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: A raised red rash is not typically indicative of venous insufficiency but could suggest an allergic reaction or infection.

Choice B reason: Coldness and numbness distal to the fistula site can indicate poor blood flow, which is a symptom of venous insufficiency.

Choice C reason: Pain proximal to the fistula site can be a sign of venous hypertension and insufficiency, as it may

indicate increased pressure in the veins.

Choice D reason: Foul-smelling drainage is not a typical sign of venous insufficiency but may indicate an infection.

A. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure. B. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting. C. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass. D. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria.

Correct Answer is B

Explanation

Choice A reason: Periorbital edema, dark frothy urine, and elevated blood pressure are more indicative of conditions like nephrotic syndrome rather than kidney stones.

Choice B reason: Severe flank pain, nausea, and vomiting are classic symptoms associated with kidney stones, and such clients should be educated on kidney stone prevention.

Choice C reason: Polyuria, nocturia, proteinuria, and a palpable kidney mass could suggest other renal issues, but not specifically kidney stones.

Choice D reason: Urinary urgency, weak urine stream, and dysuria could be symptoms of a urinary tract infection or prostate issues in males, rather than kidney stones.

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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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