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.

Answer and Explanation

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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Correct Answer is A

Explanation

Choice A rationale
Enlarged liver (hepatomegaly) and peripheral edema are common clinical manifestations of right heart failure (RHF). RHF leads to congestion of systemic circulation, causing fluid accumulation in the liver and peripheral tissues.
Choice B rationale
Crackles in the lungs are more commonly associated with left-sided heart failure, where fluid backs up into the pulmonary circulation, leading to pulmonary edema.
Choice C rationale
A dry hacking cough is not a typical symptom of right heart failure. It is more commonly associated with respiratory conditions such as asthma or bronchitis.
Choice D rationale
Altered mentation with pinpoint pupils is not a characteristic of right heart failure. These symptoms are more indicative of neurological conditions or opioid overdose.

A. Increased thirst. B. Increased appetite. C. Slurred speech. D. Polyuria.

Correct Answer is C

Explanation

Choice A rationale
Increased thirst is a symptom of hyperglycemia, not hypoglycemia. It occurs when high blood sugar levels cause dehydration.
Choice B rationale
Increased appetite can occur in hypoglycemia but is not as specific as other symptoms like slurred speech.
Choice C rationale
Slurred speech is a common symptom of hypoglycemia, indicating that the brain is not receiving enough glucose to function properly.
Choice D rationale
Polyuria is a symptom of hyperglycemia, where excess glucose in the blood leads to increased urine production.

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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)?

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Correct Answer is A

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Correct Answer is C

Explanation

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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)?