NCLEX RN Renal Disorders Practice
Exam 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026
1. A client with acute kidney injury (AKI) has a urine output of 15 mL/hr for
the past 3 hours. Which finding requires the nurse's priority attention?
A. Blood pressure of 138/84 mm Hg
B. Serum creatinine of 1.8 mg/dL
C. Urine output of 15 mL/hr
D. Mild dependent edema
Answer: C. Urine output of 15 mL/hr
Rationale: Urine output below approximately 30 mL/hr in an adult may
indicate significant renal hypoperfusion or impaired kidney function and
requires prompt assessment.
2. Which laboratory finding is most concerning in a client with renal failure?
A. Sodium 138 mEq/L
B. Calcium 9.2 mg/dL
C. Hemoglobin 11.8 g/dL
D. Potassium 6.4 mEq/L
Answer: D. Potassium 6.4 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias. Cardiac monitoring and prompt treatment are priorities.
3. A client with chronic kidney disease (CKD) is prescribed epoetin alfa. The
nurse explains that the medication is primarily used to treat:
,A. Hyperkalemia
B. Fluid overload
C. Anemia
D. Metabolic acidosis
Answer: C. Anemia
Rationale: Diseased kidneys produce inadequate erythropoietin, resulting in
decreased red blood cell production. Epoetin alfa stimulates erythropoiesis.
4. Which dietary instruction is most appropriate for a client with advanced
chronic kidney disease?
A. Increase potassium-rich foods
B. Increase sodium intake
C. Limit sodium and follow prescribed protein, potassium, and phosphorus
restrictions
D. Consume unlimited dairy products
Answer: C. Limit sodium and follow prescribed protein, potassium, and
phosphorus restrictions
Rationale: Dietary restrictions in CKD are individualized but commonly
include sodium, potassium, phosphorus, and sometimes protein to reduce
complications and metabolic waste.
5. A client with nephrotic syndrome is most likely to demonstrate which
finding?
A. Severe dehydration
B. Generalized edema
C. Hypercalcemia
D. Bradycardia
Answer: B. Generalized edema
Rationale: Nephrotic syndrome causes significant protein loss in the urine,
leading to hypoalbuminemia and decreased oncotic pressure, resulting in
edema.
6. Which assessment finding is most characteristic of nephrotic syndrome?
,A. Glycosuria
B. Massive proteinuria
C. Hemoptysis
D. Severe leukocytosis
Answer: B. Massive proteinuria
Rationale: Heavy protein loss through the glomeruli is a hallmark of
nephrotic syndrome and contributes to hypoalbuminemia and edema.
7. A client with acute glomerulonephritis has dark, tea-colored urine. The
nurse recognizes this finding as:
A. Normal urine concentration
B. Chyluria
C. Hematuria
D. Glycosuria
Answer: C. Hematuria
Rationale: Glomerular inflammation can cause red blood cells to enter the
urine, producing smoky, tea-colored, or cola-colored urine.
8. Which assessment finding is expected in acute glomerulonephritis?
A. Polyuria
B. Hypertension
C. Severe hypoglycemia
D. Increased appetite
Answer: B. Hypertension
Rationale: Reduced glomerular filtration and sodium and water retention can
cause fluid overload and hypertension.
9. A client with chronic kidney disease reports increasing shortness of
breath. Which assessment is the priority?
A. Bowel sounds
B. Skin turgor
C. Lung sounds
D. Pupil response
, Answer: C. Lung sounds
Rationale: CKD can cause fluid retention and pulmonary edema. Assessing
the lungs helps identify potentially life-threatening fluid accumulation.
10.Which medication should the nurse question for a client with significant
renal impairment?
A. Acetaminophen
B. Stool softener
C. Nonsteroidal anti-inflammatory drug (NSAID)
D. Topical moisturizer
Answer: C. Nonsteroidal anti-inflammatory drug (NSAID)
Rationale: NSAIDs can reduce renal blood flow and may worsen kidney injury,
particularly in clients with impaired renal function.
11.A client is receiving hemodialysis through an arteriovenous fistula. Which
assessment indicates that the fistula is functioning?
A. Absence of swelling
B. Palpable thrill and audible bruit
C. Warm fingers only
D. Capillary refill under 5 seconds
Answer: B. Palpable thrill and audible bruit
Rationale: A palpable thrill and audible bruit indicate blood flow through the
vascular access. Their absence may indicate thrombosis or access dysfunction.
12.Which action should the nurse avoid when caring for an arm containing
an arteriovenous fistula?
A. Inspecting the access site
B. Checking for a thrill
C. Taking blood pressure on the access arm
D. Auscultating for a bruit
Answer: C. Taking blood pressure on the access arm
Rationale: Blood pressure measurements and venipuncture can compromise
the fistula by causing trauma, compression, or thrombosis.
Exam 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026
1. A client with acute kidney injury (AKI) has a urine output of 15 mL/hr for
the past 3 hours. Which finding requires the nurse's priority attention?
A. Blood pressure of 138/84 mm Hg
B. Serum creatinine of 1.8 mg/dL
C. Urine output of 15 mL/hr
D. Mild dependent edema
Answer: C. Urine output of 15 mL/hr
Rationale: Urine output below approximately 30 mL/hr in an adult may
indicate significant renal hypoperfusion or impaired kidney function and
requires prompt assessment.
2. Which laboratory finding is most concerning in a client with renal failure?
A. Sodium 138 mEq/L
B. Calcium 9.2 mg/dL
C. Hemoglobin 11.8 g/dL
D. Potassium 6.4 mEq/L
Answer: D. Potassium 6.4 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias. Cardiac monitoring and prompt treatment are priorities.
3. A client with chronic kidney disease (CKD) is prescribed epoetin alfa. The
nurse explains that the medication is primarily used to treat:
,A. Hyperkalemia
B. Fluid overload
C. Anemia
D. Metabolic acidosis
Answer: C. Anemia
Rationale: Diseased kidneys produce inadequate erythropoietin, resulting in
decreased red blood cell production. Epoetin alfa stimulates erythropoiesis.
4. Which dietary instruction is most appropriate for a client with advanced
chronic kidney disease?
A. Increase potassium-rich foods
B. Increase sodium intake
C. Limit sodium and follow prescribed protein, potassium, and phosphorus
restrictions
D. Consume unlimited dairy products
Answer: C. Limit sodium and follow prescribed protein, potassium, and
phosphorus restrictions
Rationale: Dietary restrictions in CKD are individualized but commonly
include sodium, potassium, phosphorus, and sometimes protein to reduce
complications and metabolic waste.
5. A client with nephrotic syndrome is most likely to demonstrate which
finding?
A. Severe dehydration
B. Generalized edema
C. Hypercalcemia
D. Bradycardia
Answer: B. Generalized edema
Rationale: Nephrotic syndrome causes significant protein loss in the urine,
leading to hypoalbuminemia and decreased oncotic pressure, resulting in
edema.
6. Which assessment finding is most characteristic of nephrotic syndrome?
,A. Glycosuria
B. Massive proteinuria
C. Hemoptysis
D. Severe leukocytosis
Answer: B. Massive proteinuria
Rationale: Heavy protein loss through the glomeruli is a hallmark of
nephrotic syndrome and contributes to hypoalbuminemia and edema.
7. A client with acute glomerulonephritis has dark, tea-colored urine. The
nurse recognizes this finding as:
A. Normal urine concentration
B. Chyluria
C. Hematuria
D. Glycosuria
Answer: C. Hematuria
Rationale: Glomerular inflammation can cause red blood cells to enter the
urine, producing smoky, tea-colored, or cola-colored urine.
8. Which assessment finding is expected in acute glomerulonephritis?
A. Polyuria
B. Hypertension
C. Severe hypoglycemia
D. Increased appetite
Answer: B. Hypertension
Rationale: Reduced glomerular filtration and sodium and water retention can
cause fluid overload and hypertension.
9. A client with chronic kidney disease reports increasing shortness of
breath. Which assessment is the priority?
A. Bowel sounds
B. Skin turgor
C. Lung sounds
D. Pupil response
, Answer: C. Lung sounds
Rationale: CKD can cause fluid retention and pulmonary edema. Assessing
the lungs helps identify potentially life-threatening fluid accumulation.
10.Which medication should the nurse question for a client with significant
renal impairment?
A. Acetaminophen
B. Stool softener
C. Nonsteroidal anti-inflammatory drug (NSAID)
D. Topical moisturizer
Answer: C. Nonsteroidal anti-inflammatory drug (NSAID)
Rationale: NSAIDs can reduce renal blood flow and may worsen kidney injury,
particularly in clients with impaired renal function.
11.A client is receiving hemodialysis through an arteriovenous fistula. Which
assessment indicates that the fistula is functioning?
A. Absence of swelling
B. Palpable thrill and audible bruit
C. Warm fingers only
D. Capillary refill under 5 seconds
Answer: B. Palpable thrill and audible bruit
Rationale: A palpable thrill and audible bruit indicate blood flow through the
vascular access. Their absence may indicate thrombosis or access dysfunction.
12.Which action should the nurse avoid when caring for an arm containing
an arteriovenous fistula?
A. Inspecting the access site
B. Checking for a thrill
C. Taking blood pressure on the access arm
D. Auscultating for a bruit
Answer: C. Taking blood pressure on the access arm
Rationale: Blood pressure measurements and venipuncture can compromise
the fistula by causing trauma, compression, or thrombosis.
