NUR 252 Exam 1 | Mental Health Nursing (2026) Q&A | Galen
College
1. A nurse is reviewing laboratory values for a patient with acute kidney injury. Which finding is
most indicative of AKI rather than a simple drop in urine output?
A) Blood urea nitrogen (BUN) of 22 mg/dL
B) Serum creatinine elevation from baseline
C) Serum potassium of 4.2 mEq/L
D) Urine specific gravity of 1.020
Correct Answer: B) Serum creatinine elevation from baseline
Rationale: A rise in creatinine is a hallmark of acute kidney injury (AKI) because creatinine is
filtered exclusively by the kidneys and is not significantly affected by hydration status alone.
While BUN can be elevated in prerenal states, creatinine elevation is a direct sign of renal
function decline.
2. The nurse is planning care for a patient with AKI who has a nursing diagnosis of Excess Fluid
Volume. Which assessment finding supports this diagnosis?
A) Pitting edema in the lower extremities
B) Bowel sounds positive in four quadrants
C) Wheezing in the lungs
D) Generalized weakness
Correct Answer: A) Pitting edema in the lower extremities
Rationale: The patient in acute kidney injury will likely be edematous because the kidneys are
not producing urine. Wheezing is an assessment consistent with asthma, not AKI. Bowel sounds
,in four quadrants is a normal finding. Generalized weakness may be due to the underlying
disease process.
3. A patient admitted with AKI asks the nurse, "Are my kidneys failing? Will I need a kidney
transplant?" Which response by the nurse is most appropriate?
A) "No, don't think that. You're going to be fine."
B) "In most cases, your condition can be reversed with prompt treatment and usually will not
destroy the kidneys."
C) "Kidney transplantation is highly likely, so it would be a good idea to start talking to your
family about organ donation."
D) "When the doctor comes to see you, we can talk about whether you will need a transplant."
Correct Answer: B) "In most cases, your condition can be reversed with prompt treatment and
usually will not destroy the kidneys."
Rationale: Acute kidney injury is often resolved without the need for transplant if treatment is
initiated quickly. There is no need to start lining up donors or wait for the provider to arrive.
Telling the client that everything will be fine is condescending and provides no information.
4. A client with frequent urinary tract infections is seen in the urology clinic. The nurse
determines the client is at risk for AKI. Which items in the client's history support this
conclusion? (Select all that apply)
A) Dehydration
B) Renal calculi
C) Ineffective wound healing
D) Low serum albumin
E) Hypertension
Correct Answer: A, B, E
,Rationale: Dehydration, renal calculi, and hypertension can all precipitate acute kidney injury.
Ineffective wound healing has not been shown to cause renal failure unless the infection
becomes systemic. A low serum albumin does not cause AKI.
5. A young school-age client is in the hospital with an AKI diagnosis following a streptococcus
infection. The parents ask what mistake they made that caused their child to be so sick. Which
response by the nurse is most appropriate?
A) "Your child does not eat enough dietary protein."
B) "Your child has a congenital defect that led to renal failure."
C) "Your child's renal failure has been caused by a low calcium level."
D) "Your child's recent infection may have caused the renal failure."
Correct Answer: D) "Your child's recent infection may have caused the renal failure."
Rationale: Clients with streptococcus are at risk for kidney and cardiac sequelae. A low-protein
or low-calcium diet will not lead to AKI. Congenital defects are not the likely cause in this
scenario.
6. The nurse is assessing a patient with AKI. Which phase is characterized by a gradual increase
in urine output and a risk for dehydration and electrolyte imbalances?
A) Initiation phase
B) Oliguric phase
C) Diuresis phase
D) Recovery phase
Correct Answer: C) Diuresis phase
, Rationale: The diuresis phase of AKI involves a gradual increase in urine output, with concerns
for dehydration and electrolyte imbalances as fluids are lost. The oliguric phase is characterized
by decreased urine output and fluid overload.
7. Which cause of AKI is classified as prerenal?
A) Trauma
B) Medication toxicity
C) Severe dehydration
D) Benign prostatic hyperplasia
Correct Answer: C) Severe dehydration
Rationale: Prerenal AKI is caused by hypoperfusion to the kidneys from conditions such as
dehydration, blood loss, shock, diarrhea, or burns. Intrarenal causes include trauma,
medications, and infections. Postrenal causes include BPH and kidney stones.
8. What is the normal range for urine output in an adult?
A) 10-20 mL/hr
B) 30-50 mL/hr
C) 60-80 mL/hr
D) 100-120 mL/hr
Correct Answer: B) 30-50 mL/hr
Rationale: Normal urine output for an adult is at least 30 mL/hr. Oliguria is defined as urine
output of 400 mL or less in 24 hours, and anuria is less than 40 mL in 24 hours.
9. What is the defining characteristic of oliguria?
College
1. A nurse is reviewing laboratory values for a patient with acute kidney injury. Which finding is
most indicative of AKI rather than a simple drop in urine output?
A) Blood urea nitrogen (BUN) of 22 mg/dL
B) Serum creatinine elevation from baseline
C) Serum potassium of 4.2 mEq/L
D) Urine specific gravity of 1.020
Correct Answer: B) Serum creatinine elevation from baseline
Rationale: A rise in creatinine is a hallmark of acute kidney injury (AKI) because creatinine is
filtered exclusively by the kidneys and is not significantly affected by hydration status alone.
While BUN can be elevated in prerenal states, creatinine elevation is a direct sign of renal
function decline.
2. The nurse is planning care for a patient with AKI who has a nursing diagnosis of Excess Fluid
Volume. Which assessment finding supports this diagnosis?
A) Pitting edema in the lower extremities
B) Bowel sounds positive in four quadrants
C) Wheezing in the lungs
D) Generalized weakness
Correct Answer: A) Pitting edema in the lower extremities
Rationale: The patient in acute kidney injury will likely be edematous because the kidneys are
not producing urine. Wheezing is an assessment consistent with asthma, not AKI. Bowel sounds
,in four quadrants is a normal finding. Generalized weakness may be due to the underlying
disease process.
3. A patient admitted with AKI asks the nurse, "Are my kidneys failing? Will I need a kidney
transplant?" Which response by the nurse is most appropriate?
A) "No, don't think that. You're going to be fine."
B) "In most cases, your condition can be reversed with prompt treatment and usually will not
destroy the kidneys."
C) "Kidney transplantation is highly likely, so it would be a good idea to start talking to your
family about organ donation."
D) "When the doctor comes to see you, we can talk about whether you will need a transplant."
Correct Answer: B) "In most cases, your condition can be reversed with prompt treatment and
usually will not destroy the kidneys."
Rationale: Acute kidney injury is often resolved without the need for transplant if treatment is
initiated quickly. There is no need to start lining up donors or wait for the provider to arrive.
Telling the client that everything will be fine is condescending and provides no information.
4. A client with frequent urinary tract infections is seen in the urology clinic. The nurse
determines the client is at risk for AKI. Which items in the client's history support this
conclusion? (Select all that apply)
A) Dehydration
B) Renal calculi
C) Ineffective wound healing
D) Low serum albumin
E) Hypertension
Correct Answer: A, B, E
,Rationale: Dehydration, renal calculi, and hypertension can all precipitate acute kidney injury.
Ineffective wound healing has not been shown to cause renal failure unless the infection
becomes systemic. A low serum albumin does not cause AKI.
5. A young school-age client is in the hospital with an AKI diagnosis following a streptococcus
infection. The parents ask what mistake they made that caused their child to be so sick. Which
response by the nurse is most appropriate?
A) "Your child does not eat enough dietary protein."
B) "Your child has a congenital defect that led to renal failure."
C) "Your child's renal failure has been caused by a low calcium level."
D) "Your child's recent infection may have caused the renal failure."
Correct Answer: D) "Your child's recent infection may have caused the renal failure."
Rationale: Clients with streptococcus are at risk for kidney and cardiac sequelae. A low-protein
or low-calcium diet will not lead to AKI. Congenital defects are not the likely cause in this
scenario.
6. The nurse is assessing a patient with AKI. Which phase is characterized by a gradual increase
in urine output and a risk for dehydration and electrolyte imbalances?
A) Initiation phase
B) Oliguric phase
C) Diuresis phase
D) Recovery phase
Correct Answer: C) Diuresis phase
, Rationale: The diuresis phase of AKI involves a gradual increase in urine output, with concerns
for dehydration and electrolyte imbalances as fluids are lost. The oliguric phase is characterized
by decreased urine output and fluid overload.
7. Which cause of AKI is classified as prerenal?
A) Trauma
B) Medication toxicity
C) Severe dehydration
D) Benign prostatic hyperplasia
Correct Answer: C) Severe dehydration
Rationale: Prerenal AKI is caused by hypoperfusion to the kidneys from conditions such as
dehydration, blood loss, shock, diarrhea, or burns. Intrarenal causes include trauma,
medications, and infections. Postrenal causes include BPH and kidney stones.
8. What is the normal range for urine output in an adult?
A) 10-20 mL/hr
B) 30-50 mL/hr
C) 60-80 mL/hr
D) 100-120 mL/hr
Correct Answer: B) 30-50 mL/hr
Rationale: Normal urine output for an adult is at least 30 mL/hr. Oliguria is defined as urine
output of 400 mL or less in 24 hours, and anuria is less than 40 mL in 24 hours.
9. What is the defining characteristic of oliguria?
