Practice Question
A nurse is reinforcing teaching with a client about the oliguric phase of acute kidney injury. Which of the following information should the nurse include in the teaching?
Answer Choices:
Correct Answer:
The client's urine output is less than 400 mL per 24 hours.
Rationale:
🍃 The oliguric phase of AKI is defined by markedly reduced urine output, typically less than 400 mL in 24 hours in adults.
🍃 This reduced output reflects severely impaired glomerular filtration and the kidneys’ inability to excrete fluid and metabolic wastes.
🍃 During this phase, clients are at risk for fluid overload, electrolyte imbalances, metabolic acidosis, and azotemia.
🍃 Monitoring urine output is crucial because decreasing output is often one of the earliest clinical indicators of AKI.
🍃 Teaching this specific volume threshold helps clients and staff recognize when oliguria may signal significant renal dysfunction.
“The oliguric phase lasts for 2 days.”
🍃 The oliguric phase typically lasts longer than 2 days, often 1–3 weeks, depending on the cause and severity of the kidney insult.
🍃 Saying it lasts only 2 days underestimates the clinical duration and may give clients a false sense of rapid recovery.
🍃 Prolonged oliguria contributes to ongoing electrolyte and fluid imbalances, requiring close monitoring over days to weeks.
🍃 Misstating the length of the phase could lead to inadequate planning for monitoring and treatment.
🍃 Therefore, this statement does not accurately reflect the usual course of oliguric AKI.
“The oliguric phase begins within 1 month of the injury.”
🍃 The oliguric phase generally begins within 1–7 days of the initial kidney injury, not as late as 1 month.
🍃 A 1-month delay would be more consistent with chronic changes, not the acute pattern seen in AKI.
🍃 Early onset is important for timely diagnosis and intervention, such as fluid management and avoiding nephrotoxins.
🍃 Teaching that it starts within a month could cause missed recognition of early oliguric changes soon after the insult.
🍃 Therefore, this answer misrepresents the timing of the oliguric phase.
“The client's BUN and creatinine decrease during this phase.”
🍃 In the oliguric phase, BUN and creatinine levels increase, not decrease, due to retention of nitrogenous wastes in the blood.
🍃 The kidneys are unable to adequately filter and excrete these substances, causing progressive azotemia.
🍃 Decreasing BUN and creatinine would suggest improvement or recovery, which typically occurs in the diuretic or recovery phases, not the oliguric phase.
🍃 Misunderstanding lab trends can lead to inaccurate interpretation of kidney status and delayed adjustments to care.
🍃 Thus, this statement is incorrect for the oliguric phase of AKI.
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This question is from Custom Fundamentals Exam 4 Fall 2025 which contains 24 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Fundamentals of Nursing
- Answer Choices: 4