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 B

Explanation

Choice A reason: Diagnosis is the identification of a disease or condition, which is not directly related to reviewing kidney function test data.

Choice B reason: Assessment involves collecting and analyzing data, which is what the nurse is doing when reviewing kidney function test results.

Choice C reason: Implementation refers to carrying out interventions, not reviewing test data.

Choice D reason: Outcomes identification involves setting goals and expected outcomes, not reviewing test data.

A. Breast cancer survivor for 8 years B. Pacemaker C. 65 years of age D. Alcohol use disorder

Correct Answer is D

Explanation

Choice A reason: Being a breast cancer survivor is not an absolute contraindication for kidney transplant. Patients with a history of malignancy should be successfully treated before proceeding with transplantation, and most candidates with a history of cancer are advised to wait a period of time between successful treatment and transplantation.

Choice B reason: Having a pacemaker is not a contraindication for kidney transplant. Patients with cardiac devices can undergo transplantation if their cardiac condition is stable and well-managed.

Choice C reason: Age alone, such as being 65 years of age, is not an absolute contraindication for kidney transplant. Many transplant centers perform successful kidney transplants in older adults, considering their overall health and potential benefits from the procedure.

Choice D reason: Active drug or alcohol addiction is considered a contraindication for kidney transplantation. Patients with addiction should be in an established recovery program and stable for a minimum of one year before being considered for transplant.

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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?

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