A nurse is caring for a male client who has chronic glomerulonephritis. Which of the following findings should the nurse expect?
Urine specific gravity 1.035
Serum creatinine 7 mg/dL
Creatinine clearance 120 mL/min
BUN 15 mg/dL
The Correct Answer is B
Choice A reason:
Urine specific gravity is a measure of urine concentration. The normal range is typically from 1.005 to 1.030. A specific gravity of 1.035 indicates very concentrated urine, which could be due to dehydration or other factors, but it is not specifically indicative of chronic glomerulonephritis.
Choice B reason:
Serum creatinine is a waste product from the normal breakdown of muscle tissue. Normal levels are approximately 0.6 to 1.2 mg/dL for males. A level of 7 mg/dL is significantly elevated and can indicate severe kidney dysfunction, which is consistent with chronic glomerulonephritis. This condition can lead to a decreased ability of the kidneys to filter waste, causing an accumulation of creatinine in the blood.
Choice C reason:
Creatinine clearance is a test that measures how well creatinine is removed from the blood by the kidneys. The normal range is about 95 to 120 mL/min. A clearance of 120 mL/min is within the normal range and would not typically be expected in a client with chronic glomerulonephritis, as this condition usually results in reduced kidney function.
Choice D reason:
Blood urea nitrogen (BUN) is another waste product filtered by the kidneys. Normal BUN levels are between 7 and 20 mg/dL. A BUN of 15 mg/dL is within the normal range and does not necessarily indicate kidney dysfunction from chronic glomerulonephritis.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The use of erythropoiesis-stimulating agents (ESAs) is indicated for anemia due to chemotherapy¹. However, the client's hemoglobin (Hgb) level is 12.1 g/dL, which is within the normal range (normal: 12-15.5 g/dL for women). Therefore, administering an ESA is not indicated based on the Hgb level provided.
Choice B reason: A diet with increased protein can be beneficial for patients undergoing chemotherapy as it helps in tissue repair and immune system function. However, the client's albumin level is 4.5 g/dL, which falls within the normal range (normal: 3.4-5.4 g/dL), suggesting adequate protein intake. Thus, there is no indication that the client requires an increased protein diet based on the albumin level provided.
Choice C reason: The client's white blood cell (WBC) count is 1,400/mm³, which is below the normal range (normal: 4,500-11,000/mm³). This condition, known as leukopenia, significantly increases the risk of infection³. Therefore, the nurse should prioritize monitoring for signs of infection and implementing infection control measures.
Choice D reason: The client's platelet count is 170,000/mm³, which is within the normal range (normal: 150,000-450,000/mm³). Although cisplatin can cause thrombocytopenia, the current platelet count does not indicate an increased risk for bleeding⁴. Therefore, this choice is not correct based on the platelet count provided.
Correct Answer is B
Explanation
Choice A reason:
This choice suggests a pH of 7.50, which is indicative of alkalosis, and not typically expected in a client with chronic kidney disease (CKD). CKD often leads to metabolic acidosis due to the accumulation of acids in the body as the kidneys fail to excrete them. The HCO₃⁻ level of 20 mEq/L is slightly lower than the normal range (22-26 mEq/L), and the PaCO₂ of 32 mm Hg is within the normal range (35-45 mm Hg), but these values do not align with the expected acidosis associated with CKD.
Choice B reason:
This set of values is consistent with metabolic acidosis, which is commonly seen in clients with CKD. A pH of 7.25 indicates acidemia, and an HCO₃⁻ level of 19 mEq/L is below the normal range, suggesting a primary metabolic acidosis. The PaCO₂ of 30 mm Hg is at the lower end of the normal range, which may indicate a compensatory respiratory response to the metabolic acidosis.
Choice C reason:
A pH of 7.30, while on the lower side, is not as acidic as one would expect in a client with CKD. The HCO₃⁻ level of 26 mEq/L is within the normal range, and a PaCO₂ of 50 mm Hg suggests respiratory acidosis, which is not the primary disorder in CKD.
Choice D reason:
This choice indicates a pH of 7.55, which is too alkaline and not characteristic of CKD, where metabolic acidosis is the expected finding. An HCO₃⁻ level of 30 mEq/L is higher than the normal range, suggesting metabolic alkalosis. The PaCO₂ of 31 mm Hg is slightly below the normal range, possibly indicating a compensatory response, but it does not align with the metabolic acidosis typically seen in CKD.
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