Acute Care Nurse Practitioner Acute Kidney Injury and Renal Replacement Therapy

Question 1

According to KDIGO criteria, which finding defines Stage 1 AKI?

Accepted Answer

Creatinine increase ≥0.3 mg/dL within 48 hours

Answer

Creatinine increase ≥2× baseline

Answer

Urine output <0.3 mL/kg/hr for >24 hours

Answer

GFR decrease >50%

Question 2

Which of the following is the MOST common cause of AKI in the ICU?

Accepted Answer

Sepsis-associated AKI

Answer

Glomerulonephritis

Answer

Urinary obstruction

Answer

Contrast nephropathy

Question 3

Which urinalysis finding MOST suggests intrinsic renal AKI (acute tubular necrosis)?

Accepted Answer

Muddy brown granular casts

Answer

Hyaline casts

Answer

RBC casts

Answer

WBC casts with eosinophils

Question 4

In pre-renal AKI, which urine chemistry finding is expected?

Accepted Answer

FeNa <1%, urine osmolality >500 mOsm/kg

Answer

FeNa >2%, urine osmolality <350 mOsm/kg

Answer

FeNa <1%, urine osmolality <300 mOsm/kg

Answer

FeNa >3%, urine sodium <20 mEq/L

Question 5

Which nephrotoxic agent is MOST commonly implicated in ICU-acquired AKI?

Accepted Answer

Aminoglycosides

Answer

Loop diuretics

Answer

ACE inhibitors

Answer

Beta-blockers

Question 6

An ACNP wants to contrast-enhance a CT scan in a patient with eGFR 28 mL/min. Which is the MOST evidence-based preventive strategy?

Accepted Answer

Ensure adequate IV hydration with isotonic saline before/after

Answer

Pre-treat with N-acetylcysteine

Answer

Use high-osmolar contrast media

Answer

Administer furosemide pre-procedure