MDC III Exam 1 (RASMUSSEN) QUESTIONS
AND CORRECT ANSWERS| LATEST
UPDATE
1. Acute kidney injury
A patient with acute kidney injury (AKI) has a rising serum creatinine level and decreasing urine
output. Which assessment finding requires the most immediate attention?
A. Mild fatigue B. Potassium level of 6.4 mEq/L C. Decreased appetite D. Dry skin
Correct answer: B. Potassium level of 6.4 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias. The nurse
should promptly assess cardiac status, initiate appropriate monitoring, and notify the
responsible clinician.
2. Prerenal acute kidney injury
Which condition can cause prerenal AKI?
A. Severe dehydration B. Kidney stone obstructing the ureter C. Glomerular inflammation D.
Bladder tumor
Correct answer: A. Severe dehydration
Rationale: Prerenal AKI occurs when blood flow to the kidneys decreases. Dehydration,
hemorrhage, and reduced cardiac output can impair renal perfusion.
3. Postrenal acute kidney injury
Which condition is an example of postrenal AKI?
A. Severe diarrhea B. Acute tubular injury C. Urinary obstruction D. Septic shock
Correct answer: C. Urinary obstruction
Rationale: Postrenal AKI results from obstruction of urine flow, such as an obstructing stone or
enlarged prostate. Relieving the obstruction is an important part of treatment.
4. Monitoring kidney function
Which laboratory value is commonly used to assess kidney filtration?
A. Serum creatinine B. Hemoglobin A1c C. Serum amylase D. Troponin
Correct answer: A. Serum creatinine
,Rationale: Creatinine is filtered by the kidneys. An increasing level may indicate impaired
filtration, although interpretation should consider baseline function and other clinical findings.
5. Oliguria
A hospitalized adult produces very little urine over several hours. What should the nurse do
first?
A. Restrict all fluids without an order B. Assess fluid status, vital signs, and urinary catheter
patency if present C. Administer a diuretic independently D. Document the finding at the end of
the shift only
Correct answer: B. Assess fluid status, vital signs, and urinary catheter patency if present
Rationale: Low urine output may result from hypovolemia, obstruction, or kidney dysfunction.
Prompt assessment helps identify the cause before treatment is selected.
6. Chronic kidney disease
Which finding is commonly associated with advanced chronic kidney disease (CKD)?
A. Persistent elevation of kidney filtration B. Reduced kidney function with possible fluid and
electrolyte abnormalities C. Increased ability to excrete potassium D. Complete absence of
cardiovascular risk
Correct answer: B. Reduced kidney function with possible fluid and electrolyte abnormalities
Rationale: CKD is a persistent abnormality of kidney structure or function. As disease
progresses, fluid overload, electrolyte disturbances, anemia, and mineral-bone disorders may
develop.
7. Hyperkalemia in CKD
Which symptom in a patient with CKD may indicate a serious potassium disturbance?
A. New muscle weakness with palpitations B. Mild hunger before lunch C. Occasional sneezing
D. Dry lips after waking
Correct answer: A. New muscle weakness with palpitations
Rationale: Hyperkalemia can affect neuromuscular function and cardiac conduction. Obtain
prompt assessment and an ECG when indicated; symptoms alone cannot reliably establish
potassium levels.
8. Fluid overload
Which finding most strongly suggests fluid overload in a patient with kidney failure?
,A. Crackles in the lungs and increasing breathlessness B. Dry mucous membranes C. Reduced
body weight D. Decreased peripheral edema
Correct answer: A. Crackles in the lungs and increasing breathlessness
Rationale: Excess fluid can accumulate in the lungs and cause pulmonary edema. Respiratory
compromise requires urgent assessment and intervention.
9. Hemodialysis access
Which action is appropriate when assessing an arteriovenous fistula?
A. Use it routinely for blood pressure measurement B. Assess for a palpable thrill and audible
bruit C. Apply a tight dressing continuously D. Use the arm for routine venipuncture
Correct answer: B. Assess for a palpable thrill and audible bruit
Rationale: A thrill and bruit indicate blood flow through the access. Avoid blood pressure
measurements, venipuncture, and unnecessary compression on the access arm.
10. Dialysis complication
During hemodialysis, a patient develops dizziness and hypotension. Which complication should
the nurse suspect?
A. Excessive fluid removal B. Improved kidney filtration C. Increased bone density D. Increased
red blood cell production
Correct answer: A. Excessive fluid removal
Rationale: Rapid or excessive ultrafiltration can reduce circulating blood volume and blood
pressure. Assess the patient and follow the dialysis unit's emergency protocol.
11. Kidney stones
Which symptom is characteristic of ureteral calculi?
A. Severe intermittent flank pain that may radiate toward the groin B. Painless swelling of both
hands C. Chronic productive cough D. Isolated hearing loss
Correct answer: A. Severe intermittent flank pain that may radiate toward the groin
Rationale: A moving stone can cause renal colic, often accompanied by nausea, hematuria, or
urinary urgency.
12. Kidney stone complications
, A patient with a suspected kidney stone has fever, chills, severe flank pain, and difficulty passing
urine. What is the priority?
A. Recommend waiting several days B. Arrange urgent medical assessment C. Encourage the
patient to ignore the fever D. Delay care until the pain stops
Correct answer: B. Arrange urgent medical assessment
Rationale: An obstructed urinary system with infection can progress rapidly to sepsis. This
combination requires urgent evaluation and treatment.
13. Pyelonephritis
Which assessment finding is most consistent with acute pyelonephritis?
A. Fever, flank pain, and costovertebral-angle tenderness B. Isolated knee pain C. Painless
blurred vision D. Chronic ear itching
Correct answer: A. Fever, flank pain, and costovertebral-angle tenderness
Rationale: Pyelonephritis is an infection involving the kidney and upper urinary tract. Fever,
flank pain, nausea, and urinary symptoms may occur.
14. Urinary tract infection prevention
Which instruction helps reduce the risk of recurrent urinary tract infections?
A. Delay urination for as long as possible B. Maintain appropriate hydration unless medically
restricted C. Use leftover antibiotics whenever symptoms occur D. Stop prescribed antibiotics as
soon as symptoms improve
Correct answer: B. Maintain appropriate hydration unless medically restricted
Rationale: Adequate hydration supports normal urinary flow for many patients. Treatment and
prevention plans should be individualized, and antibiotics should be used as prescribed.
15. Urine specimen collection
Which action is appropriate when collecting a clean-catch midstream urine specimen?
A. Collect urine directly from the toilet B. Begin urinating, then collect the midstream urine in a
sterile container C. Touch the inside of the container D. Mix the specimen with tap water
Correct answer: B. Begin urinating, then collect the midstream urine in a sterile container
Rationale: A clean-catch technique reduces contamination from skin and surrounding tissues,
improving specimen quality.
AND CORRECT ANSWERS| LATEST
UPDATE
1. Acute kidney injury
A patient with acute kidney injury (AKI) has a rising serum creatinine level and decreasing urine
output. Which assessment finding requires the most immediate attention?
A. Mild fatigue B. Potassium level of 6.4 mEq/L C. Decreased appetite D. Dry skin
Correct answer: B. Potassium level of 6.4 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias. The nurse
should promptly assess cardiac status, initiate appropriate monitoring, and notify the
responsible clinician.
2. Prerenal acute kidney injury
Which condition can cause prerenal AKI?
A. Severe dehydration B. Kidney stone obstructing the ureter C. Glomerular inflammation D.
Bladder tumor
Correct answer: A. Severe dehydration
Rationale: Prerenal AKI occurs when blood flow to the kidneys decreases. Dehydration,
hemorrhage, and reduced cardiac output can impair renal perfusion.
3. Postrenal acute kidney injury
Which condition is an example of postrenal AKI?
A. Severe diarrhea B. Acute tubular injury C. Urinary obstruction D. Septic shock
Correct answer: C. Urinary obstruction
Rationale: Postrenal AKI results from obstruction of urine flow, such as an obstructing stone or
enlarged prostate. Relieving the obstruction is an important part of treatment.
4. Monitoring kidney function
Which laboratory value is commonly used to assess kidney filtration?
A. Serum creatinine B. Hemoglobin A1c C. Serum amylase D. Troponin
Correct answer: A. Serum creatinine
,Rationale: Creatinine is filtered by the kidneys. An increasing level may indicate impaired
filtration, although interpretation should consider baseline function and other clinical findings.
5. Oliguria
A hospitalized adult produces very little urine over several hours. What should the nurse do
first?
A. Restrict all fluids without an order B. Assess fluid status, vital signs, and urinary catheter
patency if present C. Administer a diuretic independently D. Document the finding at the end of
the shift only
Correct answer: B. Assess fluid status, vital signs, and urinary catheter patency if present
Rationale: Low urine output may result from hypovolemia, obstruction, or kidney dysfunction.
Prompt assessment helps identify the cause before treatment is selected.
6. Chronic kidney disease
Which finding is commonly associated with advanced chronic kidney disease (CKD)?
A. Persistent elevation of kidney filtration B. Reduced kidney function with possible fluid and
electrolyte abnormalities C. Increased ability to excrete potassium D. Complete absence of
cardiovascular risk
Correct answer: B. Reduced kidney function with possible fluid and electrolyte abnormalities
Rationale: CKD is a persistent abnormality of kidney structure or function. As disease
progresses, fluid overload, electrolyte disturbances, anemia, and mineral-bone disorders may
develop.
7. Hyperkalemia in CKD
Which symptom in a patient with CKD may indicate a serious potassium disturbance?
A. New muscle weakness with palpitations B. Mild hunger before lunch C. Occasional sneezing
D. Dry lips after waking
Correct answer: A. New muscle weakness with palpitations
Rationale: Hyperkalemia can affect neuromuscular function and cardiac conduction. Obtain
prompt assessment and an ECG when indicated; symptoms alone cannot reliably establish
potassium levels.
8. Fluid overload
Which finding most strongly suggests fluid overload in a patient with kidney failure?
,A. Crackles in the lungs and increasing breathlessness B. Dry mucous membranes C. Reduced
body weight D. Decreased peripheral edema
Correct answer: A. Crackles in the lungs and increasing breathlessness
Rationale: Excess fluid can accumulate in the lungs and cause pulmonary edema. Respiratory
compromise requires urgent assessment and intervention.
9. Hemodialysis access
Which action is appropriate when assessing an arteriovenous fistula?
A. Use it routinely for blood pressure measurement B. Assess for a palpable thrill and audible
bruit C. Apply a tight dressing continuously D. Use the arm for routine venipuncture
Correct answer: B. Assess for a palpable thrill and audible bruit
Rationale: A thrill and bruit indicate blood flow through the access. Avoid blood pressure
measurements, venipuncture, and unnecessary compression on the access arm.
10. Dialysis complication
During hemodialysis, a patient develops dizziness and hypotension. Which complication should
the nurse suspect?
A. Excessive fluid removal B. Improved kidney filtration C. Increased bone density D. Increased
red blood cell production
Correct answer: A. Excessive fluid removal
Rationale: Rapid or excessive ultrafiltration can reduce circulating blood volume and blood
pressure. Assess the patient and follow the dialysis unit's emergency protocol.
11. Kidney stones
Which symptom is characteristic of ureteral calculi?
A. Severe intermittent flank pain that may radiate toward the groin B. Painless swelling of both
hands C. Chronic productive cough D. Isolated hearing loss
Correct answer: A. Severe intermittent flank pain that may radiate toward the groin
Rationale: A moving stone can cause renal colic, often accompanied by nausea, hematuria, or
urinary urgency.
12. Kidney stone complications
, A patient with a suspected kidney stone has fever, chills, severe flank pain, and difficulty passing
urine. What is the priority?
A. Recommend waiting several days B. Arrange urgent medical assessment C. Encourage the
patient to ignore the fever D. Delay care until the pain stops
Correct answer: B. Arrange urgent medical assessment
Rationale: An obstructed urinary system with infection can progress rapidly to sepsis. This
combination requires urgent evaluation and treatment.
13. Pyelonephritis
Which assessment finding is most consistent with acute pyelonephritis?
A. Fever, flank pain, and costovertebral-angle tenderness B. Isolated knee pain C. Painless
blurred vision D. Chronic ear itching
Correct answer: A. Fever, flank pain, and costovertebral-angle tenderness
Rationale: Pyelonephritis is an infection involving the kidney and upper urinary tract. Fever,
flank pain, nausea, and urinary symptoms may occur.
14. Urinary tract infection prevention
Which instruction helps reduce the risk of recurrent urinary tract infections?
A. Delay urination for as long as possible B. Maintain appropriate hydration unless medically
restricted C. Use leftover antibiotics whenever symptoms occur D. Stop prescribed antibiotics as
soon as symptoms improve
Correct answer: B. Maintain appropriate hydration unless medically restricted
Rationale: Adequate hydration supports normal urinary flow for many patients. Treatment and
prevention plans should be individualized, and antibiotics should be used as prescribed.
15. Urine specimen collection
Which action is appropriate when collecting a clean-catch midstream urine specimen?
A. Collect urine directly from the toilet B. Begin urinating, then collect the midstream urine in a
sterile container C. Touch the inside of the container D. Mix the specimen with tap water
Correct answer: B. Begin urinating, then collect the midstream urine in a sterile container
Rationale: A clean-catch technique reduces contamination from skin and surrounding tissues,
improving specimen quality.
