ATI RN Targeted Medical-
Surgical Renal & Urinary
Practice Exam 2026–2027|
Complete Test Prep Practice
Questions With Answers &
Detailed Rationales |clinical
Judgment &Safety |A+ Rated
1.
A nurse is caring for a client with acute kidney injury (AKI). Which
laboratory value should the nurse monitor most closely?
A. Hemoglobin
B. Serum creatinine
C. Platelet count
D. Serum albumin
Answer: B. Serum creatinine
Serum creatinine is a key indicator of renal filtration and typically
rises when kidney function decreases.
2.
,A client with chronic kidney disease (CKD) has a serum potassium of
6.4 mEq/L (6.4 mmol/L). Which action should the nurse take first?
A. Encourage oral fluids
B. Place the client on a cardiac monitor
C. Administer potassium supplements
D. Encourage foods high in potassium
Answer: B. Place the client on a cardiac monitor
Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias. Continuous cardiac monitoring is a priority.
3.
Which finding is most consistent with fluid volume excess in a client
with renal failure?
A. Flat neck veins
B. Weight loss
C. Crackles in the lungs
D. Dry mucous membranes
Answer: C. Crackles in the lungs
Renal failure can impair fluid excretion, causing pulmonary edema
manifested by crackles.
4.
A nurse is teaching a client about hemodialysis. Which statement
should the nurse include?
A. "Your dialysis access arm should be used for blood pressure
measurements."
B. "You should avoid carrying heavy objects with your access arm."
C. "You should sleep directly on your access arm."
,D. "You should allow venipunctures in the access arm when
necessary."
Answer: B. "You should avoid carrying heavy objects with your
access arm."
Excessive pressure or trauma can damage the vascular access.
5.
The nurse assesses an arteriovenous fistula and does not hear a
bruit. What should the nurse do?
A. Document the finding as expected
B. Apply a warm compress
C. Notify the provider immediately
D. Encourage the client to exercise vigorously
Answer: C. Notify the provider immediately
Absence of a bruit or thrill can indicate vascular access occlusion and
requires prompt evaluation.
6.
Which assessment finding indicates that an arteriovenous fistula is
functioning?
A. Absence of a pulse
B. Presence of a bruit and thrill
C. Severe swelling of the arm
D. Coolness and pallor distal to the access
Answer: B. Presence of a bruit and thrill
A functioning fistula generally has palpable vibration (thrill) and an
audible whooshing sound (bruit).
, 7.
A client receiving hemodialysis reports muscle cramps and dizziness
during treatment. Which complication should the nurse suspect?
A. Hyperglycemia
B. Excessive fluid removal
C. Urinary retention
D. Hypercalcemia
Answer: B. Excessive fluid removal
Rapid removal of fluid during dialysis can cause hypotension,
dizziness, and muscle cramps.
8.
Which food should a client with hyperkalemia avoid?
A. Apples
B. White rice
C. Bananas
D. Blueberries
Answer: C. Bananas
Bananas are high in potassium and may worsen hyperkalemia.
9.
A client with CKD asks why protein intake may need to be controlled.
Which response is appropriate?
A. "Protein completely prevents renal disease."
B. "Protein metabolism produces waste products that impaired
kidneys may not eliminate effectively."
Surgical Renal & Urinary
Practice Exam 2026–2027|
Complete Test Prep Practice
Questions With Answers &
Detailed Rationales |clinical
Judgment &Safety |A+ Rated
1.
A nurse is caring for a client with acute kidney injury (AKI). Which
laboratory value should the nurse monitor most closely?
A. Hemoglobin
B. Serum creatinine
C. Platelet count
D. Serum albumin
Answer: B. Serum creatinine
Serum creatinine is a key indicator of renal filtration and typically
rises when kidney function decreases.
2.
,A client with chronic kidney disease (CKD) has a serum potassium of
6.4 mEq/L (6.4 mmol/L). Which action should the nurse take first?
A. Encourage oral fluids
B. Place the client on a cardiac monitor
C. Administer potassium supplements
D. Encourage foods high in potassium
Answer: B. Place the client on a cardiac monitor
Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias. Continuous cardiac monitoring is a priority.
3.
Which finding is most consistent with fluid volume excess in a client
with renal failure?
A. Flat neck veins
B. Weight loss
C. Crackles in the lungs
D. Dry mucous membranes
Answer: C. Crackles in the lungs
Renal failure can impair fluid excretion, causing pulmonary edema
manifested by crackles.
4.
A nurse is teaching a client about hemodialysis. Which statement
should the nurse include?
A. "Your dialysis access arm should be used for blood pressure
measurements."
B. "You should avoid carrying heavy objects with your access arm."
C. "You should sleep directly on your access arm."
,D. "You should allow venipunctures in the access arm when
necessary."
Answer: B. "You should avoid carrying heavy objects with your
access arm."
Excessive pressure or trauma can damage the vascular access.
5.
The nurse assesses an arteriovenous fistula and does not hear a
bruit. What should the nurse do?
A. Document the finding as expected
B. Apply a warm compress
C. Notify the provider immediately
D. Encourage the client to exercise vigorously
Answer: C. Notify the provider immediately
Absence of a bruit or thrill can indicate vascular access occlusion and
requires prompt evaluation.
6.
Which assessment finding indicates that an arteriovenous fistula is
functioning?
A. Absence of a pulse
B. Presence of a bruit and thrill
C. Severe swelling of the arm
D. Coolness and pallor distal to the access
Answer: B. Presence of a bruit and thrill
A functioning fistula generally has palpable vibration (thrill) and an
audible whooshing sound (bruit).
, 7.
A client receiving hemodialysis reports muscle cramps and dizziness
during treatment. Which complication should the nurse suspect?
A. Hyperglycemia
B. Excessive fluid removal
C. Urinary retention
D. Hypercalcemia
Answer: B. Excessive fluid removal
Rapid removal of fluid during dialysis can cause hypotension,
dizziness, and muscle cramps.
8.
Which food should a client with hyperkalemia avoid?
A. Apples
B. White rice
C. Bananas
D. Blueberries
Answer: C. Bananas
Bananas are high in potassium and may worsen hyperkalemia.
9.
A client with CKD asks why protein intake may need to be controlled.
Which response is appropriate?
A. "Protein completely prevents renal disease."
B. "Protein metabolism produces waste products that impaired
kidneys may not eliminate effectively."
