A 72-year-old patient with a history of chronic hypertension is diagnosed with acute kidney injury (AKI) secondary to contrast-induced nephropathy. Which clinical finding would most likely be present in this patient?

Decreased blood pressure

Metabolic acidosis

Hypocalcemia

Increased urine specific gravity

Answer and Explanation

The Correct Answer is B

A.   Decreased blood pressure is not typically associated with contrast-induced nephropathy. In fact, patients may present with normal or elevated blood pressure, especially in those with a history of chronic hypertension.
B.   Metabolic acidosis is a common complication of acute kidney injury (AKI), including contrast-induced nephropathy. As kidney function declines, the kidneys' ability to excrete acids diminishes, leading to the accumulation of acids in the blood and resulting in metabolic acidosis.
C.   Hypocalcemia is not a common feature of contrast-induced nephropathy. While AKI can cause disturbances in calcium and phosphate balance, hypocalcemia is not typically a predominant finding.
D.   Increased urine specific gravity may not be a significant finding in contrast-induced nephropathy. This condition generally leads to impaired kidney function, which may present with urine output changes, but urine specific gravity can vary depending on the stage of AKI.

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Correct Answer is B

Explanation

A. Iron deficiency anemia typically presents with a low MCV, not an elevated MCV, and it is less likely to be associated with the symptoms of glossitis and peripheral neuropathy.
B. Vitamin B12 deficiency anemia is a likely diagnosis in this patient. Chronic alcohol use can lead to malabsorption of vitamin B12, which contributes to macrocytic anemia (high MCV). Symptoms like glossitis and peripheral neuropathy are common in B12 deficiency.
C. Thalassemia minor usually presents with microcytic anemia and would not typically cause the elevated MCV or neurological symptoms seen in this patient.
D. Anemia of chronic disease typically presents with a normal or low MCV and is not associated with elevated MCV or the neurological symptoms seen in this patient.

A. Administer the feeding solution directly from the refrigerator. B. Flush the tube with 10 mL of cold water C. Position the patient supine at 30 degrees. D. Verify the pH of gastric aspirate is less than 5.0.

Correct Answer is D

Explanation

A. Administering feeding solution directly from the refrigerator can cause discomfort to the patient and increase the risk of gastric upset.
B. Flushing the tube with cold water is not appropriate, as it may irritate the stomach and cause discomfort.
C. Positioning the patient supine at 30 degrees is unsafe, as it increases the risk of aspiration. The patient should be at a higher angle, typically 30-45 degrees.
D. Verifying the pH of gastric aspirate is crucial to ensure the feeding tube is in the correct position and to prevent aspiration of feeding material into the lungs.

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A 72-year-old patient with a history of chronic hypertension is diagnosed with acute kidney injury (AKI) secondary to contrast-induced nephropathy. Which clinical finding would most likely be present in this patient?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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