💊 NCLEX-RN Exam Prep

A patient in the oliguric phase of acute kidney injury (AKI) has gained 3 kg overnight and has crackles bilaterally in the lungs. Which additional assessment finding requires the nurse's immediate intervention?

A Blood pressure 150/90 mmHg
B Urine output of 10 mL/hour
C Jugular vein distention (JVD)
D New onset S3 heart sound

✓ Correct Answer: Option D

An S3 heart sound indicates ventricular dysfunction and is a significant sign of worsening fluid overload and impending heart failure, requiring immediate medical intervention to prevent further cardiac compromise.

💡 Why is D) the correct answer?

The correct answer to the question "A patient in the oliguric phase of acute kidney injury (AKI) has gained 3 kg overnight and has crackles bilaterally in the lungs. Which additional assessment finding requires the nurse's immediate intervention?" is Option D: New onset S3 heart sound.

The other options — A) Blood pressure 150/90 mmHg, B) Urine output of 10 mL/hour, C) Jugular vein distention (JVD) — are incorrect for this NCLEX-RN Exam Prep question. As explained above: An S3 heart sound indicates ventricular dysfunction and is a significant sign of worsening fluid overload and impending heart failure, requiring immediate medical intervention to prevent further card…

📚 About This NCLEX-RN Exam Prep Practice Question

This 3-level NCLEX-RN Exam Prep question from the Physiological Integrity topic is part of BrainForge Quiz's free exam preparation library. Each question includes the correct answer and a detailed explanation to help you understand the underlying concept, not just memorize the answer.

How to use this page: Read the question above, consider all four options (A through D), then check the highlighted correct answer and explanation. For active timed practice, start a free NCLEX-RN Exam Prep practice test or use flashcards for spaced repetition review.

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