A nurse has identified a fluid volume deficit in the patient who has suffered prolonged vomiting and diarrhea.
Which assessment data is most important in identifying that the patient may be developing prerenal acute kidney injury (AKI)?
Urine specific gravity of 1.029.
BUN of 28 mg/dL.
Creatinine of 2.4 mg/dL.
Dry mucous membranes.
The Correct Answer is C
Choice A rationale
Urine specific gravity of 1.029 indicates concentrated urine, which is common in dehydration but not specific to prerenal AKI. It reflects the kidney’s ability to concentrate urine in response to fluid deficit.
Choice B rationale
BUN of 28 mg/dL can indicate dehydration or renal impairment. However, it is not as specific as creatinine in diagnosing prerenal AKI. BUN can be elevated due to other factors like high protein intake or gastrointestinal bleeding.
Choice C rationale
Creatinine of 2.4 mg/dL is a critical indicator of kidney function. Elevated creatinine levels are more specific to renal impairment, including prerenal AKI, as they reflect the kidney’s ability to filter waste products.
Choice D rationale
Dry mucous membranes are a sign of dehydration but are not specific to prerenal AKI. They indicate fluid volume deficit but do not directly reflect kidney function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A respiratory rate of 28 breaths per minute indicates tachypnea, which is a sign of respiratory distress. Immediate intervention is needed to address the underlying cause and prevent further deterioration of the patient’s condition.
Choice B rationale
A temperature of 38°C (100.4°F) indicates a fever, which may suggest an infection. While this requires medical attention, it is not as immediately critical as respiratory distress.
Choice C rationale
A blood pressure of 140/90 mmHg is considered high, but it does not indicate an immediate need for intervention in the context of COPD. Hypertension should be managed, but it is not an acute emergency.
Choice D rationale
A heart rate of 90 beats per minute is within the normal range and does not indicate an immediate need for intervention. Monitoring the patient’s heart rate is important, but it is not an urgent concern in this scenario.
Correct Answer is D
Explanation
Choice A rationale
The left extrapyramidal tract is involved in motor control, but lesions here would not cause right homonymous hemianopia or inability to move the right arm. These symptoms are more indicative of a lesion in the cerebral hemisphere.
Choice B rationale
A lesion in the right cerebral hemisphere would cause left-sided symptoms, not right-sided. The patient’s symptoms are indicative of a lesion in the left cerebral hemisphere.
Choice C rationale
The cerebellum is involved in coordination and balance, not in causing right homonymous hemianopia or inability to move the right arm. These symptoms are more indicative of a lesion in the cerebral hemisphere.
Choice D rationale
A lesion in the left cerebral hemisphere can cause right homonymous hemianopia and inability to move the right arm. This is because the left hemisphere controls the right side of the body and processes visual information from the right visual field.
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