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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Hypernatremia, which is an abnormally high level of sodium in the blood, is not typically associated with prerenal AKI. Prerenal AKI is often related to hypovolemia, which can lead to hyponatremia rather than hypernatremia.
Choice B reason: Hypophosphatemia, or low levels of phosphate in the blood, is not a common finding in prerenal AKI. Phosphate levels are more often affected in intrinsic renal diseases or refeeding syndrome.
Choice C reason: Hypercalcemia, or high levels of calcium in the blood, is not commonly seen in prerenal AKI. It is more frequently associated with malignancies or hyperparathyroidism.
Choice D reason: Hyperkalemia, which is an elevated level of potassium in the blood, is a common electrolyte imbalance in prerenal AKI. This occurs due to decreased renal perfusion and the kidney's reduced ability to excrete potassium.

Correct Answer is B
Explanation
Choice A reason: The end of a menstrual period is not relevant to the intravenous pyelogram procedure.
Choice B reason: An allergy to shellfish is important to report as the contrast dye used in an intravenous pyelogram may contain iodine, which can cause an allergic reaction in individuals with shellfish allergies.
Choice C reason: Drinking fluids is generally encouraged to prevent kidney stones and is not a concern for the provider.
Choice D reason: Painful and red-tinged urination is a symptom of kidney stones but does not need to be reported unless it is a new or worsening symptom.
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