NSG 252 Exam 1– Questions With Clear
Solutions
NSG 252 Exam 1 — 200 Original Practice Questions
Table of Contents
1. Acute Kidney Injury (AKI) — Questions 1–50
2. Chronic Kidney Disease (CKD) — Questions 51–100
3. Dialysis (Hemodialysis & Peritoneal) — Questions 101–150
4. Electrolyte Imbalances — Questions 151–200
Section 1: Acute Kidney Injury (AKI) — Questions 1–50
1. A nurse is assessing a client with acute kidney injury (AKI). Which finding is most
characteristic of the oliguric phase?
A. Polyuria
B. Urine output less than 400 mL/24 hours
C. Hypernatremia
D. Metabolic alkalosis
Correct Answer: B
Rationale: The oliguric phase of AKI is characterized by urine output less than 400 mL/24 hours.
This phase typically lasts 1–3 weeks and is associated with fluid retention, hyperkalemia, and
metabolic acidosis.
2. A nurse is reviewing the lab results of a client with AKI. Which finding indicates the client is
in the diuretic phase?
A. Urine output of 100 mL/24 hours
B. Urine output of 3,000 mL/24 hours
C. Serum potassium of 6.5 mEq/L
D. BUN of 80 mg/dL
,Correct Answer: B
Rationale: The diuretic phase of AKI is characterized by increased urine output (sometimes
3,000–5,000 mL/24 hours) as the kidneys recover.
3. A nurse is caring for a client with prerenal AKI. Which cause should the nurse suspect?
A. Glomerulonephritis
B. Severe dehydration
C. Nephrotoxic medications
D. Kidney stones
Correct Answer: B
Rationale: Prerenal AKI is caused by decreased blood flow to the kidneys. Severe dehydration,
heart failure, and shock are common causes.
4. A nurse is caring for a client with intrarenal AKI. Which cause should the nurse suspect?
A. Heart failure
B. Glomerulonephritis
C. Kidney stones
D. Hypovolemia
Correct Answer: B
Rationale: Intrarenal AKI is caused by damage to the kidney tissue itself. Glomerulonephritis,
nephrotoxic medications, and infections are common causes.
5. A nurse is caring for a client with postrenal AKI. Which cause should the nurse suspect?
A. Glomerulonephritis
B. Heart failure
C. Kidney stones
D. Severe dehydration
Correct Answer: C
Rationale: Postrenal AKI is caused by obstruction of urine flow. Kidney stones, tumors, and
enlarged prostate are common causes.
,6. A nurse is assessing a client with AKI. Which finding indicates fluid overload?
A. Flat neck veins
B. Pitting edema
C. Decreased blood pressure
D. Dry mucous membranes
Correct Answer: B
Rationale: Fluid overload in AKI presents with pitting edema, jugular vein distention,
hypertension, and weight gain.
7. A nurse is assessing a client with AKI. Which lab value indicates hyperkalemia?
A. Potassium 3.5 mEq/L
B. Potassium 5.0 mEq/L
C. Potassium 6.5 mEq/L
D. Potassium 4.0 mEq/L
Correct Answer: C
Rationale: Hyperkalemia is defined as potassium greater than 5.0 mEq/L. It is a life-threatening
complication of AKI.
8. A nurse is assessing a client with AKI. Which finding indicates metabolic acidosis?
A. pH 7.45, HCO3 28
B. pH 7.30, HCO3 18
C. pH 7.50, HCO3 30
D. pH 7.35, HCO3 24
Correct Answer: B
Rationale: Metabolic acidosis presents with low pH (<7.35) and low HCO3 (<22). It occurs in AKI
due to the kidneys' inability to excrete hydrogen ions.
9. A nurse is caring for a client with AKI. Which medication should the nurse anticipate
administering to treat hyperkalemia?
A. Furosemide
B. Sodium polystyrene sulfonate
C. Calcium gluconate
D. Both B and C
, Correct Answer: D
Rationale: Hyperkalemia in AKI is treated with sodium polystyrene sulfonate (Kayexalate) to
remove potassium, calcium gluconate to stabilize the myocardium, and insulin with glucose to
shift potassium into cells.
10. A nurse is teaching a client with AKI about dietary restrictions. Which statement indicates
understanding?
A. "I will eat a high-protein diet."
B. "I will limit my sodium and potassium intake."
C. "I will drink at least 3 liters of fluid daily."
D. "I will eat bananas for potassium."
Correct Answer: B
Rationale: Clients with AKI should limit sodium, potassium, and phosphorus. Protein may be
restricted depending on the phase. Fluid intake is often restricted.
11. A nurse is assessing a client with AKI. Which finding indicates improvement?
A. Increased BUN
B. Increased creatinine
C. Increased urine output
D. Increased potassium
Correct Answer: C
Rationale: Increased urine output indicates recovery of renal function. BUN and creatinine
should decrease as the kidneys recover.
12. A nurse is caring for a client with AKI. Which nursing diagnosis is priority?
A. Risk for Infection
B. Excess Fluid Volume
C. Impaired Skin Integrity
D. Activity Intolerance
Correct Answer: B
Rationale: Excess Fluid Volume is the priority nursing diagnosis for AKI due to the risk of
pulmonary edema and heart failure.
Solutions
NSG 252 Exam 1 — 200 Original Practice Questions
Table of Contents
1. Acute Kidney Injury (AKI) — Questions 1–50
2. Chronic Kidney Disease (CKD) — Questions 51–100
3. Dialysis (Hemodialysis & Peritoneal) — Questions 101–150
4. Electrolyte Imbalances — Questions 151–200
Section 1: Acute Kidney Injury (AKI) — Questions 1–50
1. A nurse is assessing a client with acute kidney injury (AKI). Which finding is most
characteristic of the oliguric phase?
A. Polyuria
B. Urine output less than 400 mL/24 hours
C. Hypernatremia
D. Metabolic alkalosis
Correct Answer: B
Rationale: The oliguric phase of AKI is characterized by urine output less than 400 mL/24 hours.
This phase typically lasts 1–3 weeks and is associated with fluid retention, hyperkalemia, and
metabolic acidosis.
2. A nurse is reviewing the lab results of a client with AKI. Which finding indicates the client is
in the diuretic phase?
A. Urine output of 100 mL/24 hours
B. Urine output of 3,000 mL/24 hours
C. Serum potassium of 6.5 mEq/L
D. BUN of 80 mg/dL
,Correct Answer: B
Rationale: The diuretic phase of AKI is characterized by increased urine output (sometimes
3,000–5,000 mL/24 hours) as the kidneys recover.
3. A nurse is caring for a client with prerenal AKI. Which cause should the nurse suspect?
A. Glomerulonephritis
B. Severe dehydration
C. Nephrotoxic medications
D. Kidney stones
Correct Answer: B
Rationale: Prerenal AKI is caused by decreased blood flow to the kidneys. Severe dehydration,
heart failure, and shock are common causes.
4. A nurse is caring for a client with intrarenal AKI. Which cause should the nurse suspect?
A. Heart failure
B. Glomerulonephritis
C. Kidney stones
D. Hypovolemia
Correct Answer: B
Rationale: Intrarenal AKI is caused by damage to the kidney tissue itself. Glomerulonephritis,
nephrotoxic medications, and infections are common causes.
5. A nurse is caring for a client with postrenal AKI. Which cause should the nurse suspect?
A. Glomerulonephritis
B. Heart failure
C. Kidney stones
D. Severe dehydration
Correct Answer: C
Rationale: Postrenal AKI is caused by obstruction of urine flow. Kidney stones, tumors, and
enlarged prostate are common causes.
,6. A nurse is assessing a client with AKI. Which finding indicates fluid overload?
A. Flat neck veins
B. Pitting edema
C. Decreased blood pressure
D. Dry mucous membranes
Correct Answer: B
Rationale: Fluid overload in AKI presents with pitting edema, jugular vein distention,
hypertension, and weight gain.
7. A nurse is assessing a client with AKI. Which lab value indicates hyperkalemia?
A. Potassium 3.5 mEq/L
B. Potassium 5.0 mEq/L
C. Potassium 6.5 mEq/L
D. Potassium 4.0 mEq/L
Correct Answer: C
Rationale: Hyperkalemia is defined as potassium greater than 5.0 mEq/L. It is a life-threatening
complication of AKI.
8. A nurse is assessing a client with AKI. Which finding indicates metabolic acidosis?
A. pH 7.45, HCO3 28
B. pH 7.30, HCO3 18
C. pH 7.50, HCO3 30
D. pH 7.35, HCO3 24
Correct Answer: B
Rationale: Metabolic acidosis presents with low pH (<7.35) and low HCO3 (<22). It occurs in AKI
due to the kidneys' inability to excrete hydrogen ions.
9. A nurse is caring for a client with AKI. Which medication should the nurse anticipate
administering to treat hyperkalemia?
A. Furosemide
B. Sodium polystyrene sulfonate
C. Calcium gluconate
D. Both B and C
, Correct Answer: D
Rationale: Hyperkalemia in AKI is treated with sodium polystyrene sulfonate (Kayexalate) to
remove potassium, calcium gluconate to stabilize the myocardium, and insulin with glucose to
shift potassium into cells.
10. A nurse is teaching a client with AKI about dietary restrictions. Which statement indicates
understanding?
A. "I will eat a high-protein diet."
B. "I will limit my sodium and potassium intake."
C. "I will drink at least 3 liters of fluid daily."
D. "I will eat bananas for potassium."
Correct Answer: B
Rationale: Clients with AKI should limit sodium, potassium, and phosphorus. Protein may be
restricted depending on the phase. Fluid intake is often restricted.
11. A nurse is assessing a client with AKI. Which finding indicates improvement?
A. Increased BUN
B. Increased creatinine
C. Increased urine output
D. Increased potassium
Correct Answer: C
Rationale: Increased urine output indicates recovery of renal function. BUN and creatinine
should decrease as the kidneys recover.
12. A nurse is caring for a client with AKI. Which nursing diagnosis is priority?
A. Risk for Infection
B. Excess Fluid Volume
C. Impaired Skin Integrity
D. Activity Intolerance
Correct Answer: B
Rationale: Excess Fluid Volume is the priority nursing diagnosis for AKI due to the risk of
pulmonary edema and heart failure.
