ATI Medical-Surgical Renal/Urinary Practice
Exam Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is caring for a client who has acute kidney injury (AKI).
Which laboratory finding should the nurse anticipate?
A. Decreased serum creatinine
B. Decreased blood urea nitrogen (BUN)
C. Increased serum creatinine
D. Increased glomerular filtration rate
Correct answer: C. Increased serum creatinine
Rationale: Serum creatinine rises when the kidneys are unable
to adequately filter metabolic waste from the blood. A rising
creatinine is an important indicator of declining kidney function
and is commonly monitored when evaluating AKI. BUN may also
increase, while GFR generally decreases rather than increases.
AKI can develop rapidly and may be associated with decreased
,urine output, although urine output can vary depending on the
cause and stage of the injury.
Question 2
Which client is at greatest risk for developing prerenal acute
kidney injury?
A. A client with renal calculi
B. A client with glomerulonephritis
C. A client experiencing severe hypovolemia
D. A client with bladder cancer
Correct answer: C. A client experiencing severe hypovolemia
Rationale: Prerenal AKI occurs when renal perfusion decreases
without an initial structural injury to the kidneys. Severe
hypovolemia from hemorrhage, dehydration, vomiting,
diarrhea, or excessive fluid loss can markedly reduce renal blood
flow. Renal calculi and bladder cancer are associated more
closely with postrenal obstruction, while glomerulonephritis
represents an intrinsic renal process.
Question 3
A client has AKI related to urinary tract obstruction. How should
the nurse classify this type of AKI?
,A. Prerenal
B. Intrarenal
C. Postrenal
D. Functional
Correct answer: C. Postrenal
Rationale: Postrenal AKI occurs when urine cannot adequately
flow out of the urinary system because of an obstruction.
Possible causes include renal calculi, tumors, enlarged prostate,
blood clots, or other obstructive conditions. Prompt
identification and correction of the obstruction are important
because prolonged obstruction can cause kidney damage.
Question 4
A client with AKI has a potassium level of 6.4 mEq/L (6.4
mmol/L). Which action is the nurse's priority?
A. Encourage foods high in potassium
B. Administer a potassium supplement
C. Place the client on cardiac monitoring
D. Encourage increased oral fluids
Correct answer: C. Place the client on cardiac monitoring
Rationale: Severe hyperkalemia can cause potentially life-
threatening cardiac dysrhythmias. Cardiac monitoring allows
the nurse to identify conduction abnormalities while the
, healthcare team initiates treatment to lower serum potassium
and protect cardiac function. Potassium intake should generally
be restricted rather than increased in significant hyperkalemia.
Question 5
Which urine finding is most suggestive of acute tubular
necrosis?
A. Clear urine with no sediment
B. White blood cell casts
C. Muddy brown granular casts
D. Large amounts of glucose
Correct answer: C. Muddy brown granular casts
Rationale: Muddy brown granular casts are classically
associated with tubular injury, particularly acute tubular
necrosis, an intrinsic form of AKI. Tubular epithelial injury
interferes with normal renal filtration and reabsorption. The
finding helps distinguish intrinsic renal injury from prerenal
causes, which generally do not produce muddy brown casts.
Question 6
A client with CKD asks why anemia develops. Which response
by the nurse is most accurate?
Exam Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is caring for a client who has acute kidney injury (AKI).
Which laboratory finding should the nurse anticipate?
A. Decreased serum creatinine
B. Decreased blood urea nitrogen (BUN)
C. Increased serum creatinine
D. Increased glomerular filtration rate
Correct answer: C. Increased serum creatinine
Rationale: Serum creatinine rises when the kidneys are unable
to adequately filter metabolic waste from the blood. A rising
creatinine is an important indicator of declining kidney function
and is commonly monitored when evaluating AKI. BUN may also
increase, while GFR generally decreases rather than increases.
AKI can develop rapidly and may be associated with decreased
,urine output, although urine output can vary depending on the
cause and stage of the injury.
Question 2
Which client is at greatest risk for developing prerenal acute
kidney injury?
A. A client with renal calculi
B. A client with glomerulonephritis
C. A client experiencing severe hypovolemia
D. A client with bladder cancer
Correct answer: C. A client experiencing severe hypovolemia
Rationale: Prerenal AKI occurs when renal perfusion decreases
without an initial structural injury to the kidneys. Severe
hypovolemia from hemorrhage, dehydration, vomiting,
diarrhea, or excessive fluid loss can markedly reduce renal blood
flow. Renal calculi and bladder cancer are associated more
closely with postrenal obstruction, while glomerulonephritis
represents an intrinsic renal process.
Question 3
A client has AKI related to urinary tract obstruction. How should
the nurse classify this type of AKI?
,A. Prerenal
B. Intrarenal
C. Postrenal
D. Functional
Correct answer: C. Postrenal
Rationale: Postrenal AKI occurs when urine cannot adequately
flow out of the urinary system because of an obstruction.
Possible causes include renal calculi, tumors, enlarged prostate,
blood clots, or other obstructive conditions. Prompt
identification and correction of the obstruction are important
because prolonged obstruction can cause kidney damage.
Question 4
A client with AKI has a potassium level of 6.4 mEq/L (6.4
mmol/L). Which action is the nurse's priority?
A. Encourage foods high in potassium
B. Administer a potassium supplement
C. Place the client on cardiac monitoring
D. Encourage increased oral fluids
Correct answer: C. Place the client on cardiac monitoring
Rationale: Severe hyperkalemia can cause potentially life-
threatening cardiac dysrhythmias. Cardiac monitoring allows
the nurse to identify conduction abnormalities while the
, healthcare team initiates treatment to lower serum potassium
and protect cardiac function. Potassium intake should generally
be restricted rather than increased in significant hyperkalemia.
Question 5
Which urine finding is most suggestive of acute tubular
necrosis?
A. Clear urine with no sediment
B. White blood cell casts
C. Muddy brown granular casts
D. Large amounts of glucose
Correct answer: C. Muddy brown granular casts
Rationale: Muddy brown granular casts are classically
associated with tubular injury, particularly acute tubular
necrosis, an intrinsic form of AKI. Tubular epithelial injury
interferes with normal renal filtration and reabsorption. The
finding helps distinguish intrinsic renal injury from prerenal
causes, which generally do not produce muddy brown casts.
Question 6
A client with CKD asks why anemia develops. Which response
by the nurse is most accurate?
