HESI CASE STUDY – CHRONIC KIDNEY
DISEASE QUESTIONS WITH SOLUTIONS
2026/2027
Instructions: This exam contains multiple-choice and select-all-that-apply
questions covering the core content tested in the HESI Chronic Kidney Disease
Case Study. Topics include CKD etiology, lab values, uremia, dialysis modalities,
vascular access, and kidney transplantation.
1. Judy Harrison is a 38-year-old African American female with a long
history of type 2 diabetes mellitus and hypertension. She has
experienced renal insufficiency for the last two years. Which
explanation by the nurse is an accurate description of CKD?
A. There are frequent exacerbations since half of all nephrons are
damaged
B. It is a fatal disorder unless renal replacement therapy is received
C. The condition has a rapid onset with frequent remissions
D. Symptoms are reversible with lifelong medication
Correct Answer: B — It is a fatal disorder unless renal replacement
therapy is received
,Rationale: CKD is fatal unless some form of renal replacement therapy
(dialysis or organ transplant) is done, whereas acute renal failure has a
good prognosis for the return of kidney function if appropriate
supportive care is provided during the acute period. Symptoms are not
reversible, onset is gradual, and about 90% of nephrons are typically
involved in CKD .
2. What additional information in Judy's history may be related to the
onset of ESRD? (Select all that apply.)
A. Hypertension
B. Polycystic kidney disease
C. Hysterectomy at age 35
D. Female gender
E. African-American ethnicity
Correct Answers: A, E
Rationale: Hypertension is one of the primary causes of CKD, and
African American clients are more likely to develop ESKD and have
, hypertensive ESKD. Polycystic kidney disease is a possible factor but is
not confirmed in Judy's history. Hysterectomy and female gender are
not risk factors .
3. Which lab value is likely to be decreased in a client with chronic
kidney disease?
A. Serum potassium
B. Serum BUN and creatinine
C. Serum calcium
D. Serum phosphorus
Correct Answer: C — Serum calcium
Rationale: Serum calcium is decreased in CKD in response to an
increase in serum phosphorus. Serum potassium, BUN, creatinine, and
phosphorus are all increased in CKD .
4. Judy's hemoglobin level is 7.8 g/dL. Which underlying pathology does
the nurse recognize as the cause of this abnormal lab value?
DISEASE QUESTIONS WITH SOLUTIONS
2026/2027
Instructions: This exam contains multiple-choice and select-all-that-apply
questions covering the core content tested in the HESI Chronic Kidney Disease
Case Study. Topics include CKD etiology, lab values, uremia, dialysis modalities,
vascular access, and kidney transplantation.
1. Judy Harrison is a 38-year-old African American female with a long
history of type 2 diabetes mellitus and hypertension. She has
experienced renal insufficiency for the last two years. Which
explanation by the nurse is an accurate description of CKD?
A. There are frequent exacerbations since half of all nephrons are
damaged
B. It is a fatal disorder unless renal replacement therapy is received
C. The condition has a rapid onset with frequent remissions
D. Symptoms are reversible with lifelong medication
Correct Answer: B — It is a fatal disorder unless renal replacement
therapy is received
,Rationale: CKD is fatal unless some form of renal replacement therapy
(dialysis or organ transplant) is done, whereas acute renal failure has a
good prognosis for the return of kidney function if appropriate
supportive care is provided during the acute period. Symptoms are not
reversible, onset is gradual, and about 90% of nephrons are typically
involved in CKD .
2. What additional information in Judy's history may be related to the
onset of ESRD? (Select all that apply.)
A. Hypertension
B. Polycystic kidney disease
C. Hysterectomy at age 35
D. Female gender
E. African-American ethnicity
Correct Answers: A, E
Rationale: Hypertension is one of the primary causes of CKD, and
African American clients are more likely to develop ESKD and have
, hypertensive ESKD. Polycystic kidney disease is a possible factor but is
not confirmed in Judy's history. Hysterectomy and female gender are
not risk factors .
3. Which lab value is likely to be decreased in a client with chronic
kidney disease?
A. Serum potassium
B. Serum BUN and creatinine
C. Serum calcium
D. Serum phosphorus
Correct Answer: C — Serum calcium
Rationale: Serum calcium is decreased in CKD in response to an
increase in serum phosphorus. Serum potassium, BUN, creatinine, and
phosphorus are all increased in CKD .
4. Judy's hemoglobin level is 7.8 g/dL. Which underlying pathology does
the nurse recognize as the cause of this abnormal lab value?
