NURS 120 Introduction to Medical-Surgical Nursing: Renal & Urinary
Disorders (2026 Update) WCU
1. A patient with Chronic Kidney Disease (CKD) has a glomerular filtration rate
(GFR) of 14 mL/min/1.73m². Which stage of CKD does this represent?
A. Stage 3
B. Stage 5
C. Stage 4
D. Stage 2
Answer: B
Rationale: Stage 5 CKD, or End-Stage Renal Disease (ESRD), is defined by a GFR of less
than 15 mL/min/1.73m², requiring dialysis or transplant.
2. Which assessment finding is most suggestive of peritonitis in a patient
receiving peritoneal dialysis?
A. Clear dialysate effluent
B. Cloudy dialysate outflow
C. Hyperactive bowel sounds
D. Occasional abdominal cramping
Answer: B
Rationale: Cloudy or opaque effluent is the earliest sign of peritonitis. Other signs include
fever, abdominal pain, and rebound tenderness.
,3. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury
(AKI). Which electrolyte abnormality is the highest priority to monitor?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Rationale: During the oliguric phase, the kidneys’ inability to excrete potassium leads to
hyperkalemia, which can cause life-threatening cardiac arrhythmias.
4. Which medication should the nurse expect to hold prior to a patient
undergoing hemodialysis?
A. Phosphate binders
B. Insulin
C. Calcium supplements
D. Lisinopril
Answer: D
Rationale: Antihypertensives, such as ACE inhibitors (Lisinopril), are usually held because
dialysis can cause hypotension, and the drug might be dialyzed out.
5. A patient with nephrotic syndrome presents with massive edema. What is the
primary physiological cause of this edema?
A. Increased capillary hydrostatic pressure
B. Decreased glomerular permeability
C. Increased sodium retention
D. Decreased serum albumin level
Answer: D
Rationale: In nephrotic syndrome, massive proteinuria leads to hypoalbuminemia, which
decreases plasma oncotic pressure, causing fluid to shift into the interstitium.
, 6. Which clinical manifestation is a classic sign of Acute Post-Streptococcal
Glomerulonephritis (APSGN)?
A. Painless gross hematuria
B. Profuse watery diarrhea
C. Cola-colored or tea-colored urine
D. Hypotension
Answer: C
Rationale: APSGN is characterized by ‘smoky’ or cola-colored urine due to the presence of
RBCs and hemoglobin being degraded by the acidity of the urine.
7. Which intervention is essential when caring for a patient with an
arteriovenous (AV) fistula?
A. Palpate for a thrill and auscultate for a bruit
B. Perform venipuncture in the fistula arm for labs
C. Take blood pressures on the arm with the fistula
D. Apply a tight dressing to the site post-treatment
Answer: A
Rationale: The presence of a thrill (palpable) and bruit (audible) indicates that the fistula
is patent and functioning correctly.
8. A patient has a large renal calculus in the ureter. Which type of Acute Kidney
Injury (AKI) is this patient at risk for?
A. Postrenal
B. Intrarenal
C. Prerenal
D. Intrinsic
Answer: A
Rationale: Postrenal AKI is caused by mechanical obstruction of the outflow of urine, such
as stones, tumors, or BPH.
Disorders (2026 Update) WCU
1. A patient with Chronic Kidney Disease (CKD) has a glomerular filtration rate
(GFR) of 14 mL/min/1.73m². Which stage of CKD does this represent?
A. Stage 3
B. Stage 5
C. Stage 4
D. Stage 2
Answer: B
Rationale: Stage 5 CKD, or End-Stage Renal Disease (ESRD), is defined by a GFR of less
than 15 mL/min/1.73m², requiring dialysis or transplant.
2. Which assessment finding is most suggestive of peritonitis in a patient
receiving peritoneal dialysis?
A. Clear dialysate effluent
B. Cloudy dialysate outflow
C. Hyperactive bowel sounds
D. Occasional abdominal cramping
Answer: B
Rationale: Cloudy or opaque effluent is the earliest sign of peritonitis. Other signs include
fever, abdominal pain, and rebound tenderness.
,3. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury
(AKI). Which electrolyte abnormality is the highest priority to monitor?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Rationale: During the oliguric phase, the kidneys’ inability to excrete potassium leads to
hyperkalemia, which can cause life-threatening cardiac arrhythmias.
4. Which medication should the nurse expect to hold prior to a patient
undergoing hemodialysis?
A. Phosphate binders
B. Insulin
C. Calcium supplements
D. Lisinopril
Answer: D
Rationale: Antihypertensives, such as ACE inhibitors (Lisinopril), are usually held because
dialysis can cause hypotension, and the drug might be dialyzed out.
5. A patient with nephrotic syndrome presents with massive edema. What is the
primary physiological cause of this edema?
A. Increased capillary hydrostatic pressure
B. Decreased glomerular permeability
C. Increased sodium retention
D. Decreased serum albumin level
Answer: D
Rationale: In nephrotic syndrome, massive proteinuria leads to hypoalbuminemia, which
decreases plasma oncotic pressure, causing fluid to shift into the interstitium.
, 6. Which clinical manifestation is a classic sign of Acute Post-Streptococcal
Glomerulonephritis (APSGN)?
A. Painless gross hematuria
B. Profuse watery diarrhea
C. Cola-colored or tea-colored urine
D. Hypotension
Answer: C
Rationale: APSGN is characterized by ‘smoky’ or cola-colored urine due to the presence of
RBCs and hemoglobin being degraded by the acidity of the urine.
7. Which intervention is essential when caring for a patient with an
arteriovenous (AV) fistula?
A. Palpate for a thrill and auscultate for a bruit
B. Perform venipuncture in the fistula arm for labs
C. Take blood pressures on the arm with the fistula
D. Apply a tight dressing to the site post-treatment
Answer: A
Rationale: The presence of a thrill (palpable) and bruit (audible) indicates that the fistula
is patent and functioning correctly.
8. A patient has a large renal calculus in the ureter. Which type of Acute Kidney
Injury (AKI) is this patient at risk for?
A. Postrenal
B. Intrarenal
C. Prerenal
D. Intrinsic
Answer: A
Rationale: Postrenal AKI is caused by mechanical obstruction of the outflow of urine, such
as stones, tumors, or BPH.
