ISFM FSVO CERTIFICATION SCRIPT
2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◍ Acute renal failure.
Answer: ReversibleDetermining prognosis- kidneys respond to diuretic with
good output; this indicates that kidneys are functioning well
◍ Acute Pyelonephritis.
Answer: Diagnosing by clinical symptoms alone can be difficult; can be
similar to cystitisDiagnosis established by:-Urine culture-Urinalysis (WBC
casts indicates pyelonephritis, but may not always be
present)-Signs/Symptoms-Complicated pyelonephritis requires blood
cultures and urinary tract imaging
◍ What are the normal's for the following labs1) Urine Specific Gravity 2)
Serum Osmolality 3) ABG (pH, HCO3, PaCO2, PaO2)4) troponin I 5)
electrolyte panel( Na+, K+, Ca+, Mg+)6) BUN & Creatinine7) CBC ( hgb,
hct, RBC, WBC, platelets).
Answer: 1) 1.000-1.0302) 270-3003) pH 7.35-7.45// HC03 22-26// PaCO2
35-45// Pa02 80-1004) troponin I <0.03 ng/mL5) Na+ 135-145//K+ 3.5-5//
Ca+ 9-10.5//Mg+ 1.2-26) BUN 10-20//Creat 0.5-1.27) hgb 12-18// hct
37-52%// rbc 4.2-6.1// wbc 5,000-10,000// platelets 150,000-400,000
◍ Renal Calculi (Renal Stones).
Answer: Goals of Treatment:Manage acute painPromote passage of
stoneReduce size of stonePrevent new stone formation
◍ Match the lab profile with the most likely fluid imbalance like A) Fluid
Volume Deficit 2) Fluid Volume Excess1) ____Na 148; Hct 40% yesterday,
49% today; serum osmolarity 3082) ____Hgb 13.2 yesterday, 10.1 today;
, Urine specific gravity 1.0013) ____BUN 45; Cr 0.7.
Answer: 1) A2) B3) A
◍ Chronic Renal Failure.
Answer: Chronic Kidney Disease (CKD) is a progressive loss of renal
function associated with systemic disease such as hypertension, diabetes
mellitus (most significant risk factor), systemic lupus erythematosus or
intrinsic kidney diseaseCKD stage is determined by estimates of GFR and
albuminuria
◍ The nurse is preparing to administer lisinopril (Zestril) to a patient with
acute coronary syndrome. Which of the following findings should prompt
the nurse to hold the medication and consult the healthcare provider?a)
Serum sodium level 134b) Serum potassium 5.6c) Heart rate 58d) Blood
pressure 125/78.
Answer: b) Serum potassium 5.6*ACE inhibitors can cause/exacerbate
hyperkalemia.
◍ Who is a candidate for dialysis?.
Answer: End-stage renal disease (ESRD) is the final stage of CKD with the
number one cause being diabetes mellitus combined with hypertension. At
this point, the patient is completely dependent on dialysis to survive.CKD is
classified into five stages and is based on the patient's GFR rather than
symptoms.Patients will need dialysis when the following symptoms are
present:--Metabolic acidosis.--Hyperkalemia: Hyperkalemia in the presence
of EKG changes (peaked T-waves) is an indication for dialysis.
--Hyperkalemia by itself is not an indication for dialysis.--Drug toxicity:
Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene
glycol).--Fluid volume overload that is not responsive to diuretics.--Uremic
symptoms due to nitrogenous wastes in the blood stream.
◍ Stage I CKD.
Answer: There is kidney damage with normal or elevated GFR90-120
◍ Stage II CKD.
, Answer: There is kidney damage with mild decrease in GFR60-89
◍ The nurse is caring for a patient who is in hypovolemic shock following an
extensive burn injury. What is the intravenous fluid of choice for this patient
in the emergent phase of treatment?a) Lactated Ringersb) 0.45 NS with 20
mEq potassium chloridec) Fresh Frozen Plasmad) 5% Dextrose in saline.
Answer: a) Lactated Ringers*Isotonic solutions (crystalloids) are used to
restore fluid volume in patients with shock. Lactated Ringers is isotonic.
Normal saline is also isotonic.
◍ The client on a ventilator is assessed for untoward responses to the therapy.
Which of the following would indicate a possible complication of ventilator
therapy?a) Blood pressure has increased 5mmHg in the last 24 hoursb) Lung
sounds absent on one side.c) Forceful cough periodicallyd)
Broncho-vesicular breath sounds throughout peripheral lung fields..
Answer: b) Lung sounds absent on one side.*This may indicate a
pneumothorax--a complication caused by barotrauma.
◍ Stage III CKD.
Answer: There is a moderate decrease in GFR30-59
◍ The pressure reading during inspiration on the ventilator of a client
receiving mechanical ventilation is high and alarming intermittently. What
is the nurse's first action?a) Assess the client's oxygenation.b) Call the RT to
check the ventilator settings.c) Listen for bilateral lung sounds.d) Determine
whether an air leak is present in the client's endotracheal tube cuff..
Answer: a) Assess the client's oxygenation.
◍ Stage IV CKD.
Answer: There is a severe decrease in GFR15-29
◍ Which assessment finding best indicates that fluid resuscitation therapy for
the patient with hypertonic dehydration has acheived the desired effect?a)
Peripheral pulses changed from 1+ to 3+b) Neck veins slightly distended @
30 degreesc) Serum sodium level has changed from 151 to 143.d) Pulse
oximetry shows oxygen saturation of 95%.
, Answer: c) Serum sodium level has changed from 151 to 143.
◍ Which intravenous solution should you be prepared to administer to a
patient with isotonic dehydration?a) 0.45% salineb) Dextrose 5% in waterc)
Dextrose 10% in waterd) 0.9% saline.
Answer: d) 0.9% saline
◍ Stage V CKD.
Answer: Kidney failure- End-stage renal disease<15 (dialysis) Once Stage
IV is reached, progression to Stage V is inevitable as well as dialysis or
kidney transplant
◍ A patient is receiving dobutamine [Dobutrex] as a continuous infusion in the
immediate postoperative period. The patient also is receiving a diuretic.
What adverse drug reactions are possible in this patient? (select all that
apply)a)Anginab)Hypotensionc)Dysrhythmiasd)Oliguriae)Tachycardia.
Answer: a)Anginac)Dysrhythmiase)Tachycardia*Is a beta1 aderenergic
agonist; general anesthetics can increase the likelihood of dysrhythmias.
Dobutamine elevates BP by increasing CO. Diuretics complement the
beneficial effects of dobutamine on the kidney, so urine output would be
increased, not decreased.
◍ A patient who has severe sepsis is receiving an intravenous normal saline
infusion. She weighs 78 kgs. Which of the following is an indicator that the
therapeutic goal has been met?a) 250 mL of urine in the past 6 hoursb)
Arterial blood pressure is 90/42c) Central Venous Pressure is 2 mm Hgd)
Patient's heart rate is 101.
Answer: a) 250 mL of urine in the past 6 hours*Fluid resuscitation goals in
sepsis are: MAP > 65, UO . 0.5 mL/kg/hr, and/or CVP 8-12 mm Hg.
◍ Complications of Decreased GFR.
Answer: AnemiaHypertensionDecreased calcium
absorptionHyperlipidemiaHeart failureLeft ventricular hypertrophyFluid
volume
overloadHyperkalemiaHyperparathyroidismHyperphosphatemiaMetabolic
acidosisMalnutrition (late complication)
2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◍ Acute renal failure.
Answer: ReversibleDetermining prognosis- kidneys respond to diuretic with
good output; this indicates that kidneys are functioning well
◍ Acute Pyelonephritis.
Answer: Diagnosing by clinical symptoms alone can be difficult; can be
similar to cystitisDiagnosis established by:-Urine culture-Urinalysis (WBC
casts indicates pyelonephritis, but may not always be
present)-Signs/Symptoms-Complicated pyelonephritis requires blood
cultures and urinary tract imaging
◍ What are the normal's for the following labs1) Urine Specific Gravity 2)
Serum Osmolality 3) ABG (pH, HCO3, PaCO2, PaO2)4) troponin I 5)
electrolyte panel( Na+, K+, Ca+, Mg+)6) BUN & Creatinine7) CBC ( hgb,
hct, RBC, WBC, platelets).
Answer: 1) 1.000-1.0302) 270-3003) pH 7.35-7.45// HC03 22-26// PaCO2
35-45// Pa02 80-1004) troponin I <0.03 ng/mL5) Na+ 135-145//K+ 3.5-5//
Ca+ 9-10.5//Mg+ 1.2-26) BUN 10-20//Creat 0.5-1.27) hgb 12-18// hct
37-52%// rbc 4.2-6.1// wbc 5,000-10,000// platelets 150,000-400,000
◍ Renal Calculi (Renal Stones).
Answer: Goals of Treatment:Manage acute painPromote passage of
stoneReduce size of stonePrevent new stone formation
◍ Match the lab profile with the most likely fluid imbalance like A) Fluid
Volume Deficit 2) Fluid Volume Excess1) ____Na 148; Hct 40% yesterday,
49% today; serum osmolarity 3082) ____Hgb 13.2 yesterday, 10.1 today;
, Urine specific gravity 1.0013) ____BUN 45; Cr 0.7.
Answer: 1) A2) B3) A
◍ Chronic Renal Failure.
Answer: Chronic Kidney Disease (CKD) is a progressive loss of renal
function associated with systemic disease such as hypertension, diabetes
mellitus (most significant risk factor), systemic lupus erythematosus or
intrinsic kidney diseaseCKD stage is determined by estimates of GFR and
albuminuria
◍ The nurse is preparing to administer lisinopril (Zestril) to a patient with
acute coronary syndrome. Which of the following findings should prompt
the nurse to hold the medication and consult the healthcare provider?a)
Serum sodium level 134b) Serum potassium 5.6c) Heart rate 58d) Blood
pressure 125/78.
Answer: b) Serum potassium 5.6*ACE inhibitors can cause/exacerbate
hyperkalemia.
◍ Who is a candidate for dialysis?.
Answer: End-stage renal disease (ESRD) is the final stage of CKD with the
number one cause being diabetes mellitus combined with hypertension. At
this point, the patient is completely dependent on dialysis to survive.CKD is
classified into five stages and is based on the patient's GFR rather than
symptoms.Patients will need dialysis when the following symptoms are
present:--Metabolic acidosis.--Hyperkalemia: Hyperkalemia in the presence
of EKG changes (peaked T-waves) is an indication for dialysis.
--Hyperkalemia by itself is not an indication for dialysis.--Drug toxicity:
Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene
glycol).--Fluid volume overload that is not responsive to diuretics.--Uremic
symptoms due to nitrogenous wastes in the blood stream.
◍ Stage I CKD.
Answer: There is kidney damage with normal or elevated GFR90-120
◍ Stage II CKD.
, Answer: There is kidney damage with mild decrease in GFR60-89
◍ The nurse is caring for a patient who is in hypovolemic shock following an
extensive burn injury. What is the intravenous fluid of choice for this patient
in the emergent phase of treatment?a) Lactated Ringersb) 0.45 NS with 20
mEq potassium chloridec) Fresh Frozen Plasmad) 5% Dextrose in saline.
Answer: a) Lactated Ringers*Isotonic solutions (crystalloids) are used to
restore fluid volume in patients with shock. Lactated Ringers is isotonic.
Normal saline is also isotonic.
◍ The client on a ventilator is assessed for untoward responses to the therapy.
Which of the following would indicate a possible complication of ventilator
therapy?a) Blood pressure has increased 5mmHg in the last 24 hoursb) Lung
sounds absent on one side.c) Forceful cough periodicallyd)
Broncho-vesicular breath sounds throughout peripheral lung fields..
Answer: b) Lung sounds absent on one side.*This may indicate a
pneumothorax--a complication caused by barotrauma.
◍ Stage III CKD.
Answer: There is a moderate decrease in GFR30-59
◍ The pressure reading during inspiration on the ventilator of a client
receiving mechanical ventilation is high and alarming intermittently. What
is the nurse's first action?a) Assess the client's oxygenation.b) Call the RT to
check the ventilator settings.c) Listen for bilateral lung sounds.d) Determine
whether an air leak is present in the client's endotracheal tube cuff..
Answer: a) Assess the client's oxygenation.
◍ Stage IV CKD.
Answer: There is a severe decrease in GFR15-29
◍ Which assessment finding best indicates that fluid resuscitation therapy for
the patient with hypertonic dehydration has acheived the desired effect?a)
Peripheral pulses changed from 1+ to 3+b) Neck veins slightly distended @
30 degreesc) Serum sodium level has changed from 151 to 143.d) Pulse
oximetry shows oxygen saturation of 95%.
, Answer: c) Serum sodium level has changed from 151 to 143.
◍ Which intravenous solution should you be prepared to administer to a
patient with isotonic dehydration?a) 0.45% salineb) Dextrose 5% in waterc)
Dextrose 10% in waterd) 0.9% saline.
Answer: d) 0.9% saline
◍ Stage V CKD.
Answer: Kidney failure- End-stage renal disease<15 (dialysis) Once Stage
IV is reached, progression to Stage V is inevitable as well as dialysis or
kidney transplant
◍ A patient is receiving dobutamine [Dobutrex] as a continuous infusion in the
immediate postoperative period. The patient also is receiving a diuretic.
What adverse drug reactions are possible in this patient? (select all that
apply)a)Anginab)Hypotensionc)Dysrhythmiasd)Oliguriae)Tachycardia.
Answer: a)Anginac)Dysrhythmiase)Tachycardia*Is a beta1 aderenergic
agonist; general anesthetics can increase the likelihood of dysrhythmias.
Dobutamine elevates BP by increasing CO. Diuretics complement the
beneficial effects of dobutamine on the kidney, so urine output would be
increased, not decreased.
◍ A patient who has severe sepsis is receiving an intravenous normal saline
infusion. She weighs 78 kgs. Which of the following is an indicator that the
therapeutic goal has been met?a) 250 mL of urine in the past 6 hoursb)
Arterial blood pressure is 90/42c) Central Venous Pressure is 2 mm Hgd)
Patient's heart rate is 101.
Answer: a) 250 mL of urine in the past 6 hours*Fluid resuscitation goals in
sepsis are: MAP > 65, UO . 0.5 mL/kg/hr, and/or CVP 8-12 mm Hg.
◍ Complications of Decreased GFR.
Answer: AnemiaHypertensionDecreased calcium
absorptionHyperlipidemiaHeart failureLeft ventricular hypertrophyFluid
volume
overloadHyperkalemiaHyperparathyroidismHyperphosphatemiaMetabolic
acidosisMalnutrition (late complication)
