The nurse is assessing a patient with renal failure and notes fatigue, muscle cramps, confusion, and headache. Which laboratory abnormality corresponds with these findings?

Correct Answer: B

Rationale: The correct answer is B: Sodium of 129 mEq/L. In renal failure, hyponatremia (low sodium) can cause fatigue, muscle cramps, confusion, and headache. Low sodium levels can lead to neurological symptoms and muscle weakness. Other choices are incorrect: A: Hypokalemia can cause muscle weakness but not confusion or headache. C: Hypocalcemia can cause muscle cramps but not confusion. D: Hypochloremia is not associated with the described symptoms.

Correct Answer: A

Rationale: The correct answer is A: sepsis. Sepsis is the leading cause of acute kidney injury in critically ill patients due to systemic inflammation and decreased blood flow to the kidneys. Sepsis can lead to septic shock, causing renal hypoperfusion. Fluid overload (B) can contribute to kidney injury but is not the most common cause. Medications (C) can cause kidney injury, but sepsis is more prevalent in critically ill patients. Hemodynamic instability (D) can lead to kidney injury, but sepsis is a more frequent cause in this population.

Correct Answer: D

Rationale: The correct answer is D: "Recovery is possible, but it may take several months." This response provides a balanced and realistic outlook for the patient. Acute kidney injury can be reversible with appropriate treatment and management. Recovery time varies, and it may take several months for the kidneys to regain function. Option A is incorrect as it inaccurately states kidney injury is always permanent. Option B is incorrect as kidney function returning within 2 weeks is not typical in cases of acute kidney injury. Option C is incorrect as increased urination is not a definitive indicator of kidney recovery. Thus, option D is the best response as it offers hope for recovery while acknowledging the potential time it may take.

Correct Answer: C

Rationale: The correct answer is C: multiplied by 0.85. This adjustment accounts for the smaller muscle mass in women compared to men, leading to lower creatinine production. To calculate GFR, creatinine clearance is multiplied by 0.85 in women to adjust for this difference. This adjustment ensures a more accurate estimation of GFR in women. Choices A and B are incorrect because creatinine clearance is not the same or greater in women compared to men due to the physiological differences in muscle mass. Choice D is incorrect because multiplying by 1.15 would overestimate GFR in women.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown leads to the release of myoglobin which can cause renal damage. IV fluids and mannitol are given to prevent kidney injury. Assessing the patient's lungs is important to monitor for potential complications such as pulmonary edema, a serious side effect of mannitol therapy. This assessment will help the nurse detect any signs of respiratory distress early on, allowing for prompt intervention. Choices A, C, and D are incorrect: A: Assess the patient's hearing - This is not directly related to the treatment of rhabdomyolysis and mannitol administration. C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids prematurely can lead to inadequate hydration and worsen kidney function. D: Give extra doses before giving radiological contrast agents - This is not indicated in the treatment of rhabdomyolysis and can potentially harm the patient.