1 :

Hint : Validates concerns, opens dialogue.

Correct Answers:

  • "Clients with this disease typically have concerns with finances, treatment and adjusting to a new normal.


Rationale :

⚫This response promotes therapeutic communication by validating the client’s concerns while introducing the emotional and practical aspects of living with acute kidney injury (AKI).

⚫It encourages patient reflection, establishes empathy, and opens the door to further education and planning.

⚫Unlike dismissive or false reassurance, this answer fosters psychological readiness for health behavior changes and self-management.


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2 :

Hint : Toxic damage inside the kidney.

Correct Answers:

  • An intrarenal acute kidney injury


Rationale :

✅Gentamicin is an aminoglycoside antibiotic known to cause nephrotoxicity, specifically acute tubular necrosis, which is a form of intrarenal AKI.

✅Elevated BUN (31), creatinine (1.8), and reduced GFR (55 mL/min) point to impaired filtration at the nephron level, not just reduced perfusion (pre-renal) or obstruction (post-renal).

✅This classification is critical for determining the appropriate intervention and monitoring.


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3 :

Hint : Obstruction + bladder compensation.

Correct Answers:

  • Dysuria
  • Urinary urgency
  • Incontinence
  • Urinary frequency
  • Inability to void


Rationale :

✅BPH causes urinary obstruction and bladder irritation, leading to:

  • Dysuria : pain from incomplete emptying or straining.
  • Urgency : from bladder hyperactivity due to obstruction.
  • Incontinence : often overflow incontinence from full bladder.
  • Frequency : small frequent voids due to reduced bladder capacity.
  • Inability to void : late-stage retention or acute urinary retention.
  • Impotence is not a direct result of BPH, though it may coexist due to age or other factors.

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4 :

Hint : Neuro or fluid-related disorders.

Correct Answers:

  • Heart failure
  • Diabetes mellitus
  • Multiple sclerosis


Rationale :

✅Conditions linked to neurological dysfunction or fluid imbalance often contribute to urinary incontinence:

  • Heart failure: causes nocturia, urgency due to fluid shifts.
  • Diabetes: leads to diabetic neuropathy, affecting bladder innervation.
  • Multiple sclerosis: disrupts central control over the bladder.
  • COPD is not directly associated unless the client is significantly debilitated.

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5 :

Hint : Avoid potassium in renal disease.

Correct Answers:

  • Banana


Rationale :

🔹Bananas are rich in potassium (~422 mg per medium banana), which must be limited in clients with chronic glomerulonephritis due to reduced potassium excretion.

🔹Excess serum potassium (hyperkalemia) can cause life-threatening cardiac arrhythmias.

🔹Safer alternatives include fruits with lower potassium content like apples and grapes.


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6 :

Hint : Progressive nephron scarring.

Correct Answers:

  • Chronic nephropathies that lead to fibrosis and destruction of normal kidney structure and function


Rationale :

✅Chronic kidney disease (CKD) results from long-standing nephron damage due to conditions like hypertension and diabetes mellitus, leading to renal fibrosis, glomerulosclerosis, and tubular atrophy.

✅These structural changes impair kidney function over time, culminating in fluid overload and symptoms such as shortness of breath from pulmonary edema.


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7 :

Hint : Follow strict fluid and symptom guidelines.

Correct Answers:

  • "l will drink only the amount of fluid in a day that my doctor told me to."
  • "l will call my doctor if I feel short of breath all of a sudden."


Rationale :

✅Clients on intermittent peritoneal dialysis must manage fluid intake to prevent volume overload.

  • Fluid intake must be limited based on the nephrologist’s recommendation and dialysis adequacy.
  • Sudden shortness of breath suggests fluid overload or infection—both requiring immediate provider notification.
  • Weight every other day and conditional medicinal use reflect poor fluid and medication adherence.

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8 :

Hint : Kidney toxins and perfusion issues.

Correct Answers:

  • A client who is taking gentamicin for infection
  • A client who has heart failure
  • A client who is 1 day postoperative following a colon resection


Rationale :

✅AKI risk is elevated in clients with:

  • Gentamicin: nephrotoxic potential.
  • Heart failure: low cardiac output → reduced renal perfusion.
  • Postoperative patients: risk from anesthesia, blood loss, or hypovolemia.
  • Pneumonia, unless severe or septic, is not a strong independent AKI risk factor.

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9 :

Hint : Benign overgrowth in prostate tissue.

Correct Answers:

  • "It is caused by smooth muscle and epithelial cells multiplying at an uncontrolled rate within the transition zone."


Rationale :

🔹BPH results from hormonal changes (especially increased dihydrotestosterone) leading to hyperplasia of smooth muscle and epithelial cells in the transition zone of the prostate.

🔹This growth narrows the urethra, impeding urine flow.

🔹The condition is non-malignant and differs from conditions involving cysts, glomerular inflammation, or renal stones.


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10 :

Hint : Restricted access → functional incontinence.

Correct Answers:

  • "l probably have problems with incontinence due to our strict break policy that they monitor very closely. "


Rationale :

✅This reflects functional incontinence, where external or environmental barriers (like limited restroom breaks) prevent timely urination.

✅The cause is not due to bladder dysfunction but from impaired ability to respond to the urge.

✅Recognizing this helps direct workplace modifications or behavior-based strategies.


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Total Questions: 10

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