NUR 265 Exam 1 V1, V2 and V3|
Questions and Answers | 2026 Update |
100% Correct - Galen College of Nursing.
Renal – Acute Kidney Injury (AKI)
1. A client is admitted with acute kidney injury (AKI) secondary to
dehydration. Which laboratory finding is most consistent with
a prerenal cause of AKI?
A) Urine sodium > 40 mEq/L
B) Fractional excretion of sodium (FeNa) < 1%
C) Urine osmolality < 350 mOsm/kg
D) Presence of granular casts
Correct ,,,,answer,,,: B
Rationale: In prerenal AKI, the kidneys are functioning but hypoperfused;
they avidly reabsorb sodium, leading to a FeNa < 1%. Urine sodium is
typically low (< 20 mEq/L) and urine osmolality is high (> 500 mOsm/kg).
Granular casts ("muddy brown casts") suggest intrarenal injury. (Source:
Galen NUR 265 Enrichment – AKI diagnostics)
2. During the diuretic phase of acute kidney injury, the nurse should
prioritize which intervention?
A) Restrict daily fluid intake to 1 liter
B) Administer potassium-sparing diuretics as ordered
,C) Replace fluids and monitor electrolytes closely
D) Limit protein intake to 0.6 g/kg/day
Correct ,,,,answer,,,: C
Rationale: The diuretic phase is characterized by a high urine output (up
to 3–6 L/day). The kidneys may excrete large amounts of water and
electrolytes, leading to dehydration, hyponatremia, and hypokalemia.
Fluid and electrolyte replacement is critical. [Source: Galen Advanced
Medsurg NUR265 Exam 1 – AKI]
3. A client with AKI has a serum potassium of 6.9 mEq/L. Which ECG
change is most characteristic of hyperkalemia?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Prolonged PR interval
Correct ,,,,answer,,,: C
Rationale: Tall, peaked ("tented") T waves are the earliest ECG sign of
hyperkalemia. As potassium rises, widened QRS, loss of P wave, and sine
wave pattern can precede cardiac arrest.
4. A client with AKI in the oliguric phase has a potassium level of 6.2
mEq/L. Which intervention should the nurse anticipate first?
A) Administer oral sodium polystyrene sulfonate
B) Initiate a potassium-restricted diet
,C) Prepare for emergent hemodialysis
D) Give calcium gluconate IV
Correct ,,,,answer,,,: D
Rationale: Calcium gluconate is the first intervention for severe
hyperkalemia when ECG changes are present or potassium is dangerously
high. It stabilizes the cardiac membrane but does not lower potassium.
Insulin + glucose, albuterol, and sodium polystyrene sulfonate are used to
shift or remove potassium, with dialysis for refractory cases.
5. A client with AKI has a blood urea nitrogen (BUN) of 85 mg/dL and
creatinine of 5.2 mg/dL. Which assessment finding is most consistent
with uremia?
A) Hyperactive bowel sounds
B) Pericardial friction rub
C) Pink, well-hydrated mucous membranes
D) Bounding peripheral pulses
Correct ,,,,answer,,,: B
Rationale: Uremic pericarditis can occur when BUN is very high and
manifests as a pericardial friction rub. Pericarditis is a medical emergency
in AKI as it can progress to cardiac tamponade.
6. A client with AKI is receiving a loop diuretic. Which outcome indicates
the medication is effective?
, A) Serum potassium decreases to 3.8 mEq/L
B) Urine output increases to 1,200 mL/day
C) Blood pressure rises to 142/88 mmHg
D) Urine specific gravity is 1.015
Correct ,,,,answer,,,: B
Rationale: Loop diuretics (furosemide, bumetanide, torsemide) are used
in AKI to convert oliguric to non-oliguric renal failure and manage volume
overload, provided urinary elimination is still present. They are not
effective in ESKD. [Source: Galen NUR265 Exam 1 Notes]
7. A client with AKI has developed metabolic acidosis. Which arterial
blood gas (ABG) finding supports this diagnosis?
A) pH 7.48, PaCO₂ 32, HCO₃⁻ 26
B) pH 7.32, PaCO₂ 35, HCO₃⁻ 18
C) pH 7.38, PaCO₂ 45, HCO₃⁻ 24
D) pH 7.25, PaCO₂ 50, HCO₃⁻ 22
Correct ,,,,answer,,,: B
Rationale: Metabolic acidosis = low pH (< 7.35) and low HCO₃⁻ (< 22). In
AKI, the kidneys cannot excrete hydrogen ions or reabsorb bicarbonate.
8. The nurse is assessing a client in the oliguric phase of AKI. Which
finding is most concerning?
A) Crackles in lung bases and 2+ pitting edema
B) Serum potassium of 5.1 mEq/L
Questions and Answers | 2026 Update |
100% Correct - Galen College of Nursing.
Renal – Acute Kidney Injury (AKI)
1. A client is admitted with acute kidney injury (AKI) secondary to
dehydration. Which laboratory finding is most consistent with
a prerenal cause of AKI?
A) Urine sodium > 40 mEq/L
B) Fractional excretion of sodium (FeNa) < 1%
C) Urine osmolality < 350 mOsm/kg
D) Presence of granular casts
Correct ,,,,answer,,,: B
Rationale: In prerenal AKI, the kidneys are functioning but hypoperfused;
they avidly reabsorb sodium, leading to a FeNa < 1%. Urine sodium is
typically low (< 20 mEq/L) and urine osmolality is high (> 500 mOsm/kg).
Granular casts ("muddy brown casts") suggest intrarenal injury. (Source:
Galen NUR 265 Enrichment – AKI diagnostics)
2. During the diuretic phase of acute kidney injury, the nurse should
prioritize which intervention?
A) Restrict daily fluid intake to 1 liter
B) Administer potassium-sparing diuretics as ordered
,C) Replace fluids and monitor electrolytes closely
D) Limit protein intake to 0.6 g/kg/day
Correct ,,,,answer,,,: C
Rationale: The diuretic phase is characterized by a high urine output (up
to 3–6 L/day). The kidneys may excrete large amounts of water and
electrolytes, leading to dehydration, hyponatremia, and hypokalemia.
Fluid and electrolyte replacement is critical. [Source: Galen Advanced
Medsurg NUR265 Exam 1 – AKI]
3. A client with AKI has a serum potassium of 6.9 mEq/L. Which ECG
change is most characteristic of hyperkalemia?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Prolonged PR interval
Correct ,,,,answer,,,: C
Rationale: Tall, peaked ("tented") T waves are the earliest ECG sign of
hyperkalemia. As potassium rises, widened QRS, loss of P wave, and sine
wave pattern can precede cardiac arrest.
4. A client with AKI in the oliguric phase has a potassium level of 6.2
mEq/L. Which intervention should the nurse anticipate first?
A) Administer oral sodium polystyrene sulfonate
B) Initiate a potassium-restricted diet
,C) Prepare for emergent hemodialysis
D) Give calcium gluconate IV
Correct ,,,,answer,,,: D
Rationale: Calcium gluconate is the first intervention for severe
hyperkalemia when ECG changes are present or potassium is dangerously
high. It stabilizes the cardiac membrane but does not lower potassium.
Insulin + glucose, albuterol, and sodium polystyrene sulfonate are used to
shift or remove potassium, with dialysis for refractory cases.
5. A client with AKI has a blood urea nitrogen (BUN) of 85 mg/dL and
creatinine of 5.2 mg/dL. Which assessment finding is most consistent
with uremia?
A) Hyperactive bowel sounds
B) Pericardial friction rub
C) Pink, well-hydrated mucous membranes
D) Bounding peripheral pulses
Correct ,,,,answer,,,: B
Rationale: Uremic pericarditis can occur when BUN is very high and
manifests as a pericardial friction rub. Pericarditis is a medical emergency
in AKI as it can progress to cardiac tamponade.
6. A client with AKI is receiving a loop diuretic. Which outcome indicates
the medication is effective?
, A) Serum potassium decreases to 3.8 mEq/L
B) Urine output increases to 1,200 mL/day
C) Blood pressure rises to 142/88 mmHg
D) Urine specific gravity is 1.015
Correct ,,,,answer,,,: B
Rationale: Loop diuretics (furosemide, bumetanide, torsemide) are used
in AKI to convert oliguric to non-oliguric renal failure and manage volume
overload, provided urinary elimination is still present. They are not
effective in ESKD. [Source: Galen NUR265 Exam 1 Notes]
7. A client with AKI has developed metabolic acidosis. Which arterial
blood gas (ABG) finding supports this diagnosis?
A) pH 7.48, PaCO₂ 32, HCO₃⁻ 26
B) pH 7.32, PaCO₂ 35, HCO₃⁻ 18
C) pH 7.38, PaCO₂ 45, HCO₃⁻ 24
D) pH 7.25, PaCO₂ 50, HCO₃⁻ 22
Correct ,,,,answer,,,: B
Rationale: Metabolic acidosis = low pH (< 7.35) and low HCO₃⁻ (< 22). In
AKI, the kidneys cannot excrete hydrogen ions or reabsorb bicarbonate.
8. The nurse is assessing a client in the oliguric phase of AKI. Which
finding is most concerning?
A) Crackles in lung bases and 2+ pitting edema
B) Serum potassium of 5.1 mEq/L
