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Quizzes > Health & Medicine

CKD NCLEX Questions: Chronic Kidney Disease Practice Quiz

Quick, free CKD practice quiz to test your knowledge. Instant results.

Editorial: Review CompletedCreated By: Destini HutchinsUpdated Aug 23, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art kidneys stethoscope quiz on golden yellow background free ESRD NCLEX challenge for chronic kidney disease

This quiz helps you practice chronic kidney disease NCLEX questions and find weak spots before the exam. Work through CKD care, dialysis basics, meds, labs, and safety scenarios, then extend your review with related systems, including heart failure NCLEX questions and diabetes nclex questions too.

What is the earliest clinical indicator of chronic kidney disease?
Decreased glomerular filtration rate
Microalbuminuria
Oliguria
Hypertension
Chronic kidney disease often progresses silently and early glomerular filtration rate changes are not detected until late. Microalbuminuria is the earliest sign of kidney damage, appearing before significant GFR decline. Early detection allows for interventions to slow progression.
Which nutrient should a patient with chronic kidney disease most restrict to help control fluid retention and hypertension?
Vitamin D
Protein
Sodium
Calcium
Sodium retention contributes to fluid overload, hypertension, and edema in CKD patients. Restricting sodium helps manage blood pressure and reduce excess fluid. Protein restriction is for reducing nitrogenous waste but does not directly control fluid.
Which electrolyte imbalance is most commonly associated with end-stage renal disease?
Hypercalcemia
Hyperkalemia
Hypophosphatemia
Hypokalemia
As kidney function declines, potassium excretion is impaired, leading to hyperkalemia. Elevated serum potassium can cause cardiac dysrhythmias and muscle weakness. Monitoring and managing potassium intake and medications is critical.
Which acid - base disturbance is typically seen in chronic kidney disease?
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
CKD reduces the kidneys' ability to excrete hydrogen ions and regenerate bicarbonate, resulting in metabolic acidosis. Patients often compensate with increased respiratory rate (Kussmaul respirations). This acid - base imbalance can exacerbate bone demineralization and muscle wasting.
A patient's GFR is measured at 12 mL/min/1.73 m². This patient would be classified as which stage of chronic kidney disease?
Stage 5
Stage 2
Stage 3
Stage 4
Stage 5 CKD is defined by a GFR less than 15 mL/min/1.73 m² and is also referred to as end-stage renal disease. At this stage, dialysis or transplantation is typically required. Stages are categorized to guide treatment and predict outcomes.
What is the most common cause of chronic kidney disease in adults?
Polycystic kidney disease
Hypertension
Glomerulonephritis
Diabetes mellitus
Diabetes mellitus, particularly long-standing uncontrolled hyperglycemia, leads to diabetic nephropathy - the top cause of CKD in adults. High glucose levels damage glomerular capillaries and cause proteinuria. Effective glycemic control can slow progression.
To assess the patency of a newly created arteriovenous fistula before dialysis, the nurse should:
Measure capillary refill in the hand
Auscultate for bruits and palpate for thrills
Take the patient's blood pressure on that arm
Check distal pedal pulses
Palpating for a thrill and auscultating for a bruit over the fistula are standard methods to confirm patency and adequate blood flow. Blood pressure measurements or venipunctures should be avoided in the fistula arm. Regular checks prevent access failure.
Peritoneal dialysis uses which type of dialysis solution to promote ultrafiltration?
Isotonic saline
Hypotonic dextrose
Hypertonic dextrose
Hypertonic saline
Hypertonic dextrose solutions create an osmotic gradient that draws fluid from the capillaries into the peritoneal cavity. The higher dextrose concentration increases ultrafiltration rate. Patients can adjust the dextrose strength based on fluid removal needs.
Which medication is most appropriate to manage hyperphosphatemia in patients with chronic kidney disease?
Alendronate
Furosemide
Sevelamer
Calcitonin
Sevelamer is a phosphate binder that attaches to dietary phosphate in the gastrointestinal tract, reducing its absorption. It is indicated for CKD patients with hyperphosphatemia. Unlike calcium-based binders, it does not raise serum calcium levels.
A patient with CKD develops secondary hyperparathyroidism. Which medication is most appropriate to suppress parathyroid hormone secretion?
Calcium carbonate
Calcitriol
Cinacalcet
Alendronate
Calcitriol, the active form of vitamin D, increases calcium absorption and suppresses parathyroid hormone (PTH) secretion. It helps correct secondary hyperparathyroidism seen in CKD. Cinacalcet is also used in some cases but active vitamin D remains first-line.
Which complication is most commonly associated with long-term peritoneal dialysis?
Peritonitis
Pneumothorax
Hypotension
Disequilibrium syndrome
Peritonitis is the most frequent and serious complication of peritoneal dialysis due to repeated catheter access. Symptoms include abdominal pain, fever, and cloudy effluent. Strict aseptic technique and exit-site care reduce risk.
Impaired activation of vitamin D in chronic kidney disease leads primarily to which electrolyte abnormality?
Hypocalcemia
Hyperkalemia
Hypernatremia
Hypermagnesemia
The failing kidney cannot convert 25-hydroxyvitamin D to its active form, calcitriol, reducing intestinal calcium absorption. This results in hypocalcemia and stimulates secondary hyperparathyroidism. Correcting vitamin D levels is crucial to prevent bone disease.
According to the AEIOU criteria for emergent dialysis, which finding indicates an immediate need for renal replacement therapy?
Anemia with hemoglobin of 8 g/dL
Hyponatremia with sodium 130 mEq/L
Serum creatinine >5 mg/dL
Symptomatic uremic pericarditis
The 'U' in AEIOU represents uremia, with pericarditis being a classic emergent sign requiring immediate dialysis. Elevated creatinine alone, mild hyponatremia, and anemia are not sole indications unless accompanied by severe symptoms. Recognizing pericardial friction rub or chest pain is critical.
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Study Outcomes

  1. Analyze Clinical Scenarios -

    Apply critical thinking to interpret patient data and laboratory values in chronic kidney disease NCLEX questions, ensuring accurate assessment and prioritization of nursing interventions.

  2. Understand Pathophysiology -

    Outline the stages, risk factors, and pathophysiological mechanisms of chronic renal failure NCLEX questions to inform evidence-based care planning.

  3. Apply Treatment Protocols -

    Demonstrate proficiency in selecting and managing dialysis, medication, and dietary interventions for end stage renal disease quiz scenarios.

  4. Evaluate Patient Safety -

    Assess potential complications and implement preventive measures in ESRD NCLEX questions to maintain patient safety and reduce adverse outcomes.

  5. Interpret Question Formats -

    Familiarize yourself with renal failure NCLEX practice styles and time-management strategies to boost confidence and test readiness.

Cheat Sheet

  1. eGFR and CKD Staging -

    Review the CKD-EPI equation for estimating GFR and memorize the five CKD stages (Stage 1: ≥90 mL/min/1.73 m² to Stage 5: <15 mL/min/1.73 m²). Use the "GFR Funnel" mnemonic - Good, Fair, Poor, Danger, Emergency - to recall stages when tackling chronic kidney disease NCLEX questions. Accurate staging guides treatment plans and informs when to prepare for renal replacement therapy.

  2. Fluid and Electrolyte Management -

    Monitor hyperkalemia risk by understanding K❺ shifts in acidosis and cell lysis; the "A SIC WALT" mnemonic (Acidosis = Shift K❺ Out) helps recall that acidosis drives potassium out of cells. Remember typical serum K❺ should be 3.5 - 5.0 mEq/L, and interventions include IV insulin with glucose or sodium polystyrene sulfonate. These principles frequently appear in chronic renal failure NCLEX questions to test critical thinking.

  3. Acid-Base Imbalances in ESRD -

    End-stage renal disease often causes a normal anion gap metabolic acidosis due to decreased H❺ excretion; calculate the anion gap (Na❺ - [Cl❻ + HCO₃❻]) to distinguish gap vs non-gap acidosis. Treatment may include oral sodium bicarbonate to maintain serum HCO₃❻ above 22 mEq/L. Mastering this concept is essential for ESRD NCLEX questions on acid-base disturbances.

  4. Anemia and Mineral-Bone Disorder -

    In CKD, reduced erythropoietin production leads to normocytic anemia; track hemoglobin levels (target 10 - 11.5 g/dL) and iron studies (ferritin >200 ng/mL, transferrin saturation >20%) before initiating erythropoiesis-stimulating agents. For bone-mineral disease, remember "Phos High, Ca Low" when prescribing phosphate binders or vitamin D analogs. These protocols often appear in renal failure NCLEX practice questions to test medication management.

  5. Dialysis Modalities and Access Care -

    Differentiate hemodialysis (HD) and peritoneal dialysis (PD) by understanding solute clearance rates, access types (arteriovenous fistula vs catheter), and frequency (HD: 3×/week; PD: daily). Use the mnemonic "HD = High-flow Dialysis; PD = Peritoneum as Dialyzer" to recall modality differences. Confidence in these distinctions will boost your performance on the end stage renal disease quiz.

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