AH3 EXAM 5 QUESTIONS AND ANSWERS
1. How do you determine that a patient's oliguria is associated with acute renal failure (ARF)?
A. Specific gravity of urine at 3 different times is 1.010.
B. The serum creatinine level is normal.
C. The blood urea nitrogen (BUN) level is normal or below.
D. Hypokalemia is identified. - CORRECT ANSWER✅✅✅ANS: A
A urinalysis may show casts, red blood cells (RBCs), white blood cells (WBCs), a specific gravity fixed at
about 1.010, and urine osmolality at about 300 mOsm/kg.
Reference: 1167
2. When caring for a patient during the oliguric phase of acute kidney injury, what would be an
appropriate nursing intervention?
A. Weigh patient three times weekly
B. Increase dietary sodium and potassium
C. Provide a low-protein, high-carbohydrate diet
D. Restrict fluids according to the previous day's fluid loss - CORRECT ANSWER✅✅✅ANS: D
Patients in the oliguric phase of acute kidney injury have fluid volume excess with potassium and sodium
retention. They will need to have dietary sodium, potassium, and fluids restricted. Daily fluid intake is
based on the previous 24-hour fluid loss (measured output plus 600 mL for insensible loss). The diet also
needs to provide adequate, not low, protein intake to prevent catabolism. The patient should also be
weighed daily, not just three times per week.
Reference: 1167
,3. Which assessment finding is commonly found in the oliguric phase of acute kidney injury (AKI)?
A. Hypovolemia
B. Hyperkalemia
C. Hypernatremia
D. Thrombocytopenia - CORRECT ANSWER✅✅✅ANS: B
In AKI, the serum potassium levels increase because the normal ability of the kidneys to excrete
potassium is impaired. Sodium levels are typically normal or diminished, whereas fluid volume is
normally increased due to decreased urine output. Thrombocytopenia is not a consequence of AKI,
although altered platelet function may occur in AKI.
Reference: 1167
4. Which patient has the greatest risk for prerenal AKI?
A. The patient is hypovolemic because of hemorrhage.
B. The patient relates a history of chronic urinary tract obstruction.
C. The patient has vascular changes related to coagulopathies.
D. The patient is receiving antibiotics such as gentamicin. - CORRECT ANSWER✅✅✅ANS: A
Prerenal causes of AKI are factors external to the kidneys. These factors reduce systemic circulation,
causing a reduction in renal blood flow, and they lead to decreased glomerular perfusion and filtration
of the kidneys.
Reference: 1165
,5. The patient admitted to the intensive care unit after a motor vehicle accident has been diagnosed
with AKI. Which finding indicates the onset of oliguria resulting from AKI?
A. Urine output less than 1000 mL for the past 24 hours
B. Urine output less than 800 mL for the past 24 hours
C. Urine output less than 600 mL for the past 24 hours
D. Urine output less than 400 mL for the past 24 hours - CORRECT ANSWER✅✅✅ANS: D
The most common initial manifestation of AKI is oliguria, a reduction to urine output to less than 400
mL/day.
Reference: 1166
6. The patient in the oliguric phase of AKI excreted 300 mL of urine in addition to 100 mL of other losses
during the past 24 hours. With appropriate calculations, you determine that for the next 24 hours the
patient's fluid allocation is
A. 600 mL.
B. 800 mL.
C. 1000 mL.
D. 1200 mL. - CORRECT ANSWER✅✅✅
7. Your plan for care of a patient with AKI includes which goal of dietary management?
A. Provide sufficient calories while preventing nitrogen excess.
, B. Deliver adequate calories while restricting fat and protein intake.
C. Replace protein intake with enough fat intake to sustain metabolism.
D. Restrict fluids, increase potassium intake, and regulate sodium intake. - CORRECT
ANSWER✅✅✅ANS: A
The challenge of nutrition management in AKI is to provide adequate calories to prevent catabolism
despite the restrictions required to prevent electrolyte and fluid disorders and azotemia.
Reference: 1168
8. For the patient with AKI, which laboratory result would cause you the greatest concern?
A. Potassium level of 5.9 mEq/L
B. BUN level of 25 mg/dL
C. Sodium level of 144 mEq/L
D. pH of 7.5 - CORRECT ANSWER✅✅✅ANS: A
Hyperkalemia is one of the most serious complications in AKI because it can cause life-threatening
cardiac dysrhythmias.
Reference: 1168
9. Important nursing interventions for the patient with AKI are (select all that apply)
A. careful monitoring of intake and output.
B. daily patient weights.
C. meticulous aseptic technique.
1. How do you determine that a patient's oliguria is associated with acute renal failure (ARF)?
A. Specific gravity of urine at 3 different times is 1.010.
B. The serum creatinine level is normal.
C. The blood urea nitrogen (BUN) level is normal or below.
D. Hypokalemia is identified. - CORRECT ANSWER✅✅✅ANS: A
A urinalysis may show casts, red blood cells (RBCs), white blood cells (WBCs), a specific gravity fixed at
about 1.010, and urine osmolality at about 300 mOsm/kg.
Reference: 1167
2. When caring for a patient during the oliguric phase of acute kidney injury, what would be an
appropriate nursing intervention?
A. Weigh patient three times weekly
B. Increase dietary sodium and potassium
C. Provide a low-protein, high-carbohydrate diet
D. Restrict fluids according to the previous day's fluid loss - CORRECT ANSWER✅✅✅ANS: D
Patients in the oliguric phase of acute kidney injury have fluid volume excess with potassium and sodium
retention. They will need to have dietary sodium, potassium, and fluids restricted. Daily fluid intake is
based on the previous 24-hour fluid loss (measured output plus 600 mL for insensible loss). The diet also
needs to provide adequate, not low, protein intake to prevent catabolism. The patient should also be
weighed daily, not just three times per week.
Reference: 1167
,3. Which assessment finding is commonly found in the oliguric phase of acute kidney injury (AKI)?
A. Hypovolemia
B. Hyperkalemia
C. Hypernatremia
D. Thrombocytopenia - CORRECT ANSWER✅✅✅ANS: B
In AKI, the serum potassium levels increase because the normal ability of the kidneys to excrete
potassium is impaired. Sodium levels are typically normal or diminished, whereas fluid volume is
normally increased due to decreased urine output. Thrombocytopenia is not a consequence of AKI,
although altered platelet function may occur in AKI.
Reference: 1167
4. Which patient has the greatest risk for prerenal AKI?
A. The patient is hypovolemic because of hemorrhage.
B. The patient relates a history of chronic urinary tract obstruction.
C. The patient has vascular changes related to coagulopathies.
D. The patient is receiving antibiotics such as gentamicin. - CORRECT ANSWER✅✅✅ANS: A
Prerenal causes of AKI are factors external to the kidneys. These factors reduce systemic circulation,
causing a reduction in renal blood flow, and they lead to decreased glomerular perfusion and filtration
of the kidneys.
Reference: 1165
,5. The patient admitted to the intensive care unit after a motor vehicle accident has been diagnosed
with AKI. Which finding indicates the onset of oliguria resulting from AKI?
A. Urine output less than 1000 mL for the past 24 hours
B. Urine output less than 800 mL for the past 24 hours
C. Urine output less than 600 mL for the past 24 hours
D. Urine output less than 400 mL for the past 24 hours - CORRECT ANSWER✅✅✅ANS: D
The most common initial manifestation of AKI is oliguria, a reduction to urine output to less than 400
mL/day.
Reference: 1166
6. The patient in the oliguric phase of AKI excreted 300 mL of urine in addition to 100 mL of other losses
during the past 24 hours. With appropriate calculations, you determine that for the next 24 hours the
patient's fluid allocation is
A. 600 mL.
B. 800 mL.
C. 1000 mL.
D. 1200 mL. - CORRECT ANSWER✅✅✅
7. Your plan for care of a patient with AKI includes which goal of dietary management?
A. Provide sufficient calories while preventing nitrogen excess.
, B. Deliver adequate calories while restricting fat and protein intake.
C. Replace protein intake with enough fat intake to sustain metabolism.
D. Restrict fluids, increase potassium intake, and regulate sodium intake. - CORRECT
ANSWER✅✅✅ANS: A
The challenge of nutrition management in AKI is to provide adequate calories to prevent catabolism
despite the restrictions required to prevent electrolyte and fluid disorders and azotemia.
Reference: 1168
8. For the patient with AKI, which laboratory result would cause you the greatest concern?
A. Potassium level of 5.9 mEq/L
B. BUN level of 25 mg/dL
C. Sodium level of 144 mEq/L
D. pH of 7.5 - CORRECT ANSWER✅✅✅ANS: A
Hyperkalemia is one of the most serious complications in AKI because it can cause life-threatening
cardiac dysrhythmias.
Reference: 1168
9. Important nursing interventions for the patient with AKI are (select all that apply)
A. careful monitoring of intake and output.
B. daily patient weights.
C. meticulous aseptic technique.
