Acute Care Nurse Practitioner Acute Kidney Injury and Renal Replacement Therapy 3

Question 1

Which diuretic is FIRST-LINE for managing volume overload in AKI patients who are not yet requiring RRT?

Accepted Answer

Furosemide (loop diuretic)

Answer

Furosemide is the first-line diuretic for volume overload in AKI; high doses may be needed in patients with reduced tubular function.

Question 2

A dialysis patient presents to the ICU with peaked T waves and widened QRS on ECG. Potassium is 7.2 mEq/L. What is the IMMEDIATE first step?

Accepted Answer

Give IV calcium gluconate

Answer

IV calcium gluconate immediately stabilizes the cardiac membrane without lowering potassium, buying time for definitive treatment.

Question 3

Which finding indicates successful AKI recovery and readiness to discontinue RRT?

Accepted Answer

Urine output >500 mL/day spontaneously

Answer

Spontaneous urine output >500 mL/day indicates recovering tubular function and is a key criterion for considering RRT discontinuation.

Question 4

Which medication dose adjustment is required in a critically ill patient with AKI (eGFR 15 mL/min)?

Accepted Answer

Vancomycin — reduce dose and extend dosing interval

Answer

Vancomycin is renally cleared; dose reduction and extended dosing intervals with TDM are required in AKI to avoid toxicity.

Question 5

Rhabdomyolysis-induced AKI is BEST prevented by which intervention?

Accepted Answer

Aggressive IV fluid resuscitation with normal saline

Answer

Aggressive IV hydration with isotonic saline is the cornerstone of rhabdomyolysis management, diluting myoglobin and maintaining urine flow.

Acute Care Nurse Practitioner Practice Test