MD3 EXAMINATION SHEET 2025/2026 QUESTIONS WITH
ANSWERS GRADED A+
✔✔Acute Kidney Injury (AKI) - ✔✔Sudden cessation of renal function that occurs when
blood flow to the kidneys is significantly compromised. Clinical manifestations occur
abruptly with AKI.
✔✔Acute Kidney Injury (AKI) Electrolyte Imbalances - ✔✔Hypernatremia or
Hyponatremia
Hyperkalemia
Hyperphosphatemia
Hypocalcemia
✔✔Acute Kidney Injury (AKI) Treatment - ✔✔IV Fluids (Promotes kidney profusion)
Diuretics (Increase filtration of blood by the kidney) Continuous Renal Replacement
Therapy
Hemodialysis
Peritoneal Dialysis
✔✔Functions of Dialysis - ✔✔Rids body of excess fluids & electrolytes
Achieves acid-base balance
Eliminates waste
Restores homeostasis
✔✔Hemodialysis - ✔✔Shunts blood from the body through a dialyzer and back into
circulation
Requires Vascular Access
Based on manifestations, not glomerular filtration rater
✔✔Peritoneal Dialysis - ✔✔Involves instillation of hypertonic dialysate solution into the
peritoneal cavity and subsequent dwell times
Drain the dialysate that contains the waste products
The peritoneum serves as the filtration membrane
✔✔Indications for Peritoneal Dialysis - ✔✔Unable to tolerate anticoagulation
Difficulty w/ vascular access
Chronic Infections or Unstable
Have Chronic Disease (Diabetes, Hypertension, CHF)
✔✔Indications for Hemodialysis - ✔✔Renal Insufficiency
Acute Kidney Injury (AKI)
, Chronic Kidney Disease (CKD)
Medication or Illicit Drug Toxicity
Persistent Hyperkalemia
Hypervolemia that does NOT respond to diuretics
✔✔Chronic Kidney Disease (CKD) - ✔✔Progressive, irreversible kidney disease.
◯ A client who has a diagnosis of CKD may be asymptomatic except during periods of
stress (infection, surgery, trauma). As kidney dysfunction progresses, clinical
manifestations become apparent.
◯ Older adult clients are at an increased risk for chronic kidney disease related to the
normal aging process (decreased number of functioning nephrons, decreased GFR).
◯ Older adults clients who are on bed rest, confused, have a lack of thirst, and do not
have easy access to water are at a higher risk for dehydration leading to chronic kidney
disease.
Dialysis or kidney transplantation can maintain life, but neither is a cure for CKD.
✔✔Diabetic Nephropathy - ✔✔Damage to the kidneys from prolonged elevated blood
glucose levels/dehydration
The blood vessels near the kidneys become more permeable , allowing fluids to escape
and can become scarred over time
✔✔Diabetic Nephropathy Patient Education - ✔✔Yearly urine analysis, BUN, Serum
creatinine
Encourage to avoid soda, alcohol, toxic levels of Acetaminophen and NSAIDs
Teach client to consume 2 to 3 L of fluid per day from food and beverage sources and
to drink adequate amount of water
Tell clients report decrease in output to provider
✔✔Urolithiasis (kidney stones) - ✔✔The presence of calculi (stones) in the urinary tract
Majority of calculi are composed of calcium phosphate or calcium oxalate
Can contain other substances such as uric acid, struvite, cysteine
✔✔Urolithiasis (kidney stones) S/S - ✔✔Severe Pain
Urinary frequency or dysuria
Fever
Diaphoresis
ANSWERS GRADED A+
✔✔Acute Kidney Injury (AKI) - ✔✔Sudden cessation of renal function that occurs when
blood flow to the kidneys is significantly compromised. Clinical manifestations occur
abruptly with AKI.
✔✔Acute Kidney Injury (AKI) Electrolyte Imbalances - ✔✔Hypernatremia or
Hyponatremia
Hyperkalemia
Hyperphosphatemia
Hypocalcemia
✔✔Acute Kidney Injury (AKI) Treatment - ✔✔IV Fluids (Promotes kidney profusion)
Diuretics (Increase filtration of blood by the kidney) Continuous Renal Replacement
Therapy
Hemodialysis
Peritoneal Dialysis
✔✔Functions of Dialysis - ✔✔Rids body of excess fluids & electrolytes
Achieves acid-base balance
Eliminates waste
Restores homeostasis
✔✔Hemodialysis - ✔✔Shunts blood from the body through a dialyzer and back into
circulation
Requires Vascular Access
Based on manifestations, not glomerular filtration rater
✔✔Peritoneal Dialysis - ✔✔Involves instillation of hypertonic dialysate solution into the
peritoneal cavity and subsequent dwell times
Drain the dialysate that contains the waste products
The peritoneum serves as the filtration membrane
✔✔Indications for Peritoneal Dialysis - ✔✔Unable to tolerate anticoagulation
Difficulty w/ vascular access
Chronic Infections or Unstable
Have Chronic Disease (Diabetes, Hypertension, CHF)
✔✔Indications for Hemodialysis - ✔✔Renal Insufficiency
Acute Kidney Injury (AKI)
, Chronic Kidney Disease (CKD)
Medication or Illicit Drug Toxicity
Persistent Hyperkalemia
Hypervolemia that does NOT respond to diuretics
✔✔Chronic Kidney Disease (CKD) - ✔✔Progressive, irreversible kidney disease.
◯ A client who has a diagnosis of CKD may be asymptomatic except during periods of
stress (infection, surgery, trauma). As kidney dysfunction progresses, clinical
manifestations become apparent.
◯ Older adult clients are at an increased risk for chronic kidney disease related to the
normal aging process (decreased number of functioning nephrons, decreased GFR).
◯ Older adults clients who are on bed rest, confused, have a lack of thirst, and do not
have easy access to water are at a higher risk for dehydration leading to chronic kidney
disease.
Dialysis or kidney transplantation can maintain life, but neither is a cure for CKD.
✔✔Diabetic Nephropathy - ✔✔Damage to the kidneys from prolonged elevated blood
glucose levels/dehydration
The blood vessels near the kidneys become more permeable , allowing fluids to escape
and can become scarred over time
✔✔Diabetic Nephropathy Patient Education - ✔✔Yearly urine analysis, BUN, Serum
creatinine
Encourage to avoid soda, alcohol, toxic levels of Acetaminophen and NSAIDs
Teach client to consume 2 to 3 L of fluid per day from food and beverage sources and
to drink adequate amount of water
Tell clients report decrease in output to provider
✔✔Urolithiasis (kidney stones) - ✔✔The presence of calculi (stones) in the urinary tract
Majority of calculi are composed of calcium phosphate or calcium oxalate
Can contain other substances such as uric acid, struvite, cysteine
✔✔Urolithiasis (kidney stones) S/S - ✔✔Severe Pain
Urinary frequency or dysuria
Fever
Diaphoresis
