Renal Nursing Exam Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download
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1. A client with chronic kidney disease is being assessed for complications
related to decreased erythropoietin production. Which finding should the
nurse expect?
A. Polycythemia
B. Increased platelet production
C. Anemia
D. Leukocytosis
Answer: C. Anemia
Rationale: The kidneys normally produce erythropoietin, a hormone that stimulates
red blood cell production in the bone marrow. As kidney function declines,
erythropoietin production decreases, commonly resulting in normocytic anemia.
The client may experience fatigue, weakness, pallor, and reduced exercise tolerance.
Polycythemia, thrombocytosis, and leukocytosis are not expected consequences of
reduced renal erythropoietin production.
2. Which laboratory value is most directly used to evaluate the kidneys' ability
to filter blood?
A. Serum amylase
B. Estimated glomerular filtration rate
C. Serum bilirubin
D. Troponin level
Answer: B. Estimated glomerular filtration rate
,Rationale: Estimated glomerular filtration rate, or eGFR, is a major indicator of
kidney filtration function. It estimates how much blood the kidneys filter per minute
and is used to classify and monitor chronic kidney disease. A declining eGFR
generally indicates worsening renal function. The other laboratory values primarily
evaluate pancreatic, hepatic, or cardiac conditions rather than renal filtration.
3. A client with acute kidney injury has a rapidly increasing serum creatinine
level. How should the nurse interpret this finding?
A. Improved renal filtration
B. Decreased muscle metabolism
C. Worsening kidney function
D. Increased erythropoietin production
Answer: C. Worsening kidney function
Rationale: Creatinine is a metabolic waste product that is normally removed from
the blood by the kidneys. When renal filtration decreases, creatinine accumulates in
the bloodstream. A rapidly rising serum creatinine in a client with acute kidney
injury is therefore concerning for worsening renal function. Trends in creatinine are
particularly important when evaluating whether kidney injury is improving or
progressing.
4. Which assessment finding is most characteristic of fluid volume overload in a
client with renal failure?
A. Dry mucous membranes
B. Hypotension
C. Peripheral edema
D. Poor skin turgor
Answer: C. Peripheral edema
Rationale: When the kidneys cannot adequately excrete sodium and water, fluid
accumulates in the intravascular and interstitial spaces. This can cause dependent
or peripheral edema, rapid weight gain, hypertension, pulmonary crackles, and
,potentially pulmonary edema. Dry mucous membranes, hypotension, and poor skin
turgor are more consistent with fluid volume deficit rather than fluid excess.
5. A nurse is teaching a client with chronic kidney disease about daily weights.
Which instruction is most appropriate?
A. Weigh at different times each day
B. Weigh immediately after meals
C. Weigh at approximately the same time each day
D. Weigh only when edema is present
Answer: C. Weigh at approximately the same time each day
Rationale: Daily weight provides an important estimate of changes in fluid balance.
For reliable comparison, the client should weigh at approximately the same time
each day, preferably under similar conditions, such as after voiding and before
breakfast. Rapid weight gain can indicate fluid retention. Waiting until visible
edema appears may delay recognition of significant fluid accumulation.
6. Which electrolyte imbalance is particularly dangerous in a client with severe
renal failure?
A. Hyperkalemia
B. Hypochloremia
C. Mild hypocalcemia
D. Hypermagnesemia
Answer: A. Hyperkalemia
Rationale: The kidneys normally excrete potassium. Severe renal dysfunction can
therefore cause potassium accumulation. Hyperkalemia is especially dangerous
because it can produce cardiac conduction abnormalities, dysrhythmias, muscle
weakness, and potentially cardiac arrest. Continuous cardiac monitoring may be
required for clients with significant hyperkalemia. Other electrolyte abnormalities
may occur with renal failure, but potassium elevation can become immediately life-
threatening.
, 7. A client with chronic kidney disease has a serum potassium level of 6.4
mEq/L. Which action is the nurse's priority?
A. Encourage a high-potassium snack
B. Place the client on cardiac monitoring
C. Restrict dietary calcium
D. Encourage vigorous exercise
Answer: B. Place the client on cardiac monitoring
Rationale: A potassium level of 6.4 mEq/L represents significant hyperkalemia and
places the client at risk for life-threatening cardiac dysrhythmias. Cardiac
monitoring allows early recognition of ECG changes and dysrhythmias while
emergency treatment is initiated as prescribed. High-potassium foods and
strenuous activity would not be appropriate interventions for significant
hyperkalemia.
8. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval
C. ST elevation caused by myocardial infarction
D. Narrowed P waves with no other changes
Answer: A. Peaked T waves
Rationale: Hyperkalemia can initially cause tall, peaked T waves on the ECG. With
increasing potassium levels, additional changes can include PR prolongation, P-
wave flattening or disappearance, QRS widening, ventricular dysrhythmias, and
eventually a sine-wave pattern. ECG changes associated with hyperkalemia require
prompt recognition and treatment because severe hyperkalemia can lead to cardiac
arrest.
9. Which dietary instruction is appropriate for many clients with advanced
chronic kidney disease?
A. Consume unlimited processed foods
B. Follow the prescribed restrictions on sodium, potassium, phosphorus, and fluids
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download
1. A client with chronic kidney disease is being assessed for complications
related to decreased erythropoietin production. Which finding should the
nurse expect?
A. Polycythemia
B. Increased platelet production
C. Anemia
D. Leukocytosis
Answer: C. Anemia
Rationale: The kidneys normally produce erythropoietin, a hormone that stimulates
red blood cell production in the bone marrow. As kidney function declines,
erythropoietin production decreases, commonly resulting in normocytic anemia.
The client may experience fatigue, weakness, pallor, and reduced exercise tolerance.
Polycythemia, thrombocytosis, and leukocytosis are not expected consequences of
reduced renal erythropoietin production.
2. Which laboratory value is most directly used to evaluate the kidneys' ability
to filter blood?
A. Serum amylase
B. Estimated glomerular filtration rate
C. Serum bilirubin
D. Troponin level
Answer: B. Estimated glomerular filtration rate
,Rationale: Estimated glomerular filtration rate, or eGFR, is a major indicator of
kidney filtration function. It estimates how much blood the kidneys filter per minute
and is used to classify and monitor chronic kidney disease. A declining eGFR
generally indicates worsening renal function. The other laboratory values primarily
evaluate pancreatic, hepatic, or cardiac conditions rather than renal filtration.
3. A client with acute kidney injury has a rapidly increasing serum creatinine
level. How should the nurse interpret this finding?
A. Improved renal filtration
B. Decreased muscle metabolism
C. Worsening kidney function
D. Increased erythropoietin production
Answer: C. Worsening kidney function
Rationale: Creatinine is a metabolic waste product that is normally removed from
the blood by the kidneys. When renal filtration decreases, creatinine accumulates in
the bloodstream. A rapidly rising serum creatinine in a client with acute kidney
injury is therefore concerning for worsening renal function. Trends in creatinine are
particularly important when evaluating whether kidney injury is improving or
progressing.
4. Which assessment finding is most characteristic of fluid volume overload in a
client with renal failure?
A. Dry mucous membranes
B. Hypotension
C. Peripheral edema
D. Poor skin turgor
Answer: C. Peripheral edema
Rationale: When the kidneys cannot adequately excrete sodium and water, fluid
accumulates in the intravascular and interstitial spaces. This can cause dependent
or peripheral edema, rapid weight gain, hypertension, pulmonary crackles, and
,potentially pulmonary edema. Dry mucous membranes, hypotension, and poor skin
turgor are more consistent with fluid volume deficit rather than fluid excess.
5. A nurse is teaching a client with chronic kidney disease about daily weights.
Which instruction is most appropriate?
A. Weigh at different times each day
B. Weigh immediately after meals
C. Weigh at approximately the same time each day
D. Weigh only when edema is present
Answer: C. Weigh at approximately the same time each day
Rationale: Daily weight provides an important estimate of changes in fluid balance.
For reliable comparison, the client should weigh at approximately the same time
each day, preferably under similar conditions, such as after voiding and before
breakfast. Rapid weight gain can indicate fluid retention. Waiting until visible
edema appears may delay recognition of significant fluid accumulation.
6. Which electrolyte imbalance is particularly dangerous in a client with severe
renal failure?
A. Hyperkalemia
B. Hypochloremia
C. Mild hypocalcemia
D. Hypermagnesemia
Answer: A. Hyperkalemia
Rationale: The kidneys normally excrete potassium. Severe renal dysfunction can
therefore cause potassium accumulation. Hyperkalemia is especially dangerous
because it can produce cardiac conduction abnormalities, dysrhythmias, muscle
weakness, and potentially cardiac arrest. Continuous cardiac monitoring may be
required for clients with significant hyperkalemia. Other electrolyte abnormalities
may occur with renal failure, but potassium elevation can become immediately life-
threatening.
, 7. A client with chronic kidney disease has a serum potassium level of 6.4
mEq/L. Which action is the nurse's priority?
A. Encourage a high-potassium snack
B. Place the client on cardiac monitoring
C. Restrict dietary calcium
D. Encourage vigorous exercise
Answer: B. Place the client on cardiac monitoring
Rationale: A potassium level of 6.4 mEq/L represents significant hyperkalemia and
places the client at risk for life-threatening cardiac dysrhythmias. Cardiac
monitoring allows early recognition of ECG changes and dysrhythmias while
emergency treatment is initiated as prescribed. High-potassium foods and
strenuous activity would not be appropriate interventions for significant
hyperkalemia.
8. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval
C. ST elevation caused by myocardial infarction
D. Narrowed P waves with no other changes
Answer: A. Peaked T waves
Rationale: Hyperkalemia can initially cause tall, peaked T waves on the ECG. With
increasing potassium levels, additional changes can include PR prolongation, P-
wave flattening or disappearance, QRS widening, ventricular dysrhythmias, and
eventually a sine-wave pattern. ECG changes associated with hyperkalemia require
prompt recognition and treatment because severe hyperkalemia can lead to cardiac
arrest.
9. Which dietary instruction is appropriate for many clients with advanced
chronic kidney disease?
A. Consume unlimited processed foods
B. Follow the prescribed restrictions on sodium, potassium, phosphorus, and fluids
