Page 1 of 61
NSG 4100 EXAM 1 QUESTIONS WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
Section 1: Renal System Disorders (Questions 1-30)
1. The nurse is assessing a client suspected of having developed acute
glomerulonephritis. Which manifestation is characteristic of this health
problem?
A. Precipitous decrease in serum creatinine levels
B. Hypotension
C. Hematuria
D. Glucosuria
Rationale: Acute glomerulonephritis typically presents with hematuria,
proteinuria, hypertension, and edema. Serum creatinine levels would increase,
not decrease, due to impaired renal function.
2. A nurse is caring for a client with end-stage renal disease (ESRD) who has
developed uremia. Which finding is most concerning?
A. Pericardial friction rub
B. Mild fatigue
C. Anorexia
D. Pruritus
Rationale: A pericardial friction rub in a client with uremia indicates uremic
pericarditis, a life-threatening complication requiring immediate intervention.
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3. A nurse is teaching a client with chronic kidney disease about dietary
restrictions. Which statement indicates correct understanding?
A. "I will limit my potassium and phosphorus intake."
B. "I will increase my protein intake."
C. "I will drink as much fluid as I want."
D. "I will increase my sodium intake."
Rationale: Clients with CKD require restriction of potassium, phosphorus, sodium,
and fluids. Protein may also be restricted depending on the stage.
4. A nurse is assessing a client receiving peritoneal dialysis. Which finding
indicates peritonitis?
A. Clear dialysate outflow
B. Cloudy dialysate outflow with abdominal pain
C. Weight loss
D. Improved appetite
Rationale: Cloudy dialysate with abdominal pain and fever indicates peritonitis, a
common complication of peritoneal dialysis.
5. A nurse is caring for a client after kidney transplantation. Which finding
indicates acute rejection?
A. Increased urine output
B. Decreased urine output and fever
C. Weight loss
D. Improved laboratory values
Rationale: Acute rejection is characterized by decreased urine output, fever,
tenderness over the graft site, and elevated creatinine.
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6. What is the basic structural and functional unit of the kidney?
A. Nephron
B. Glomerulus
C. Loop of Henle
D. Collecting duct
Rationale: The nephron is the basic structural and functional unit of the kidney,
responsible for filtration, reabsorption, and secretion.
7. A nurse is assessing a client with stage 3 CKD. What is the expected GFR?
A. Greater than 90 mL/min
B. 60-89 mL/min
C. 30-59 mL/min
D. 15-29 mL/min
Rationale: Stage 3 CKD is defined by GFR 30-59 mL/min/1.73 m², representing
moderate kidney damage.
8. A nurse is caring for a client with acute kidney injury (AKI). Which phase is
characterized by a sudden drop in urine output?
A. Oliguric phase
B. Diuretic phase
C. Recovery phase
D. Prerenal phase
Rationale: The oliguric phase of AKI is characterized by urine output less than 400
mL/day.
9. A nurse is teaching a client about preventing contrast-induced nephropathy.
Which instruction is correct?
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A. "You should stop metformin 48 hours before the procedure."
B. "You should increase your fluid intake before the procedure."
C. "You should take NSAIDs for pain."
D. "You should avoid all fluids before the procedure."
Rationale: Metformin should be held 48 hours before and after contrast
administration due to the risk of lactic acidosis.
10. A nurse is assessing a client with nephrotic syndrome. Which finding is
expected?
A. Hematuria
B. Proteinuria greater than 3.5 g/day
C. Hypertension
D. Oliguria
Rationale: Nephrotic syndrome is characterized by massive proteinuria (>3.5
g/day), hypoalbuminemia, edema, and hyperlipidemia.
11. A nurse is caring for a client receiving hemodialysis. Which medication
should be held before dialysis?
A. Antihypertensives
B. Antibiotics
C. Anticonvulsants
D. Vitamins
Rationale: Antihypertensives may be held to prevent hypotension during fluid
removal.
12. A nurse is assessing a client with polycystic kidney disease. Which finding is
expected?
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NSG 4100 EXAM 1 QUESTIONS WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
Section 1: Renal System Disorders (Questions 1-30)
1. The nurse is assessing a client suspected of having developed acute
glomerulonephritis. Which manifestation is characteristic of this health
problem?
A. Precipitous decrease in serum creatinine levels
B. Hypotension
C. Hematuria
D. Glucosuria
Rationale: Acute glomerulonephritis typically presents with hematuria,
proteinuria, hypertension, and edema. Serum creatinine levels would increase,
not decrease, due to impaired renal function.
2. A nurse is caring for a client with end-stage renal disease (ESRD) who has
developed uremia. Which finding is most concerning?
A. Pericardial friction rub
B. Mild fatigue
C. Anorexia
D. Pruritus
Rationale: A pericardial friction rub in a client with uremia indicates uremic
pericarditis, a life-threatening complication requiring immediate intervention.
1|Page
,Page 2 of 61
3. A nurse is teaching a client with chronic kidney disease about dietary
restrictions. Which statement indicates correct understanding?
A. "I will limit my potassium and phosphorus intake."
B. "I will increase my protein intake."
C. "I will drink as much fluid as I want."
D. "I will increase my sodium intake."
Rationale: Clients with CKD require restriction of potassium, phosphorus, sodium,
and fluids. Protein may also be restricted depending on the stage.
4. A nurse is assessing a client receiving peritoneal dialysis. Which finding
indicates peritonitis?
A. Clear dialysate outflow
B. Cloudy dialysate outflow with abdominal pain
C. Weight loss
D. Improved appetite
Rationale: Cloudy dialysate with abdominal pain and fever indicates peritonitis, a
common complication of peritoneal dialysis.
5. A nurse is caring for a client after kidney transplantation. Which finding
indicates acute rejection?
A. Increased urine output
B. Decreased urine output and fever
C. Weight loss
D. Improved laboratory values
Rationale: Acute rejection is characterized by decreased urine output, fever,
tenderness over the graft site, and elevated creatinine.
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,Page 3 of 61
6. What is the basic structural and functional unit of the kidney?
A. Nephron
B. Glomerulus
C. Loop of Henle
D. Collecting duct
Rationale: The nephron is the basic structural and functional unit of the kidney,
responsible for filtration, reabsorption, and secretion.
7. A nurse is assessing a client with stage 3 CKD. What is the expected GFR?
A. Greater than 90 mL/min
B. 60-89 mL/min
C. 30-59 mL/min
D. 15-29 mL/min
Rationale: Stage 3 CKD is defined by GFR 30-59 mL/min/1.73 m², representing
moderate kidney damage.
8. A nurse is caring for a client with acute kidney injury (AKI). Which phase is
characterized by a sudden drop in urine output?
A. Oliguric phase
B. Diuretic phase
C. Recovery phase
D. Prerenal phase
Rationale: The oliguric phase of AKI is characterized by urine output less than 400
mL/day.
9. A nurse is teaching a client about preventing contrast-induced nephropathy.
Which instruction is correct?
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, Page 4 of 61
A. "You should stop metformin 48 hours before the procedure."
B. "You should increase your fluid intake before the procedure."
C. "You should take NSAIDs for pain."
D. "You should avoid all fluids before the procedure."
Rationale: Metformin should be held 48 hours before and after contrast
administration due to the risk of lactic acidosis.
10. A nurse is assessing a client with nephrotic syndrome. Which finding is
expected?
A. Hematuria
B. Proteinuria greater than 3.5 g/day
C. Hypertension
D. Oliguria
Rationale: Nephrotic syndrome is characterized by massive proteinuria (>3.5
g/day), hypoalbuminemia, edema, and hyperlipidemia.
11. A nurse is caring for a client receiving hemodialysis. Which medication
should be held before dialysis?
A. Antihypertensives
B. Antibiotics
C. Anticonvulsants
D. Vitamins
Rationale: Antihypertensives may be held to prevent hypotension during fluid
removal.
12. A nurse is assessing a client with polycystic kidney disease. Which finding is
expected?
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