Acute Care Nurse Practitioner Acute Kidney Injury and Renal Replacement Therapy 2

Question 1

Which indication for renal replacement therapy (RRT) is considered an EMERGENCY requiring immediate initiation?

Accepted Answer

Severe hyperkalemia with ECG changes

Answer

BUN >80 mg/dL

Answer

Creatinine >4 mg/dL

Answer

Urine output <0.5 mL/kg/hr for 6 hours

Question 2

Which modality of RRT is preferred for hemodynamically unstable ICU patients?

Accepted Answer

Continuous renal replacement therapy (CRRT)

Answer

Intermittent hemodialysis (IHD)

Answer

Peritoneal dialysis

Answer

Sustained low-efficiency dialysis (SLED)

Question 3

Which anticoagulation is MOST commonly used in CRRT to prevent circuit clotting while minimizing systemic bleeding risk?

Accepted Answer

Citrate regional anticoagulation

Answer

Systemic heparin infusion

Answer

Warfarin

Answer

Enoxaparin

Question 4

A patient on CRRT receiving citrate anticoagulation develops rising total calcium with decreasing ionized calcium. What does this indicate?

Accepted Answer

Citrate toxicity/accumulation

Answer

Adequate anticoagulation

Answer

Hypocalcemia from calcium chelation

Answer

Equipment malfunction

Question 5

Which condition is MOST likely to cause a false elevation in serum creatinine without true reduction in GFR?

Accepted Answer

Trimethoprim use

Answer

High protein diet

Answer

Rhabdomyolysis

Answer

Hypoalbuminemia

Question 6

Recovery of renal function after AKI in the ICU is BEST predicted by which factor?

Accepted Answer

Underlying cause of AKI (reversibility)

Answer

Peak creatinine level

Answer

Duration of oliguria before RRT initiation

Answer

Patient age