NRSG 3420 EXAM 3
(NORTHEASTERN) LATEST
2026/ 2027 TEST BANK| NRSG
3420 NURSING CARE OF
ADULTS 2 EXAM 3
1.
A client with severe vomiting and diarrhea develops acute kidney
injury (AKI). Which finding is most consistent with prerenal AKI?
A. Red blood cell casts
B. Elevated BUN and creatinine
C. Hydronephrosis
D. Glomerular inflammation
Rationale: Prerenal AKI results from decreased renal perfusion.
Reduced filtration causes nitrogenous waste products such as BUN
and creatinine to accumulate.
2.
Which assessment finding is most concerning in a client with acute
kidney injury?
A. Urine output of 45 mL/hr
B. BUN of 38 mg/dL
C. Serum potassium of 6.4 mEq/L
D. Hemoglobin of 10.8 g/dL
,Rationale: Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias and requires prompt intervention.
3.
A client with AKI has oliguria. Which nursing intervention is
appropriate?
A. Encourage unlimited oral fluids
B. Administer potassium supplements
C. Monitor intake and output closely
D. Encourage a high-sodium diet
Rationale: Fluid balance can change rapidly in AKI. Accurate intake
and output monitoring helps detect fluid retention or worsening
renal function.
4.
Which urine output most strongly suggests oliguria in an adult?
A. 1,500 mL/day
B. 1,000 mL/day
C. 700 mL/day
D. 300 mL/day
Rationale: Oliguria is commonly defined as urine output below
approximately 400 mL/day in adults.
5.
A client with AKI develops crackles, dyspnea, and peripheral edema.
Which complication should the nurse suspect?
A. Hypovolemia
B. Fluid overload
C. Hypoglycemia
D. Metabolic alkalosis
,Rationale: Reduced renal excretion can cause sodium and water
retention, resulting in edema and pulmonary congestion.
6.
Which laboratory value is most important for the nurse to monitor in
severe AKI?
A. Albumin
B. Calcium only
C. Potassium
D. Cholesterol
Rationale: Impaired renal potassium excretion can produce
dangerous hyperkalemia and dysrhythmias.
7.
A client with AKI has a potassium level of 6.8 mEq/L and peaked T
waves. Which action is the priority?
A. Encourage ambulation
B. Administer oral iron
C. Notify the provider and prepare for emergency treatment of
hyperkalemia
D. Restrict dietary phosphorus only
Rationale: Severe hyperkalemia with ECG changes is a medical
emergency because ventricular dysrhythmias and cardiac arrest
may occur.
8.
Which condition is a common cause of prerenal AKI?
A. Kidney stone obstructing the ureter
B. Acute glomerulonephritis
C. Severe dehydration
D. Polycystic kidney disease
, Rationale: Prerenal AKI occurs when renal perfusion falls,
commonly because of dehydration, hemorrhage, or shock.
9.
Which condition is classified as postrenal AKI?
A. Septic shock
B. Acute tubular necrosis
C. Glomerulonephritis
D. Urinary tract obstruction
Rationale: Postrenal AKI results from obstruction of urine outflow,
such as stones, strictures, tumors, or enlarged prostate.
10.
A client with AKI has a urinary catheter. Which finding requires
immediate assessment?
A. Clear yellow urine
B. Urine output of 60 mL/hr
C. Sudden absence of urine output
D. Mild urinary sediment
Rationale: Sudden anuria may indicate catheter obstruction, severe
renal deterioration, or urinary tract obstruction and requires
prompt assessment.
11.
Which client is at greatest risk for acute tubular necrosis?
A. Client with seasonal allergies
B. Client with mild hypertension
C. Client who experienced prolonged hypotension
D. Client with controlled hypothyroidism
Rationale: Prolonged renal ischemia from hypotension can damage
renal tubular cells and cause acute tubular necrosis.
(NORTHEASTERN) LATEST
2026/ 2027 TEST BANK| NRSG
3420 NURSING CARE OF
ADULTS 2 EXAM 3
1.
A client with severe vomiting and diarrhea develops acute kidney
injury (AKI). Which finding is most consistent with prerenal AKI?
A. Red blood cell casts
B. Elevated BUN and creatinine
C. Hydronephrosis
D. Glomerular inflammation
Rationale: Prerenal AKI results from decreased renal perfusion.
Reduced filtration causes nitrogenous waste products such as BUN
and creatinine to accumulate.
2.
Which assessment finding is most concerning in a client with acute
kidney injury?
A. Urine output of 45 mL/hr
B. BUN of 38 mg/dL
C. Serum potassium of 6.4 mEq/L
D. Hemoglobin of 10.8 g/dL
,Rationale: Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias and requires prompt intervention.
3.
A client with AKI has oliguria. Which nursing intervention is
appropriate?
A. Encourage unlimited oral fluids
B. Administer potassium supplements
C. Monitor intake and output closely
D. Encourage a high-sodium diet
Rationale: Fluid balance can change rapidly in AKI. Accurate intake
and output monitoring helps detect fluid retention or worsening
renal function.
4.
Which urine output most strongly suggests oliguria in an adult?
A. 1,500 mL/day
B. 1,000 mL/day
C. 700 mL/day
D. 300 mL/day
Rationale: Oliguria is commonly defined as urine output below
approximately 400 mL/day in adults.
5.
A client with AKI develops crackles, dyspnea, and peripheral edema.
Which complication should the nurse suspect?
A. Hypovolemia
B. Fluid overload
C. Hypoglycemia
D. Metabolic alkalosis
,Rationale: Reduced renal excretion can cause sodium and water
retention, resulting in edema and pulmonary congestion.
6.
Which laboratory value is most important for the nurse to monitor in
severe AKI?
A. Albumin
B. Calcium only
C. Potassium
D. Cholesterol
Rationale: Impaired renal potassium excretion can produce
dangerous hyperkalemia and dysrhythmias.
7.
A client with AKI has a potassium level of 6.8 mEq/L and peaked T
waves. Which action is the priority?
A. Encourage ambulation
B. Administer oral iron
C. Notify the provider and prepare for emergency treatment of
hyperkalemia
D. Restrict dietary phosphorus only
Rationale: Severe hyperkalemia with ECG changes is a medical
emergency because ventricular dysrhythmias and cardiac arrest
may occur.
8.
Which condition is a common cause of prerenal AKI?
A. Kidney stone obstructing the ureter
B. Acute glomerulonephritis
C. Severe dehydration
D. Polycystic kidney disease
, Rationale: Prerenal AKI occurs when renal perfusion falls,
commonly because of dehydration, hemorrhage, or shock.
9.
Which condition is classified as postrenal AKI?
A. Septic shock
B. Acute tubular necrosis
C. Glomerulonephritis
D. Urinary tract obstruction
Rationale: Postrenal AKI results from obstruction of urine outflow,
such as stones, strictures, tumors, or enlarged prostate.
10.
A client with AKI has a urinary catheter. Which finding requires
immediate assessment?
A. Clear yellow urine
B. Urine output of 60 mL/hr
C. Sudden absence of urine output
D. Mild urinary sediment
Rationale: Sudden anuria may indicate catheter obstruction, severe
renal deterioration, or urinary tract obstruction and requires
prompt assessment.
11.
Which client is at greatest risk for acute tubular necrosis?
A. Client with seasonal allergies
B. Client with mild hypertension
C. Client who experienced prolonged hypotension
D. Client with controlled hypothyroidism
Rationale: Prolonged renal ischemia from hypotension can damage
renal tubular cells and cause acute tubular necrosis.
