A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

Serum creatinine 1.8 mg/dL

Blood urea nitrogen (BUN) 200 mg/dL

Serum osmolality 290 mOsm/kg H2O

Magnesium 2.0 mEq/L

Answer and Explanation

Correct Answer : A,B

Choice A reason: The normal range for serum creatinine in adult females is approximately 0.6–1.1 mg/dL. A level of 1.8 mg/dL is elevated and indicates impaired kidney function, which is a risk factor for AKI.

Choice B reason: Normal BUN levels are generally between 6 to 24 mg/dL⁸. A BUN level of 200 mg/dL is significantly elevated and suggests kidney dysfunction, which can lead to AKI.

Choice C reason: Serum osmolality in the normal range, which is typically between 275 to 295 mOsm/kg H2O for adults⁹[13][^10^][14][16], does not indicate an increased risk of AKI.

Choice D reason: The normal range for serum magnesium is typically 1.7 to 2.2 mg/dL or 0.85 to 1.10 mmol/L. A level of 2.0 mEq/L (which is equivalent to 2.0 mg/dL) is within the normal range and does not indicate an increased risk for AKI.

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Correct Answer is D

Explanation

Choice A reason: A pH of 7.26 indicates acidosis, but an HCO3 of 24 and PaCO2 of 46 suggest a respiratory cause rather than metabolic, which is not typical for AKI.

Choice B reason: A pH of 7.49 indicates alkalosis, and with an HCO3 of 30 and PaCO2 of 40, this suggests metabolic alkalosis, which is not expected in AKI.

Choice C reason: A pH of 7.49 indicates alkalosis. An HCO3 of 24 is normal, and a PaCO2 of 30 would suggest respiratory alkalosis, not typically associated with AKI.

Choice D reason: A pH of 7.26 indicates acidosis, and with an HCO3 of 14, this suggests metabolic acidosis, which is consistent with AKI. The PaCO2 of 30 indicates a compensatory respiratory response to the metabolic acidosis. This ABG result aligns with the expected findings in a patient with AKI, where there is an accumulation of acids and a decrease in bicarbonate due to the kidneys' inability to filter and excrete hydrogen ions effectively.

A. The client who had general anesthesia for back surgery 8 hours ago. B. The client who has a history of liver failure. C. The client who reported eating a diet high in calcium oxalate. D. The client who was treated with antibiotics for Staphylococcus aureus infection of the skin 2 weeks ago.

Correct Answer is A

Explanation

Choice A reason: General anesthesia can impair the autonomic nervous system, which controls bladder function, leading to urinary retention. This risk is particularly high shortly after surgery.

Choice B reason: While liver failure can lead to multiple organ dysfunction, it is not directly associated with urinary retention unless there are concurrent issues affecting the urinary system.

Choice C reason: A diet high in calcium oxalate can contribute to kidney stones, which could potentially cause urinary obstruction, but it is not a direct cause of urinary retention.

Choice D reason: Antibiotics for a skin infection would not typically lead to urinary retention unless there were an allergic reaction or other rare side effects that affect the urinary system.

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A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas (ABG) values would the nurse expect this client to have?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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