,NUR 221 Exam 2 Nursing II Questions And Answers 2026/2027 Jersey
College
Q1. Which laboratory value is most useful for trending changes in
glomerular filtration in a patient with suspected acute kidney
injury?
A) Hemoglobin
B) Serum bilirubin
C) Serum creatinine
D) Cardiac troponin
Correct Answer: C) Serum creatinine
Rationale: Serum creatinine rises when glomerular filtration declines and is
commonly followed over time to assess changes in renal function.
Q2. A patient has had severe vomiting and diarrhea for several days
and now has oliguria with an elevated creatinine level. Which type
of acute kidney injury is most likely initially?
A) Prerenal acute kidney injury
B) Intrarenal glomerular injury
C) Postrenal obstruction
D) Chronic end-stage kidney disease
Correct Answer: A) Prerenal acute kidney injury
Rationale: Significant fluid loss can reduce circulating volume and renal
perfusion, producing prerenal acute kidney injury.
Q3. Which finding in a patient with acute kidney injury requires the
most immediate intervention?
A) Mild fatigue
B) Serum creatinine of 2.1 mg/dL
C) Urine output of 28 mL/hr
D) Potassium of 6.8 mEq/L with ECG changes
Correct Answer: D) Potassium of 6.8 mEq/L with ECG changes
Rationale: Severe hyperkalemia can rapidly cause life-threatening cardiac
conduction abnormalities and requires urgent treatment.
Q4. A patient with severe hyperkalemia receives IV insulin with
dextrose. What is the purpose of this treatment?
,A) Increase renal potassium excretion permanently
B) Shift potassium temporarily from the extracellular space into cells
C) Replace intracellular sodium
D) Neutralize potassium in the gastrointestinal tract
Correct Answer: B) Shift potassium temporarily from the extracellular space
into cells
Rationale: Insulin stimulates cellular uptake of potassium, temporarily
lowering the serum concentration. Dextrose is given to reduce the risk of
hypoglycemia.
Q5. Which assessment finding best indicates that renal perfusion is
improving after treatment of severe dehydration?
A) Urine output increases toward an adequate level
B) Peripheral edema worsens
C) Serum potassium rises
D) Crackles develop bilaterally
Correct Answer: A) Urine output increases toward an adequate level
Rationale: Improved urine output suggests better renal blood flow and
filtration when obstruction is not present.
Q6. Which condition is the most common major contributor to
chronic kidney disease in adults?
A) Seasonal allergies
B) Acute appendicitis
C) Diabetes mellitus
D) Migraine headaches
Correct Answer: C) Diabetes mellitus
Rationale: Chronic hyperglycemia can damage glomerular structures over
time, making diabetes a major cause of progressive chronic kidney disease.
Q7. Why does chronic kidney disease commonly produce anemia?
A) Excessive red blood cell destruction occurs in every patient
B) Iron absorption stops completely
C) Platelet production replaces erythrocyte production
D) Diseased kidneys produce less erythropoietin
Correct Answer: D) Diseased kidneys produce less erythropoietin
, Rationale: Erythropoietin stimulates bone marrow production of red blood
cells. Reduced renal production contributes to the normocytic anemia of
chronic kidney disease.
Q8. A patient with chronic kidney disease has persistent
hyperphosphatemia. Which instruction is appropriate for prescribed
phosphate binders?
A) Take them only at bedtime
B) Take them with meals
C) Take them several hours after eating
D) Use them only when phosphate causes symptoms
Correct Answer: B) Take them with meals
Rationale: Phosphate binders work in the gastrointestinal tract by binding
dietary phosphorus before it is absorbed.
Q9. Which finding is most consistent with uremia in advanced
kidney disease?
A) Improved appetite and increased energy
B) Polycythemia
C) Nausea, pruritus, fatigue, and cognitive changes
D) Markedly increased kidney filtration
Correct Answer: C) Nausea, pruritus, fatigue, and cognitive changes
Rationale: Accumulation of metabolic waste products in advanced renal
failure can affect multiple systems and produce gastrointestinal, neurologic,
and integumentary symptoms.
Q10. Which measurement provides the most useful routine indicator
of changing fluid balance in a patient with chronic kidney disease?
A) Daily body weight under consistent conditions
B) Height
C) Pupil diameter
D) Hand circumference
Correct Answer: A) Daily body weight under consistent conditions
Rationale: Short-term changes in body weight largely reflect changes in
total body fluid and are particularly useful for detecting retention or
excessive removal.
College
Q1. Which laboratory value is most useful for trending changes in
glomerular filtration in a patient with suspected acute kidney
injury?
A) Hemoglobin
B) Serum bilirubin
C) Serum creatinine
D) Cardiac troponin
Correct Answer: C) Serum creatinine
Rationale: Serum creatinine rises when glomerular filtration declines and is
commonly followed over time to assess changes in renal function.
Q2. A patient has had severe vomiting and diarrhea for several days
and now has oliguria with an elevated creatinine level. Which type
of acute kidney injury is most likely initially?
A) Prerenal acute kidney injury
B) Intrarenal glomerular injury
C) Postrenal obstruction
D) Chronic end-stage kidney disease
Correct Answer: A) Prerenal acute kidney injury
Rationale: Significant fluid loss can reduce circulating volume and renal
perfusion, producing prerenal acute kidney injury.
Q3. Which finding in a patient with acute kidney injury requires the
most immediate intervention?
A) Mild fatigue
B) Serum creatinine of 2.1 mg/dL
C) Urine output of 28 mL/hr
D) Potassium of 6.8 mEq/L with ECG changes
Correct Answer: D) Potassium of 6.8 mEq/L with ECG changes
Rationale: Severe hyperkalemia can rapidly cause life-threatening cardiac
conduction abnormalities and requires urgent treatment.
Q4. A patient with severe hyperkalemia receives IV insulin with
dextrose. What is the purpose of this treatment?
,A) Increase renal potassium excretion permanently
B) Shift potassium temporarily from the extracellular space into cells
C) Replace intracellular sodium
D) Neutralize potassium in the gastrointestinal tract
Correct Answer: B) Shift potassium temporarily from the extracellular space
into cells
Rationale: Insulin stimulates cellular uptake of potassium, temporarily
lowering the serum concentration. Dextrose is given to reduce the risk of
hypoglycemia.
Q5. Which assessment finding best indicates that renal perfusion is
improving after treatment of severe dehydration?
A) Urine output increases toward an adequate level
B) Peripheral edema worsens
C) Serum potassium rises
D) Crackles develop bilaterally
Correct Answer: A) Urine output increases toward an adequate level
Rationale: Improved urine output suggests better renal blood flow and
filtration when obstruction is not present.
Q6. Which condition is the most common major contributor to
chronic kidney disease in adults?
A) Seasonal allergies
B) Acute appendicitis
C) Diabetes mellitus
D) Migraine headaches
Correct Answer: C) Diabetes mellitus
Rationale: Chronic hyperglycemia can damage glomerular structures over
time, making diabetes a major cause of progressive chronic kidney disease.
Q7. Why does chronic kidney disease commonly produce anemia?
A) Excessive red blood cell destruction occurs in every patient
B) Iron absorption stops completely
C) Platelet production replaces erythrocyte production
D) Diseased kidneys produce less erythropoietin
Correct Answer: D) Diseased kidneys produce less erythropoietin
, Rationale: Erythropoietin stimulates bone marrow production of red blood
cells. Reduced renal production contributes to the normocytic anemia of
chronic kidney disease.
Q8. A patient with chronic kidney disease has persistent
hyperphosphatemia. Which instruction is appropriate for prescribed
phosphate binders?
A) Take them only at bedtime
B) Take them with meals
C) Take them several hours after eating
D) Use them only when phosphate causes symptoms
Correct Answer: B) Take them with meals
Rationale: Phosphate binders work in the gastrointestinal tract by binding
dietary phosphorus before it is absorbed.
Q9. Which finding is most consistent with uremia in advanced
kidney disease?
A) Improved appetite and increased energy
B) Polycythemia
C) Nausea, pruritus, fatigue, and cognitive changes
D) Markedly increased kidney filtration
Correct Answer: C) Nausea, pruritus, fatigue, and cognitive changes
Rationale: Accumulation of metabolic waste products in advanced renal
failure can affect multiple systems and produce gastrointestinal, neurologic,
and integumentary symptoms.
Q10. Which measurement provides the most useful routine indicator
of changing fluid balance in a patient with chronic kidney disease?
A) Daily body weight under consistent conditions
B) Height
C) Pupil diameter
D) Hand circumference
Correct Answer: A) Daily body weight under consistent conditions
Rationale: Short-term changes in body weight largely reflect changes in
total body fluid and are particularly useful for detecting retention or
excessive removal.
