A nurse has identified a fluid volume deficit in the patient who has suffered prolonged vomiting and diarrhea.
Which assessment data is most important in identifying that the patient may be developing prerenal acute kidney injury (AKI)?
Urine specific gravity of 1.029.
BUN of 28 mg/dL.
Creatinine of 2.4 mg/dL.
Dry mucous membranes.
The Correct Answer is C
Choice A rationale
Urine specific gravity of 1.029 indicates concentrated urine, which is common in dehydration but not specific to prerenal AKI. It reflects the kidney’s ability to concentrate urine in response to fluid deficit.
Choice B rationale
BUN of 28 mg/dL can indicate dehydration or renal impairment. However, it is not as specific as creatinine in diagnosing prerenal AKI. BUN can be elevated due to other factors like high protein intake or gastrointestinal bleeding.
Choice C rationale
Creatinine of 2.4 mg/dL is a critical indicator of kidney function. Elevated creatinine levels are more specific to renal impairment, including prerenal AKI, as they reflect the kidney’s ability to filter waste products.
Choice D rationale
Dry mucous membranes are a sign of dehydration but are not specific to prerenal AKI. They indicate fluid volume deficit but do not directly reflect kidney function.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Administering sodium polystyrene sulfonate helps to lower potassium levels by exchanging sodium ions for potassium ions in the intestines. However, it is not the first intervention because it takes time to work and does not address the immediate risk of cardiac arrhythmias caused by hyperkalemia.
Choice B rationale
Monitoring the client’s cardiac rhythm is the first intervention because hyperkalemia can cause life-threatening cardiac arrhythmias. Continuous cardiac monitoring allows for the early detection and treatment of these arrhythmias, which is crucial for the client’s safety.
Choice C rationale
Restricting dietary potassium intake is an important long-term management strategy for hyperkalemia, especially in clients with chronic kidney disease. However, it does not address the immediate risk of cardiac arrhythmias and is not the first intervention.
Choice D rationale
Preparing the client for hemodialysis is a definitive treatment for hyperkalemia, especially in clients with chronic kidney disease. However, it is not the first intervention because it takes time to arrange and initiate dialysis. Immediate cardiac monitoring is necessary to manage the acute risk of arrhythmias.
Correct Answer is A
Explanation
Choice A rationale
Serum amylase is typically elevated in acute pancreatitis. It is one of the key diagnostic markers for this condition.
Choice B rationale
Serum potassium levels are not typically elevated in acute pancreatitis. Potassium levels are more commonly associated with kidney function and electrolyte balance.
Choice C rationale
Serum calcium levels are usually decreased, not elevated, in acute pancreatitis. Hypocalcemia can occur due to fat saponification in the pancreas.
Choice D rationale
Serum sodium levels are not typically elevated in acute pancreatitis. Sodium levels are more related to overall fluid balance and kidney function.
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