Acute Kidney Injury (AKI): Causes, Symptoms, and Treatment

Question 1

Which of the following is the most common cause of AKI in hospitalized patients?

Accepted Answer

Prerenal azotemia

Answer

Intrinsic renal disease

Answer

Postrenal obstruction

Answer

Nephrotoxin exposure

Question 2

Identify the intrinsic risk factor for acute kidney injury (AKI):

Accepted Answer

Diabetes mellitus

Answer

Congestive heart failure

Answer

Age greater than 65 years

Answer

Recent surgery

Question 3

Which pathophysiological mechanism is primarily responsible for ischemic AKI?

Accepted Answer

Hypoperfusion and hypoxia

Answer

Tubular cell injury

Answer

Interstitial inflammation

Answer

Glomerular dysfunction

Question 4

Which clinical manifestation is a typical early sign of AKI?

Accepted Answer

Oliguria

Answer

Anuria

Answer

Proteinuria

Answer

Hyperkalemia

Question 5

Which histological feature is characteristic of acute tubular necrosis (ATN)?

Accepted Answer

Necrosis of tubular epithelial cells

Answer

Inflammation of the interstitium

Answer

Glomerular hypercellularity

Answer

Interstitial fibrosis

Question 6

Which type of AKI is most frequently encountered in clinical practice?

Accepted Answer

Prerenal AKI

Answer

Intrinsic AKI

Answer

Postrenal AKI

Answer

Oliguric AKI

Question 7

Which laboratory test is considered the primary diagnostic tool for AKI?

Accepted Answer

Serum creatinine

Answer

Blood urea nitrogen (BUN)

Answer

Urine output

Answer

Estimated glomerular filtration rate (eGFR)

Question 8

Which pharmacological intervention is the cornerstone of treatment for prerenal AKI?

Accepted Answer

Intravenous fluids

Answer

Diuretics

Answer

Loop diuretics

Answer

Ace inhibitors

Question 9

What is the primary mechanism of action of loop diuretics in the management of AKI?

Accepted Answer

Promoting sodium and water excretion

Answer

Increasing glomerular filtration

Answer

Inhibiting the renin-angiotensin-aldosterone system

Answer

Reducing inflammation

Question 10

In the management of AKI, explain the rationale for using loop diuretics. Describe the physiological mechanisms involved and the essential monitoring parameters.

Accepted Answer

Loop diuretics block the sodium-potassium-chloride cotransporter in the thick ascending limb, enhancing sodium and water excretion.

Answer

Loop diuretics reduce renal blood flow, increasing glomerular filtration rate and natriuresis.

Answer

Loop diuretics are primarily used to prevent fluid overload in patients with AKI.

Question 11

How do inflammatory mediators contribute to tubular damage and the development of acute kidney injury (AKI)?

Accepted Answer

They directly trigger apoptosis and necrosis of tubular cells.

Answer

They exclusively affect the glomerulus, not the tubules.

Answer

They play no role in the pathogenesis of AKI.

Question 12

Which mechanism is primarily responsible for acute tubular necrosis (ATN)?

Accepted Answer

Ischemia

Answer

Glomerular inflammation

Answer

Tubular obstruction

Answer

Immune complex deposition

Question 13

What is the most common cause of prerenal acute kidney injury (AKI)?

Accepted Answer

Hypovolemia

Answer

Sepsis

Answer

Medications

Answer

Autoimmune disorders

Question 14

Which laboratory abnormality is most characteristic of ATN?

Accepted Answer

Elevated creatinine and blood urea nitrogen (BUN)

Answer

Proteinuria

Answer

Hematuria

Answer

Leukocyturia

Question 15

What is the initial pharmacological intervention for hyperkalemia in the setting of AKI?

Accepted Answer

Insulin and glucose

Answer

Sodium bicarbonate

Answer

Calcium gluconate

Answer

Loop diuretics

Question 16

Which intervention is inappropriate for the nursing care of patients with AKI?

Accepted Answer

Limiting fluid intake to 500 ml/day

Answer

Monitoring fluid balance

Answer

Providing oral hygiene with chlorhexidine

Answer

Daily weight monitoring

Question 17

In prerenal AKI, the primary objective of pharmacological management is to:

Accepted Answer

Restore renal perfusion

Answer

Reduce inflammation

Answer

Correct electrolyte imbalances

Answer

Prevent renal fibrosis

Question 18

The primary mechanism of renal injury in prerenal AKI is:

Accepted Answer

Ischemia

Answer

Inflammation

Answer

Nephrotoxicity

Answer

Obstruction

Question 19

The initial nursing intervention for a patient with AKI is to:

Accepted Answer

Monitor vital signs and fluid balance

Answer

Administer diuretics

Answer

Initiate dialysis

Answer

Perform a renal biopsy

Question 20

Which class of diuretics is contraindicated in patients with AKI?

Accepted Answer

Loop diuretics

Answer

Thiazide diuretics

Answer

Potassium-sparing diuretics

Answer

Osmotic diuretics

Question 21

The primary goal of renal replacement therapy (RRT) in AKI is to:

Accepted Answer

Remove waste products and fluid

Answer

Correct electrolyte imbalances

Answer

Restore renal function

Answer

Prevent further kidney damage

Question 22

What is a primary cause of acute tubular necrosis, a type of AKI?

Accepted Answer

Hypovolemia

Answer

Glomerulonephritis

Answer

Pyelonephritis

Answer

Interstitial nephritis

Question 23

What is the most common cause of AKI in hospitalized patients?

Accepted Answer

Sepsis

Answer

Kidney stones

Answer

Medication toxicity

Answer

Inflammation of the kidney's filtering units

Question 24

The primary mechanism of renal damage in ischemic AKI is:

Accepted Answer

Hypoxia

Answer

Inflammation

Answer

Nephrotoxins

Answer

Autoimmunity

Question 25

The primary goal of AKI management is:

Accepted Answer

Fluid resuscitation

Answer

Diuretics

Answer

Antibiotics

Answer

Dialysis

Question 26

Which of the following medications is commonly used to manage AKI-associatedhyperkalemia?

Accepted Answer

Sodium polystyrene sulfonate

Answer

Loop diuretics

Answer

Calcium gluconate

Answer

Amlodipine

Question 27

The primary nursing intervention for patients with AKI is:

Accepted Answer

Monitoring fluid and electrolyte balance

Answer

Administering medications

Answer

Providing emotional support

Answer

Educating patients about AKI

Question 28

Which of the following is a clinical manifestation of severe AKI?

Accepted Answer

Anuria

Answer

Edema

Answer

Fatigue

Answer

Headache

Question 29

Acute tubular necrosis (ATN) is a common cause of acute kidney injury (AKI). Which of the following best describes the pathophysiology of ATN?

Accepted Answer

Ischemia and hypoxia cause tubular cell swelling and degeneration.

Answer

Glomerular inflammation and scarring reduce glomerular filtration rate.

Answer

Interstitial inflammation and fibrosis compress tubules.

Answer

Autoimmune antibodies attack tubular cells, leading to cell death.

Question 30

Which of the following is a primary cause of prerenal AKI?

Accepted Answer

Dehydration

Answer

Glomerular inflammation

Answer

Urinary tract obstruction

Answer

Nephrotoxic insult

Question 31

Which of the following is the most common cause of AKI in hospitalized patients?

Accepted Answer

Sepsis

Answer

Diabetes

Answer

Nephrolithiasis

Answer

Polycystic kidney disease

Question 32

Which of the following laboratory values is suggestive of AKI?

Accepted Answer

Serum creatinine level of 1.5 times baseline or an absolute increase of 0.3 mg/dL within 48 hours

Answer

Hemoglobin level of 14 g/dL

Answer

Platelet count of 200,000/µL

Answer

Sodium level of 135 mEq/L

Question 33

Which of the following medications is recommended for the treatment of AKI secondary to ethylene glycol toxicity?

Accepted Answer

Fomepizole

Answer

Mannitol

Answer

Dopamine

Answer

N-acetylcysteine

Question 34

Which of the following nursing interventions is essential in preventing AKI in critically ill patients?

Accepted Answer

Maintaining adequate fluid balance

Answer

Administering prophylactic antibiotics

Answer

Providing mouth care every 4 hours

Answer

Monitoring blood pressure hourly

Question 35

Which of the following factors is NOT a commonly recognized risk factor for developing AKI?

Accepted Answer

Obesity

Answer

Sepsis

Answer

Diabetes

Answer

Contrast agents

Question 36

Which of the following is a potential complication of AKI?

Accepted Answer

Hyperkalemia

Answer

Hyperglycemia

Answer

Hyponatremia

Question 37

Which type of AKI involves damage to the renal tubules?

Accepted Answer

Intrinsic AKI

Answer

Functional AKI

Answer

Prerenal AKI

Answer

Postrenal AKI

Question 38

An appropriate nursing outcome for a patient with AKI is:

Accepted Answer

Patient will maintain stable renal function

Answer

Patient will not require dialysis

Answer

Patient will experience complete resolution of symptoms

Answer

Patient will be discharged home within 24 hours

Question 39

Which finding in a urinalysis is most specific for acute tubular necrosis (ATN)?

Accepted Answer

Granular casts

Answer

Elevated serum creatinine

Answer

Decreased urine output

Answer

Elevated potassium

Question 40

What is the primary goal of intravenous fluid resuscitation in a patient with AKI?

Accepted Answer

Restore effective intravascular volume

Answer

Lower serum creatinine

Answer

Increase urine output

Answer

Correct electrolyte imbalances

Question 41

Which of the following is a significant risk factor for developing AKI?

Accepted Answer

Sepsis

Answer

Regular exercise

Answer

Controlled hypertension

Answer

Adequate hydration

Question 42

Why might continuous renal replacement therapy (CRRT) be favored over intermittent hemodialysis in a hemodynamically unstable patient with AKI?

Accepted Answer

Allows for more gradual fluid and electrolyte removal

Answer

Shorter treatment duration

Answer

Requires less specialized equipment

Answer

Can be managed solely by nurses

Question 43

Which of the following is a common and potentially serious electrolyte disturbance associated with AKI?

Accepted Answer

Hyperkalemia

Answer

Hypernatremia

Answer

Hypocalcemia

Answer

Hypokalemia

Question 44

What is the primary mechanism of action of furosemide (Lasix) when used in the management of AKI?

Accepted Answer

Increases urine output by blocking sodium reabsorption in the loop of Henle

Answer

Increases glomerular filtration rate directly

Answer

Promotes renal vasodilation

Answer

Reduces inflammation in the kidneys

Question 45

Why might a patient with AKI require a blood transfusion?

Accepted Answer

Correct anemia and improve oxygen-carrying capacity

Answer

Reduce systemic inflammation

Answer

Directly lower serum creatinine levels

Answer

Provide clotting factors to prevent bleeding

Question 46

Which clinical sign is most suggestive of fluid overload in a patient with AKI?

Accepted Answer

Edema

Answer

Hypokalemia

Answer

Bradycardia

Answer

Decreased urine output