HIGH ACUITY NURSING VIEW AHEAD
EXAM WITH VERIFIED ANSWERS OFFICIAL
FORMAT 2026
• A patient who has acute kidney injury and who weighs 90 kg had a
urine output of 25 mL over the last 12 hours. The nurse would place this
patient in which RIFLE category?
1. Injury
2. Risk
3. Failure
4. Loss . Answer: Correct Answer: 3
Rationale 1: The injury level of RIFLE criteria is urine output less than
0.5mL/kg for 12 hours. This patients output is lower than that level.
Rationale 2: The risk level of RIFLE criteria is urine output less than 0.5
mL/kg for 6 hours. This patients output is lower than that level.
Rationale 3: According to the RIFLE criteria, failure is a urine output of
less than 0.3 ml per kg of body weight or anuria for 12 hours. The
patients urine output over the last 12 hours has been 25 mL, which
would be comparable to the failure category within the RIFLE criteria.
Rationale 4: Loss is considered a complete loss of renal function for at
least 4 weeks.
,• An elderly patient is scheduled for a CT scan with contrast. The nurse
would anticipate preprocedure administration of which medication to
help prevent renal damage?
1. N-acetylcysteine
2. Vitamin B12
3. Intravenous infusion of 5% dextrose
4. Vitamin D . Answer: Correct Answer: 1
Rationale 1: Since the use of contrast dyes can be nephrotoxic, steps
must be taken to minimize nephrotoxicity. N-acetylcysteine may be
given orally or intravenously before contrast administration. N-
acetylcysteine acts as a free radical scavenger, counteracts
vasoconstriction from contrast agents, and indirectly exhibits
cytoprotective effects.
Rationale 2: Vitamin B12 does not offer kidney protection from contrast
dyes.
Rationale 3: Since the use of contrast dyes can be nephrotoxic, steps
must be taken to minimize nephrotoxicity. The patient should be
adequately hydrated with sodium chloride.
Rationale 4: Vitamin D does not provide kidney protection from contrast
dyes.
• A patients acute kidney injury is suspected of being of postrenal
etiology. Which medical history would support this diagnosis?
Note: Credit will be given only if all correct choices and no incorrect
choices are selected.
Standard Text: Select all that apply.
, 1. The patient has been taking NSAIDs for arthritis pain.
2. The patient was diagnosed with heart failure last week.
3. The patient reports having the flu with vomiting and diarrhea for the
last 6 days.
4. The patient has large renal calculi in the kidney and ureter.
5. The patient was just diagnosed with prostate cancer. . Answer:
Correct Answer: 4,5
Rationale 1: The intake of NSAIDs for arthritis would contribute to an
intrinsic cause for an acute kidney injury.
Rationale 2: The diagnosis of heart failure would be considered a
prerenal cause for an acute kidney injury.
Rationale 3: Vomiting and diarrhea for the last 6 days is considered a
prerenal cause for an acute kidney injury.
Rationale 4: Large renal calculi in the kidney and ureter are considered a
mechanical cause for a postrenal acute kidney injury since they affect
urine drainage from the kidney.
Rationale 5: Prostate cancer can cause obstruction of the urethra, which
can result in postrenal acute renal failure.
• A patients serum creatinine level is increasing, but the urine creatinine
clearance is decreasing. How would the nurse evaluate these two
findings?
1. The patient may be experiencing the onset of heart failure.
2. The patient will probably have associated hypokalemia.
3. The patient is malnourished.
EXAM WITH VERIFIED ANSWERS OFFICIAL
FORMAT 2026
• A patient who has acute kidney injury and who weighs 90 kg had a
urine output of 25 mL over the last 12 hours. The nurse would place this
patient in which RIFLE category?
1. Injury
2. Risk
3. Failure
4. Loss . Answer: Correct Answer: 3
Rationale 1: The injury level of RIFLE criteria is urine output less than
0.5mL/kg for 12 hours. This patients output is lower than that level.
Rationale 2: The risk level of RIFLE criteria is urine output less than 0.5
mL/kg for 6 hours. This patients output is lower than that level.
Rationale 3: According to the RIFLE criteria, failure is a urine output of
less than 0.3 ml per kg of body weight or anuria for 12 hours. The
patients urine output over the last 12 hours has been 25 mL, which
would be comparable to the failure category within the RIFLE criteria.
Rationale 4: Loss is considered a complete loss of renal function for at
least 4 weeks.
,• An elderly patient is scheduled for a CT scan with contrast. The nurse
would anticipate preprocedure administration of which medication to
help prevent renal damage?
1. N-acetylcysteine
2. Vitamin B12
3. Intravenous infusion of 5% dextrose
4. Vitamin D . Answer: Correct Answer: 1
Rationale 1: Since the use of contrast dyes can be nephrotoxic, steps
must be taken to minimize nephrotoxicity. N-acetylcysteine may be
given orally or intravenously before contrast administration. N-
acetylcysteine acts as a free radical scavenger, counteracts
vasoconstriction from contrast agents, and indirectly exhibits
cytoprotective effects.
Rationale 2: Vitamin B12 does not offer kidney protection from contrast
dyes.
Rationale 3: Since the use of contrast dyes can be nephrotoxic, steps
must be taken to minimize nephrotoxicity. The patient should be
adequately hydrated with sodium chloride.
Rationale 4: Vitamin D does not provide kidney protection from contrast
dyes.
• A patients acute kidney injury is suspected of being of postrenal
etiology. Which medical history would support this diagnosis?
Note: Credit will be given only if all correct choices and no incorrect
choices are selected.
Standard Text: Select all that apply.
, 1. The patient has been taking NSAIDs for arthritis pain.
2. The patient was diagnosed with heart failure last week.
3. The patient reports having the flu with vomiting and diarrhea for the
last 6 days.
4. The patient has large renal calculi in the kidney and ureter.
5. The patient was just diagnosed with prostate cancer. . Answer:
Correct Answer: 4,5
Rationale 1: The intake of NSAIDs for arthritis would contribute to an
intrinsic cause for an acute kidney injury.
Rationale 2: The diagnosis of heart failure would be considered a
prerenal cause for an acute kidney injury.
Rationale 3: Vomiting and diarrhea for the last 6 days is considered a
prerenal cause for an acute kidney injury.
Rationale 4: Large renal calculi in the kidney and ureter are considered a
mechanical cause for a postrenal acute kidney injury since they affect
urine drainage from the kidney.
Rationale 5: Prostate cancer can cause obstruction of the urethra, which
can result in postrenal acute renal failure.
• A patients serum creatinine level is increasing, but the urine creatinine
clearance is decreasing. How would the nurse evaluate these two
findings?
1. The patient may be experiencing the onset of heart failure.
2. The patient will probably have associated hypokalemia.
3. The patient is malnourished.
