Nokea
A client has developed diabetes insipidus after removal of a pituitary tumor. Which finding would the nurse expect?
- A. Polyuria
- B. Hypertension
- C. Polyphagia
- D. Hyperkalemia
Correct Answer: A
Rationale: Clients with diabetes insipidus have excessive urinary output due to a lack of antidiuretic hormone. Answers B, C, and D are not exhibited with diabetes insipidus, so they are incorrect.
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Laboratory Reference Ranges
Sodium
136-145 mEq/L
(136-145 mmol/L)
The medical-surgical nurse cares for a group of clients. Which client situations would prompt the nurse to notify the health care provider during the middle of the night? Select all that apply.
- A. Client develops right-sided upper and lower extremity drift
- B. Client found lying unconscious on the floor
- C. Client has order for heparin with surgery planned for the morning
- D. Client has serum sodium of 124 mEq/L (124 mmol/L)
- E. Client refuses a prescribed, routine pain medication
Correct Answer: A,B,C,D
Rationale: Extremity drift (A), unconsciousness (B), heparin before surgery (C), and severe hyponatremia (D) are urgent and require notification. Refusing pain medication (E) is not critical.
The nurse is collecting data from a client with primary adrenal insufficiency (Addison disease). Which of the following findings is consistent with the condition?
- A. Bronze pigmentation of the skin
- B. Increased body and facial hair
- C. Purple or red striae on the abdomen
- D. Supraclavicular fat pad
Correct Answer: A
Rationale: Bronze skin pigmentation (A) is a hallmark of Addison disease due to increased ACTH stimulating melanocytes. Increased hair (B) and supraclavicular fat pad (D) are associated with Cushing syndrome, while striae (C) are nonspecific but not typical of Addison disease.
The morning weight for a client with emphysema indicates that the client has gained 5 pounds in less than a week, even though his oral intake has been modest. The client's weight gain may reflect which associated complication of COPD?
- A. Polycythemia
- B. Cor pulmonale
- C. Left ventricular failure
- D. Compensated acidosis
Correct Answer: B
Rationale: Rapid weight gain in a client with emphysema, despite modest intake, suggests fluid retention, which is commonly associated with cor pulmonale, a complication of COPD involving right heart failure due to lung disease. Answer A (polycythemia) is a blood disorder, not directly linked to weight gain. Answer C (left ventricular failure) is less likely in COPD compared to cor pulmonale. Answer D (compensated acidosis) does not cause weight gain.
The nurse is caring for a client with a terminal illness who is expected to die during the shift. The nurse notes that the client has loud, wet respirations. Which of the following medications would effectively treat this finding?
- A. IM lorazepam
- B. sublingual atropine
- C. transdermal fentanyl
- D. sublingual ondansetron
Correct Answer: B
Rationale: Sublingual atropine (B) reduces salivary secretions, alleviating 'death rattle.' Lorazepam (A) is for anxiety, fentanyl (C) for pain, and ondansetron (D) for nausea.
The nurse is caring for a client with suspected acute rheumatic fever. Which of the following questions would be most important for the nurse to ask the client?
- A. Do you typically take all of your antibiotics when they are prescribed?
- B. Has anyone in your family had rheumatic fever?
- C. What has your temperature been over the past several days?
- D. Have you recently had a streptococcal throat infection?
Correct Answer: D
Rationale: Recent streptococcal infection (D) is the primary trigger for rheumatic fever, making it the most important question. Antibiotic compliance (A), family history (B), and fever (C) are relevant but less critical.