NSG 252 – Exam 1 Study Guide, Nursing Program2025-2026 –
comprehensive exam preparation notes
AKI - correct answer Sudden decline in kidney function (hours to days)
CKD - correct answer Progressive, irreversible loss of kidney function (moths to years)
AKI - correct answer Causes:
- hypoperfusion (pre-)
- damage to nephrons (intra-)
- obstruction (post-)
CKD - correct answer Leads to:
- F&E imbalance
- metabolic acidosis, anemia, bone disease, uremia
AKI, CKD - correct answer Major Nursing Priorities:
- Monitor fluid balance, electrolytes (esp. K+)
- Manage blood pressure
- Prevent infection
- Patient education (dialysis, meds, nutrition)
CKD - correct answer Dietary Modifications:
- Low sodium, potassium, phosphorus
- Adequate calories
- Protein restriction
A - correct answer A client with AKI has a serum potassium level of 6.2 mEq/L. Which intervention is the
priority?
A. Place the client on cardiac monitoring
B. Restrict dietary potassium intake
C. Administer phosphate binders
D. Encourage oral fluids
B - correct answer A client with stage 4 CKD asks why they are prescribed epoetin alfa. Which response
is most accurate?
,A. "It helps remove excess potassium."
B. "It stimulates your body to produce red blood cells."
C. "It improves your kidney function."
D. "It helps lower your blood pressure."
anemia - correct answer CKD causes decreased erythropoietin, leading to ______.
C - correct answer Which assessment finding indicates peritoneal dialysis is effective?
A. Serum potassium rises to 6.0 mEq/L
B. The dialysate outflow is cloudy
C. The client's weight decreases
D. The client develops crackles in the lungs
excess fluid - correct answer Effective dialysis removes ______.
peritonitis - correct answer Cloudy outflow during peritoneal dialysis indicates ______.
fluid overload - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and
swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the highlighted symptom is indicative of ______.
worsening kidney function - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia,
pruritus, and swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the client's BUN and creatinine levels are indicative of ______.
anemia - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and swelling in
his legs
,History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the client's Hgb level is indicative of ______.
dysrhythmia - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and
swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the client's K+ level puts him at risk for ______.
B, C, E - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and swelling in
his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
Which problems are priority for this client? Select all that apply.
A. hypernatremia
B. hyperkalemia
C. fluid overload
D. hypoxia
E. anemia
place on cardiac monitoring - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia,
pruritus, and swelling in his legs
, History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
What is the priority nursing action based on the scenario?
prepare to administer IV insulin + glucose and calcium gluconate for hyperkalemia - correct answer Mr.
Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
After placing the client on cardiac monitoring, the nurse should ______.
fluids, sodium - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and
swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse should restrict the client's ______ intake.
epoetin alfa, iron supplements - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia,
pruritus, and swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
In order to treat the client's anemia, the nurse will administer ______.
comprehensive exam preparation notes
AKI - correct answer Sudden decline in kidney function (hours to days)
CKD - correct answer Progressive, irreversible loss of kidney function (moths to years)
AKI - correct answer Causes:
- hypoperfusion (pre-)
- damage to nephrons (intra-)
- obstruction (post-)
CKD - correct answer Leads to:
- F&E imbalance
- metabolic acidosis, anemia, bone disease, uremia
AKI, CKD - correct answer Major Nursing Priorities:
- Monitor fluid balance, electrolytes (esp. K+)
- Manage blood pressure
- Prevent infection
- Patient education (dialysis, meds, nutrition)
CKD - correct answer Dietary Modifications:
- Low sodium, potassium, phosphorus
- Adequate calories
- Protein restriction
A - correct answer A client with AKI has a serum potassium level of 6.2 mEq/L. Which intervention is the
priority?
A. Place the client on cardiac monitoring
B. Restrict dietary potassium intake
C. Administer phosphate binders
D. Encourage oral fluids
B - correct answer A client with stage 4 CKD asks why they are prescribed epoetin alfa. Which response
is most accurate?
,A. "It helps remove excess potassium."
B. "It stimulates your body to produce red blood cells."
C. "It improves your kidney function."
D. "It helps lower your blood pressure."
anemia - correct answer CKD causes decreased erythropoietin, leading to ______.
C - correct answer Which assessment finding indicates peritoneal dialysis is effective?
A. Serum potassium rises to 6.0 mEq/L
B. The dialysate outflow is cloudy
C. The client's weight decreases
D. The client develops crackles in the lungs
excess fluid - correct answer Effective dialysis removes ______.
peritonitis - correct answer Cloudy outflow during peritoneal dialysis indicates ______.
fluid overload - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and
swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the highlighted symptom is indicative of ______.
worsening kidney function - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia,
pruritus, and swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the client's BUN and creatinine levels are indicative of ______.
anemia - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and swelling in
his legs
,History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the client's Hgb level is indicative of ______.
dysrhythmia - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and
swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse knows that the client's K+ level puts him at risk for ______.
B, C, E - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and swelling in
his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
Which problems are priority for this client? Select all that apply.
A. hypernatremia
B. hyperkalemia
C. fluid overload
D. hypoxia
E. anemia
place on cardiac monitoring - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia,
pruritus, and swelling in his legs
, History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
What is the priority nursing action based on the scenario?
prepare to administer IV insulin + glucose and calcium gluconate for hyperkalemia - correct answer Mr.
Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
After placing the client on cardiac monitoring, the nurse should ______.
fluids, sodium - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia, pruritus, and
swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
The nurse should restrict the client's ______ intake.
epoetin alfa, iron supplements - correct answer Mr. Johnson, 68 y/o, admitted with fatigue, anorexia,
pruritus, and swelling in his legs
History: HTN, diabetes, stage 4 CKD
Vitals: BP 162/94, HR 92, RR 20, SpO2 96%
Labs: K+ 5.9, BUN 65, Creatinine 5.2, Hgb 8.1
In order to treat the client's anemia, the nurse will administer ______.
