Acute vs Chronic Kidney Disease Practice Questions
18 free Acute vs Chronic Kidney Disease practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which characteristic is most suggestive of chronic kidney disease rather than acute kidney injury?
- A Rapid onset of symptoms over a few days
- B Long history of hypertension and diabetes
- C Acute drop in urine output after dehydration
- D Fully reversible after volume replacement
Correct answer: Long history of hypertension and diabetes
CKD often develops gradually over months to years, frequently in the context of long-term conditions such as hypertension or diabetes.
In differentiating AKI from CKD, the finding of small kidneys on renal ultrasound most likely indicates:
- A AKI
- B CKD
- C Neither
- D Either
Correct answer: CKD
Small or shrunken kidneys suggest long-term structural damage and are more typical of CKD.
A key risk factor for developing AKI is:
- A Long-term mild proteinuria
- B Acute sepsis in hospital
- C Stable eGFR of 60 mL/min/1.73m² for 5 years
- D Controlled hypertension without nephropathy
Correct answer: Acute sepsis in hospital
AKI often arises in the setting of an acute event such as sepsis, shock, or major surgery that suddenly impairs renal perfusion or causes intrinsic damage.
Which statement is true regarding reversibility of kidney injury?
- A CKD is typically reversible with treatment
- B AKI is often reversible if treated promptly
- C Both AKI and CKD are always irreversible
- D AKI never leads to long-term kidney damage
Correct answer: AKI is often reversible if treated promptly
AKI is more likely to be reversible, especially if the cause is corrected early, whereas CKD is usually progressive and not fully reversible.
A patient presents with hyperphosphatemia, hypocalcemia, anemia, and fatigue. These findings are more typical of:
- A AKI
- B CKD
- C Pre-renal azotemia
- D Post-renal obstruction alone
Correct answer: CKD
These metabolic changes (mineral bone disorder, anemia) tend to develop gradually and reflect long-term kidney damage seen in CKD rather than acute injury.
Which laboratory pattern is most characteristic of AKI rather than CKD?
- A Gradual monthly rise in creatinine
- B Sudden doubling of serum creatinine in 48 hours
- C Stable elevated creatinine for many months
- D eGFR persistently < 30 mL/min/1.73m² for at least 3 months
Correct answer: Sudden doubling of serum creatinine in 48 hours
AKI is defined by an abrupt increase in creatinine or decrease in urine output within hours to days. The other patterns better align with chronic disease.
Which of the following is a hallmark risk of CKD but not an early feature of AKI?
- A Sudden onset of oliguria after injury
- B Cardiovascular disease and bone disorder
- C Rapid fluid overload soon after surgery
- D Acute exposure to a nephrotoxin
Correct answer: Cardiovascular disease and bone disorder
CKD often leads to long-term complications such as cardiovascular disease, bone mineral disorders, and anemia, which are less typical in acute settings.
A patient with known CKD develops AKI superimposed on their chronic condition. This scenario is referred to as:
- A New-onset acute kidney injury
- B Newly diagnosed chronic kidney disease
- C Acute-on-chronic kidney injury
- D Established end-stage renal disease
Correct answer: Acute-on-chronic kidney injury
When an acute decline in renal function occurs in a patient with pre-existing CKD, it is termed acute-on-chronic kidney injury.
Which of the following is a common cause of AKI but less likely for CKD onset?
- A Long-term hypertension
- B Acute tubular necrosis from ischemia
- C Diabetes mellitus causing nephropathy
- D Slowly progressive glomerulonephritis
Correct answer: Acute tubular necrosis from ischemia
Acute tubular necrosis (from ischemia or toxins) is a typical cause of AKI; by contrast, hypertension, diabetes and slow glomerular damage more often underlie CKD.
In CKD, symptoms often appear only after significant damage has occurred. Which of the following reflects this?
- A Early nausea and oliguria within days
- B Long asymptomatic period despite damage
- C Rapid mental status change within 24 hours
- D Immediate need for dialysis in every case
Correct answer: Long asymptomatic period despite damage
CKD often progresses silently for months to years and patients may not notice symptoms until substantial loss of renal function occurs.
A nephrology nurse is evaluating urine output trends. Sudden oliguria post-operatively is most representative of:
- A CKD progression
- B AKI
- C A new glomerular filtration rate decline over months
- D Chronic tubular atrophy
Correct answer: AKI
Sudden reduction in urine output is a typical clinical sign of AKI, correlating with abrupt kidney injury.
Which statement best describes the typical time-frame distinction between AKI and CKD?
- A AKI evolves over months; CKD evolves over days
- B AKI over hours to days; CKD over months to years
- C Both conditions evolve at exactly the same rate
- D CKD requires fewer than 7 days to diagnose
Correct answer: AKI over hours to days; CKD over months to years
AKI is an abrupt event (hours to days), whereas CKD reflects a slow, persistent decline over months to years.
A patient with CKD is preparing for kidney transplant. Which of the following is most relevant to their condition?
- A Rapid recovery of kidney function within days
- B Persistent GFR < 60 mL/min/1.73m² for more than 3 months
- C Use of fluids and diuretics to correct acute hypoperfusion
- D Acute tubular injury from contrast media
Correct answer: Persistent GFR < 60 mL/min/1.73m² for more than 3 months
CKD is defined by reduced GFR (< 60 mL/min/1.73 m²) or kidney damage persisting for ≥3 months. The other options reflect acute changes.
Which nursing intervention is most urgent in AKI but less so in early CKD?
- A Education about long-term dialysis planning
- B Rapid correction of the underlying cause
- C Routine annual monitoring of albuminuria
- D Dietary plans for chronic phosphorus control
Correct answer: Rapid correction of the underlying cause
In AKI, immediate management of the precipitating cause (e.g., volume resuscitation) is urgent to restore function; in CKD the focus is long-term management.
Which electrolyte disturbance is more characteristic of an acute kidney injury scenario?
- A Chronic stabilized hyperphosphatemia
- B Sudden hyperkalemia after oliguria
- C Long-standing, slowly worsening anemia
- D Slow onset hypocalcemia over months
Correct answer: Sudden hyperkalemia after oliguria
AKI often leads to rapid electrolyte imbalances such as hyperkalemia due to abrupt loss of excretory function; the other disturbances are more chronic.
Which of the following prognostic statements is correct?
- A AKI always leads to full recovery with no future risk
- B CKD seldom causes cardiovascular complications
- C Surviving AKI increases future risk of developing CKD
- D CKD is easily reversible with prompt fluids
Correct answer: Surviving AKI increases future risk of developing CKD
Survivors of AKI have an elevated risk of subsequent CKD and cardiovascular disease; AKI and CKD are interconnected.
The definition of CKD includes which of the following?
- A Sudden increase in serum creatinine over 2 days
- B eGFR < 60 mL/min/1.73 m² for ≥3 months
- C Any single episode of oliguria post-surgery
- D Complete return of kidney function within 24 hours
Correct answer: eGFR < 60 mL/min/1.73 m² for ≥3 months
CKD is defined by either kidney damage or GFR < 60 mL/min/1.73 m² that persists for ≥3 months.
In terms of therapeutic focus, CKD management primarily includes:
- A Rapid reversal of the injury within 7 days
- B Long-term risk-factor control and slowing progression
- C Deliberately ignoring urine output trends
- D Only emergency dialysis when creatinine doubles in a day
Correct answer: Long-term risk-factor control and slowing progression
CKD therapy centres on controlling underlying conditions and preventing further damage over time; reversibility is limited.