale: Prerenal AKI occurs when renal perfusion decreases. Severe
dehydration can significantly reduce circulating blood volume and kidney
perfusion.
3. Which laboratory value is most important for evaluating renal filtration?
A. Hemoglobin
B. Serum creatinine
C. Serum calcium
D. Platelet count
Answer: B. Serum creatinine
Rationale: Serum creatinine is commonly used to assess kidney filtration and
identify changes in renal function.
4. A patient with AKI has a urine output of 15 mL/hr. What should the nurse
do first?
A. Document the finding and reassess tomorrow
B. Encourage a high-protein meal
C. Assess the patient's fluid status and notify the healthcare provider
D. Administer additional potassium
Answer: C. Assess the patient's fluid status and notify the healthcare provider
Rationale: Markedly decreased urine output can indicate worsening AKI. Prompt
assessment and communication are necessary to prevent complications.
5. Which condition is classified as a common cause of intrinsic AKI?
A. Severe hemorrhage
B. Renal artery stenosis
C. Acute tubular injury
D. Dehydration
Answer: C. Acute tubular injury
Rationale: Acute tubular injury is a major intrinsic renal cause of AKI and can
result from ischemia, nephrotoxins, or severe illness.
, 6. Which medication class can contribute to kidney injury, particularly in
susceptible patients?
A. Nephrotoxic medications
B. Antacids only
C. Topical moisturizers
D. Fiber supplements
Answer: A. Nephrotoxic medications
Rationale: Certain medications, including some antibiotics, NSAIDs, and contrast
agents, can impair kidney function and contribute to AKI.
7. Which assessment finding is most concerning in a patient with AKI?
A. Urine output of 40 mL/hr
B. Mild fatigue
C. New crackles and increasing respiratory distress
D. Blood pressure of 118/72 mmHg
Answer: C. New crackles and increasing respiratory distress
Rationale: AKI can cause fluid retention, resulting in pulmonary edema. New
respiratory distress requires immediate assessment and intervention.
8. Which electrolyte imbalance is particularly dangerous in severe AKI?
A. Hyperkalemia
B. Hypochloremia
C. Mild hypocalcemia
D. Hypermagnesemia only
Answer: A. Hyperkalemia
Rationale: Reduced kidney excretion of potassium can cause hyperkalemia,
which may produce life-threatening cardiac dysrhythmias.
9. Which ECG change is associated with hyperkalemia?
, A. Prolonged QT interval
B. Peaked T waves
C. ST elevation in every lead
D. Prominent U waves
Answer: B. Peaked T waves
Rationale: Tall, peaked T waves are a classic early ECG manifestation of
hyperkalemia. Severe hyperkalemia can progress to conduction abnormalities
and dysrhythmias.
10.Which patient history suggests a possible postrenal cause of AKI?
A. Recent episode of diarrhea
B. Severe blood loss
C. Enlarged prostate with urinary retention
D. Prolonged hypotension
Answer: C. Enlarged prostate with urinary retention
Rationale: Postrenal AKI results from obstruction of urinary outflow. Prostatic
enlargement can cause urinary retention and obstructive kidney injury.
11.Which diagnostic study is commonly used to evaluate urinary tract
obstruction?
A. Renal ultrasound
B. Electrocardiogram
C. Chest radiograph
D. Pulmonary function test
Answer: A. Renal ultrasound
Rationale: Renal ultrasound can identify hydronephrosis and other structural
abnormalities associated with urinary obstruction.
12.A patient with AKI has edema and elevated blood pressure. Which
complication does the nurse suspect?
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
1. Which finding is most characteristic of acute kidney injury (AKI)?
A. Gradual loss of kidney function over several years
B. Sudden decline in kidney function with rising serum creatinine
C. Persistent hypoglycemia
D. Increased erythropoietin production
Answer: B. Sudden decline in kidney function with rising serum creatinine
Rationale: AKI is characterized by an abrupt decline in kidney function,
commonly reflected by an increase in serum creatinine and/or reduced urine
output.
2. Which patient is at greatest risk for prerenal AKI?
A. Patient with severe dehydration from prolonged vomiting
B. Patient with chronic kidney disease
C. Patient with polycystic kidney disease
D. Patient with nephrotic syndrome
Answer: A. Patient with severe dehydration from prolonged vomiting
,Rationale: Prerenal AKI occurs when renal perfusion decreases. Severe
dehydration can significantly reduce circulating blood volume and kidney
perfusion.
3. Which laboratory value is most important for evaluating renal filtration?
A. Hemoglobin
B. Serum creatinine
C. Serum calcium
D. Platelet count
Answer: B. Serum creatinine
Rationale: Serum creatinine is commonly used to assess kidney filtration and
identify changes in renal function.
4. A patient with AKI has a urine output of 15 mL/hr. What should the nurse
do first?
A. Document the finding and reassess tomorrow
B. Encourage a high-protein meal
C. Assess the patient's fluid status and notify the healthcare provider
D. Administer additional potassium
Answer: C. Assess the patient's fluid status and notify the healthcare provider
Rationale: Markedly decreased urine output can indicate worsening AKI. Prompt
assessment and communication are necessary to prevent complications.
5. Which condition is classified as a common cause of intrinsic AKI?
A. Severe hemorrhage
B. Renal artery stenosis
C. Acute tubular injury
D. Dehydration
Answer: C. Acute tubular injury
Rationale: Acute tubular injury is a major intrinsic renal cause of AKI and can
result from ischemia, nephrotoxins, or severe illness.
, 6. Which medication class can contribute to kidney injury, particularly in
susceptible patients?
A. Nephrotoxic medications
B. Antacids only
C. Topical moisturizers
D. Fiber supplements
Answer: A. Nephrotoxic medications
Rationale: Certain medications, including some antibiotics, NSAIDs, and contrast
agents, can impair kidney function and contribute to AKI.
7. Which assessment finding is most concerning in a patient with AKI?
A. Urine output of 40 mL/hr
B. Mild fatigue
C. New crackles and increasing respiratory distress
D. Blood pressure of 118/72 mmHg
Answer: C. New crackles and increasing respiratory distress
Rationale: AKI can cause fluid retention, resulting in pulmonary edema. New
respiratory distress requires immediate assessment and intervention.
8. Which electrolyte imbalance is particularly dangerous in severe AKI?
A. Hyperkalemia
B. Hypochloremia
C. Mild hypocalcemia
D. Hypermagnesemia only
Answer: A. Hyperkalemia
Rationale: Reduced kidney excretion of potassium can cause hyperkalemia,
which may produce life-threatening cardiac dysrhythmias.
9. Which ECG change is associated with hyperkalemia?
, A. Prolonged QT interval
B. Peaked T waves
C. ST elevation in every lead
D. Prominent U waves
Answer: B. Peaked T waves
Rationale: Tall, peaked T waves are a classic early ECG manifestation of
hyperkalemia. Severe hyperkalemia can progress to conduction abnormalities
and dysrhythmias.
10.Which patient history suggests a possible postrenal cause of AKI?
A. Recent episode of diarrhea
B. Severe blood loss
C. Enlarged prostate with urinary retention
D. Prolonged hypotension
Answer: C. Enlarged prostate with urinary retention
Rationale: Postrenal AKI results from obstruction of urinary outflow. Prostatic
enlargement can cause urinary retention and obstructive kidney injury.
11.Which diagnostic study is commonly used to evaluate urinary tract
obstruction?
A. Renal ultrasound
B. Electrocardiogram
C. Chest radiograph
D. Pulmonary function test
Answer: A. Renal ultrasound
Rationale: Renal ultrasound can identify hydronephrosis and other structural
abnormalities associated with urinary obstruction.
12.A patient with AKI has edema and elevated blood pressure. Which
complication does the nurse suspect?
