NR601 Week 6: Geriatric Syndromes – CKD, GERD,
Malnutrition, UTI & More – 80 Multiple-Choice
Questions with Rationales- Chamberlain
CHRONIC KIDNEY DISEASE (CKD) (~20 questions)
1. A 78-year-old with Stage 4 chronic kidney disease (CKD) presents with
hyperkalemia. Which of the following medications would be most appropriate?
A. Sodium bicarbonate
B. Patiromer (Veltassa)
C. Furosemide
D. Insulin with glucose
Answer: B
Rationale: Patiromer is a potassium-binding agent used for chronic hyperkalemia in
CKD. Sodium bicarbonate is for metabolic acidosis; furosemide is acute; insulin+glucose
is emergency treatment.
2. Which of the following criteria is required for a diagnosis of chronic kidney
disease (CKD)?
A. GFR < 60 mL/min for 1 month
B. Proteinuria ≥ 300 mg/day
C. Structural or functional kidney abnormalities persisting for ≥ 3 months
D. Bilateral small kidneys on ultrasound
Answer: C
Rationale: CKD is defined by kidney damage or GFR <60 mL/min/1.73 m² for ≥3 months,
regardless of cause.
3. Which of the following medications is used in CKD to reduce proteinuria and
preserve renal function, but requires caution in clients with hyperkalemia?
A. Metformin
B. Lisinopril (Zestril)
C. Furosemide
D. Allopurinol
Answer: B
,Rationale: ACE inhibitors (lisinopril) reduce proteinuria and slow CKD progression but
can cause hyperkalemia.
4. Which class of medications is used to treat anemia in CKD by stimulating red
blood cell production?
A. Erythropoiesis-stimulating agents (ESAs)
B. Iron supplements
C. Folic acid
D. Vitamin B12
Answer: A
Rationale: ESAs (erythropoietin, darbepoetin) stimulate RBC production in CKD-related
anemia.
5. Which of the following comorbidities is most strongly associated with BOTH the
cause and progression of CKD?
A. Chronic obstructive pulmonary disease
B. Hypothyroidism
C. Depression
D. Cardiovascular disease
Answer: D
Rationale: CVD and CKD share risk factors (HTN, diabetes) and each worsens the other.
CVD is a major cause and consequence of CKD.
6. Which medication is preferred for reducing proteinuria in CKD but must be
avoided in patients with bilateral renal artery stenosis?
A. Amlodipine
B. Losartan (Cozaar)
C. Hydrochlorothiazide
D. Diltiazem
Answer: B
Rationale: ARBs (losartan) reduce proteinuria but are contraindicated in bilateral renal
artery stenosis due to risk of acute kidney injury.
7. A 72-year-old with CKD Stage 3 has a GFR of 45 mL/min. Which medication
requires dose adjustment?
, A. Acetaminophen
B. Metformin
C. Levothyroxine
D. Atorvastatin
Answer: B
Rationale: Metformin is contraindicated when GFR <30, but dose adjustment is needed
for GFR 30-45. Atorvastatin and acetaminophen are safe.
8. Which of the following is an indication for renal replacement therapy (dialysis) in
CKD?
A. GFR < 60 mL/min
B. Serum creatinine > 2 mg/dL
C. Refractory hyperkalemia or fluid overload
D. Hemoglobin < 12 g/dL
Answer: C
Rationale: Dialysis is indicated for refractory hyperkalemia, fluid overload, uremic
pericarditis, or severe uremia.
9. Which of the following is a common cause of CKD in older adults?
A. Diabetic nephropathy
B. Hypertensive nephrosclerosis
C. Glomerulonephritis
D. All of the above
Answer: D
Rationale: Diabetes, hypertension, and glomerulonephritis are leading causes. Age-
related decline also contributes.
10. A 74-year-old with CKD has hemoglobin of 10.5 g/dL, MCV 85 fL, ferritin 80
ng/mL. What is the most likely cause of anemia?
A. Iron deficiency
B. Anemia of chronic kidney disease
C. Vitamin B12 deficiency
D. Hemolysis
Answer: B
Rationale: Normocytic anemia with low erythropoietin in CKD is characteristic. Ferritin
is normal.
Malnutrition, UTI & More – 80 Multiple-Choice
Questions with Rationales- Chamberlain
CHRONIC KIDNEY DISEASE (CKD) (~20 questions)
1. A 78-year-old with Stage 4 chronic kidney disease (CKD) presents with
hyperkalemia. Which of the following medications would be most appropriate?
A. Sodium bicarbonate
B. Patiromer (Veltassa)
C. Furosemide
D. Insulin with glucose
Answer: B
Rationale: Patiromer is a potassium-binding agent used for chronic hyperkalemia in
CKD. Sodium bicarbonate is for metabolic acidosis; furosemide is acute; insulin+glucose
is emergency treatment.
2. Which of the following criteria is required for a diagnosis of chronic kidney
disease (CKD)?
A. GFR < 60 mL/min for 1 month
B. Proteinuria ≥ 300 mg/day
C. Structural or functional kidney abnormalities persisting for ≥ 3 months
D. Bilateral small kidneys on ultrasound
Answer: C
Rationale: CKD is defined by kidney damage or GFR <60 mL/min/1.73 m² for ≥3 months,
regardless of cause.
3. Which of the following medications is used in CKD to reduce proteinuria and
preserve renal function, but requires caution in clients with hyperkalemia?
A. Metformin
B. Lisinopril (Zestril)
C. Furosemide
D. Allopurinol
Answer: B
,Rationale: ACE inhibitors (lisinopril) reduce proteinuria and slow CKD progression but
can cause hyperkalemia.
4. Which class of medications is used to treat anemia in CKD by stimulating red
blood cell production?
A. Erythropoiesis-stimulating agents (ESAs)
B. Iron supplements
C. Folic acid
D. Vitamin B12
Answer: A
Rationale: ESAs (erythropoietin, darbepoetin) stimulate RBC production in CKD-related
anemia.
5. Which of the following comorbidities is most strongly associated with BOTH the
cause and progression of CKD?
A. Chronic obstructive pulmonary disease
B. Hypothyroidism
C. Depression
D. Cardiovascular disease
Answer: D
Rationale: CVD and CKD share risk factors (HTN, diabetes) and each worsens the other.
CVD is a major cause and consequence of CKD.
6. Which medication is preferred for reducing proteinuria in CKD but must be
avoided in patients with bilateral renal artery stenosis?
A. Amlodipine
B. Losartan (Cozaar)
C. Hydrochlorothiazide
D. Diltiazem
Answer: B
Rationale: ARBs (losartan) reduce proteinuria but are contraindicated in bilateral renal
artery stenosis due to risk of acute kidney injury.
7. A 72-year-old with CKD Stage 3 has a GFR of 45 mL/min. Which medication
requires dose adjustment?
, A. Acetaminophen
B. Metformin
C. Levothyroxine
D. Atorvastatin
Answer: B
Rationale: Metformin is contraindicated when GFR <30, but dose adjustment is needed
for GFR 30-45. Atorvastatin and acetaminophen are safe.
8. Which of the following is an indication for renal replacement therapy (dialysis) in
CKD?
A. GFR < 60 mL/min
B. Serum creatinine > 2 mg/dL
C. Refractory hyperkalemia or fluid overload
D. Hemoglobin < 12 g/dL
Answer: C
Rationale: Dialysis is indicated for refractory hyperkalemia, fluid overload, uremic
pericarditis, or severe uremia.
9. Which of the following is a common cause of CKD in older adults?
A. Diabetic nephropathy
B. Hypertensive nephrosclerosis
C. Glomerulonephritis
D. All of the above
Answer: D
Rationale: Diabetes, hypertension, and glomerulonephritis are leading causes. Age-
related decline also contributes.
10. A 74-year-old with CKD has hemoglobin of 10.5 g/dL, MCV 85 fL, ferritin 80
ng/mL. What is the most likely cause of anemia?
A. Iron deficiency
B. Anemia of chronic kidney disease
C. Vitamin B12 deficiency
D. Hemolysis
Answer: B
Rationale: Normocytic anemia with low erythropoietin in CKD is characteristic. Ferritin
is normal.
