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Acute Kidney Injury (AKI): Comprehensive Test Questions and Solutions, Exams of Nursing

Aims Community CollegeNursing

A comprehensive set of test questions and answers related to acute kidney injury (aki). It covers the types of aki (prerenal, intrarenal, postrenal), signs and symptoms, biomarkers, and causes. It also delves into the pathophysiology, diagnosis, and treatment of aki, including glomerulonephritis and nephrotic syndrome. The questions address key concepts such as the renin-angiotensin-aldosterone system, acute tubular necrosis, and the phases of aki (initiating, oliguria, diuretic, recovery). This resource is designed to test and reinforce understanding of aki for nursing or medical students. It includes normal values for urine output, bun, creatinine, and gfr, as well as interventions and potential complications associated with aki.

Typology: Exams

2024/2025

Available from 06/08/2025

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NUR 2016: ACUTE KIDNEY INJURY: TEST QUESTIONS
WITH COMPLETE SOLUTIONS
1) What are the three types of acute kidney injury? -- Answer โœ”โœ” Prerenal, intrarenal,
postrenal
2) What are the signs and symptoms of acute kidney injury (AKI)? -- Answer โœ”โœ”
Marked decrease in urine output, increase in BUN, creatinine
3) What are biomarkers that can detect AKI early? -- Answer โœ”โœ” Interleukin 18,
NGAL (neutrophil gelatinase-associate lipocalin), kidney injury molecule-1
4) What is the most common type of kidney injury? -- Answer โœ”โœ” Prerenal (60%)
5) What is a prerenal AKI? -- Answer โœ”โœ” Reduction of renal blood flow, decreased
perfusion and filtration
6) What causes prerenal AKI? -- Answer โœ”โœ” Hypovolemia, decreased cardiac output,
decreased peripheral vascular resistance, vascular obstruction, drug-induced altered
glomerular hemodynamics
7) What is a normal adaptive response to prerenal AKI? -- Answer โœ”โœ” Initiate RAAS
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NUR 2016: ACUTE KIDNEY INJURY: TEST QUESTIONS

WITH COMPLETE SOLUTIONS

  1. What are the three types of acute kidney injury? -- Answer โœ”โœ” Prerenal, intrarenal, postrenal
  2. What are the signs and symptoms of acute kidney injury (AKI)? -- Answer โœ”โœ” Marked decrease in urine output, increase in BUN, creatinine
  3. What are biomarkers that can detect AKI early? -- Answer โœ”โœ” Interleukin 18, NGAL (neutrophil gelatinase-associate lipocalin), kidney injury molecule- 1
  4. What is the most common type of kidney injury? -- Answer โœ”โœ” Prerenal (60%)
  5. What is a prerenal AKI? -- Answer โœ”โœ” Reduction of renal blood flow, decreased perfusion and filtration
  6. What causes prerenal AKI? -- Answer โœ”โœ” Hypovolemia, decreased cardiac output, decreased peripheral vascular resistance, vascular obstruction, drug-induced altered glomerular hemodynamics
  7. What is a normal adaptive response to prerenal AKI? -- Answer โœ”โœ” Initiate RAAS
  1. How does blood travel through the kidney? -- Answer โœ”โœ” Blood enters the kidney through the renal artery then travels to the nephrons. Inside the nephron (the functional units of the kidney), the blood goes to the glomerulus which is a cluster of capillaries. The glomerulus is surrounded by a horseshoe shaped structure called bowman's capsule. Waste products travel from the glomerulus into bowman's capsule and then through the renal tubule. From the renal tubule the waste leaves the kidney in a ureter as urine. The filtered blood then reabsorbs whatever materials it needs and leaves the kidney in the renal vein.
  2. How does the renin-angiotensin-aldosterone system work? -- Answer โœ”โœ” 1. Kidneys sense low blood volume and activates the RAAS system
  1. Renin is released into the blood stream by the kidneys
  2. Renin acts on a protein in the liver called angiotensinogen and converts it into angiotensin 1
  3. An enzyme called ACE (angiotensin-converting enzyme) converts angiotensin 1 into angiotensin 2
  4. Angiotensin 2 causes vasoconstriction, simulates aldosterone release, stimulates thirst, simulates the release of antidiuretic hormone.
  1. What does aldosterone do? -- Answer โœ”โœ” Increases reabsorption of sodium and water
  2. What is an intrarenal kidney injury? -- Answer โœ”โœ” Direct damage to renal tissue resulting in impaired nephron functioning
  3. What are the causes of intrarenal kidney injury? -- Answer โœ”โœ” Acute tubular necrosis, nephrotoxic drugs, hepatorenal syndrome
  4. What is acute tubular necrosis? -- Answer โœ”โœ” destruction of tubular epithelial cells with acute suppression of renal function
  5. What can cause acute tubular necrosis? -- Answer โœ”โœ” Infection, rhabdomyolysis
  1. Explain immunoglobulin type 1 and its effect in glomerulonephritis? -- Answer โœ”โœ” Antibodies produced are specific for antigens within the glomeruli and the glomerulus basement membrane (GBM). Immunoglobulin and complements are deposited along the basement membrane
  2. Explain immunoglobulin type 2 and its effect in glomerulonephritis. -- Answer โœ”โœ” Antibodies react to antigens not specific to the glomerulus but still deposit immune complexes on the GBM
  3. True or false: Both immunoglobulin type 1 and type 2 result in damage to the glomeruli basement membrane. This then causes a decrease in filtration (GFR) and allows more protein in the urine. -- Answer โœ”โœ” True
  4. Large molecules pull ___ towards themselves. -- Answer โœ”โœ” Fluid
  5. Examples of large molecules? -- Answer โœ”โœ” carbohydrates, proteins, fats, vitamins
  6. What are the symptoms of acute glomerulonephritis? -- Answer โœ”โœ” Protein and blood in urine, wbc and casts in urine, edema, decreased urine output, hypertension, BUN and creatinine elevated, abdominal or flank pain
  7. What are casts? -- Answer โœ”โœ” Cylindrical structures in urine that form in the renal tubules
  8. What are the interventions for acute glomerulonephritis? -- Answer โœ”โœ” Antibiotics, antihypertensives, diuretics, maybe corticosteroids, maybe plasmapheresis, rest
  9. What is plasmapheresis? -- Answer โœ”โœ” Filtering and removing plasma from blood
  1. Why may plasmapheresis be a treatment for acute glomerulonephritis? -- Answer โœ”โœ” To remove nephrotoxic antibodies in the plasma
  2. What is nephrotic syndrome? -- Answer โœ”โœ” A glomerular disease (damage to the glomerulus)
  3. How is nephrotic syndrome diagnosed? -- Answer โœ”โœ” 24 hour urine collection, serum protein levels, tissue biopsy
  4. What are the clinical manifestations of nephrotic syndrome? -- Answer โœ”โœ” Edema (soft, pitting, periorbital, ascites, anasarca), headache, irritability, fatigue, proteinuria (may be foamy), decreased albumin in the blood, edema, high serum cholesterol and hyperlipidemia
  5. What is anasarca? -- Answer โœ”โœ” generalized edema
  6. What are the complications of nephrotic syndrome? -- Answer โœ”โœ” Infection, hypercoagulability, PE, acute renal failure, accelerated atherosclerosis, poor nutrition
  7. Why does nephrotic syndrome have a risk of hypercoagulability? -- Answer โœ”โœ” There is a loss of blood proteins that help prevent clotting
  8. Why is there accelerated atherosclerosis with nephrotic syndrome? -- Answer โœ”โœ” When albumin levels fall, the liver makes more albumin. At the same time, the liver releases more cholesterol and triglycerides.
  9. What is the treatment for nephrotic syndrome? -- Answer โœ”โœ” Diuretics, ACE inhibitors, low-sodium diet, corticosteroids, cytoxan, lipid lowering meds, anticoagulation
  1. A urine out put of - mL/day would be a concern for acute kidney injury. -- Answer โœ”โœ” 400 - 500 mL/day (or 20 mL/hour)
  2. Does BUN and creatinine increase or decrease in acute kidney injury? -- Answer โœ”โœ” Increase
  3. Does GFR increase or decrease in acute kidney injury? -- Answer โœ”โœ” Decrease
  4. What is uremia? -- Answer โœ”โœ” urine in the blood
  5. When is uremia detectable? -- Answer โœ”โœ” When 2/3 of the nephrons are functionally lost.
  6. What are the phases of acute kidney injury? -- Answer โœ”โœ” Initiating, oliguria, diuretic, recovery
  7. What occurs during the initiating stage of acute kidney injury? -- Answer โœ”โœ” The initiating stage is from the beginning insult until signs and symptoms occur. Lasts hours to days. Compensatory mechanisms cause an increase in Na and water retention. Decrease in urine output, high specific gravity. (Reversible if caught in this stage)
  8. What occurs during the oliguric stage of an acute kidney injury? -- Answer โœ”โœ” Urine output is below 400 mL/day, high specific gravity, high Na, BUN and creatinine increase, electrolyte imbalances, acidosis, fluid overload.
  9. How long does the oliguric stage of an acute kidney injury last? -- Answer โœ”โœ” 14 days or longer. The longer it lasts, the poorer the prognosis
  1. ___% of patients may not exhibit oliguria, which allows more damage to occur. -- Answer โœ”โœ” 50%
  2. What is a normal specific gravity? -- Answer โœ”โœ” 1.005-1.
  3. Does acute kidney injury cause metabolic acidosis or alkalosis? -- Answer โœ”โœ” Acidosis
  4. When does the diuretic phase of acute kidney injury begin? -- Answer โœ”โœ” When the cause of AKI has been identified and treated
  5. During the diuretic phase of acute kidney injury urine output can increase to - L/day. -- Answer โœ”โœ” 3 - 5
  6. True or false: Patients can experience dehydration during the diuretic phase of AKI. -
  • Answer โœ”โœ” True
  1. How long does the diuretic phase of acute kidney injury last? -- Answer โœ”โœ” 1 - 3 weeks
  2. In what stage of acute kidney injury does electrolytes, acid base imbalances, BUN, and creatinine begin to normalize? -- Answer โœ”โœ” Diuretic
  3. What occurs during the recovery stage of acute kidney injury? -- Answer โœ”โœ” Begins as kidneys begin to return to their regular function. Basement membrane is restored, GFR increases up to 70-80% of normal, fluids and electrolytes normalize.
  4. How long can the recovery stage of acute kidney injury last? -- Answer โœ”โœ” Several months to a year