The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI). Which condition would the nurse expect to find in the patient's recent history?

Pyelonephritis

Kidney stones

Dehydration

Bladder cancer

Answer and Explanation

The Correct Answer is C

Rationale:
A. Pyelonephritis is an infection of the renal pelvis and kidney tissue, which leads to intrarenal (not prerenal) damage due to inflammation and infection within the kidneys.

B. Kidney stones obstruct urine flow and cause postrenal AKI, not prerenal. This type of injury occurs after the urine leaves the kidneys, leading to back pressure and impaired excretion.

C. Dehydration leads to reduced blood flow to the kidneys, decreasing glomerular filtration rate (GFR) and causing prerenal AKI. Prerenal injury results from conditions that impair perfusion, such as hypovolemia, hemorrhage, or hypotension.

D. Bladder cancer can cause postrenal AKI by obstructing the urinary outflow tract, but it does not affect renal perfusion directly, so it is not a prerenal cause.

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Correct Answer is A

Explanation

Rationale:
A. A serum creatinine level of 6 mg/dL is significantly elevated above the normal range (0.6–1.3 mg/dL) and is a key indicator of acute kidney injury (AKI). Creatinine rises when the kidneys cannot effectively filter waste products from the blood, reflecting a reduction in glomerular filtration rate (GFR). This finding strongly suggests impaired renal function.
B. A serum potassium of 4.5 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not indicate AKI. In kidney injury, potassium is typically elevated due to reduced excretion.
C. A hemoglobin level of 16 g/dL is within the normal range (13–17 g/dL for males, 12–15 g/dL for females) and is unrelated to AKI.
D. A BUN level of 15 mg/dL is normal (reference range 7–20 mg/dL) and does not suggest kidney dysfunction.

A. Check for bleeding at needle insertion sites. B. Assess the patient's distal pulses and circulation. C. Palpate for thrills and auscultate for bruits every 4 hours. D. Avoid taking blood pressure readings in the arm with the fistula.

Correct Answer is D

Explanation

Rationale:
A. Checking for bleeding at needle insertion sites is a nursing responsibility, not a task for unlicensed assistive personnel (UAP). It requires assessment and clinical judgment to determine if bleeding is excessive or abnormal.

B. Assessing distal pulses and circulation also requires advanced clinical skills and should be performed by a licensed nurse. UAPs can report observations, but they are not trained to interpret circulatory assessment findings.

C. Palpating for thrills and auscultating for bruits every 4 hours is essential for monitoring fistula patency, but it requires both tactile and auditory assessment skills, which are beyond the UAP scope of practice.

D. Avoiding blood pressure readings in the arm with the fistula is an appropriate instruction for UAPs. Applying a blood pressure cuff can damage the fistula, reduce blood flow, or cause clot formation. This precaution is a key safety measure that UAPs can implement under nursing supervision.

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The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI). Which condition would the nurse expect to find in the patient's recent history?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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