HESI Registered Nurse EXIT Practice Exam

Which laboratory result for a client with acute renal failure should be reported immediately?

1. Blood urea nitrogen 50 mg/dl

2. Hemoglobin of 10.3 mg/dl

3. Venous blood pH 7.30

4. Serum potassium 6 mEq/L

The correct answer is: Serum potassium 6 mEq/L

In the case of a client with acute renal failure, a serum potassium level of 6 mEq/L is critical to be reported immediately due to the high risk of hyperkalemia. Elevated potassium levels can lead to life-threatening complications, particularly cardiac dysrhythmias, as kidneys are responsible for excreting potassium from the body. In acute renal failure, the kidney's ability to regulate and eliminate potassium is compromised, making it essential for healthcare providers to be alerted to significant potassium elevations promptly. Monitoring potassium is a priority in patients with renal issues, and levels above 5.5 mEq/L are already considered elevated and warrant close observation. A level of 6 mEq/L indicates a substantial risk, often requiring immediate intervention such as medication to stabilize potassium levels or even dialysis, depending on the severity and associated symptoms. While the other laboratory results may indicate concerns, they do not pose as immediate a risk to the patient as the elevated serum potassium level. For example, while a blood urea nitrogen of 50 mg/dl indicates impaired kidney function, management may not be as acute compared to the immediate dangers posed by hyperkalemia. Thus, the high potassium level is the most critical laboratory finding needing urgent attention.