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A client with Addison disease is being discharged from the hospital and is being instructed about the dietary regimen. What type of diet should the nurse provide written and verbal instructions about?
- A. Low-carbohydrate, low-protein diet
- B. Low-fat, high-protein diet
- C. Low-protein, high-carbohydrate diet
- D. High-protein, moderate-carbohydrate diet
Correct Answer: D
Rationale: A high-protein, moderate-carbohydrate diet that is low in refined carbohydrates is recommended to reduce the risk of hypoglycemia from excess insulin secretion. The risk of hypoglycemia is also lessened by consuming frequent meals and snacks, especially a substantial bedtime snack. The other dietary regimens are not effective in the management of Addison disease.
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The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following would the nurse expect to find?
- A. Elevated serum sodium levels
- B. Decreased serum osmolarity
- C. Decreased urine sodium levels
- D. Elevated urine calcium levels
Correct Answer: B
Rationale: With SIADH, serum sodium levels and serum osmolarity are decreased. Urine sodium levels and osmolarity are high. Calcium levels are not involved with this disorder.
The nurse is administering a medication to a client with hyperthyroidism to block the production of thyroid hormone. The client is not a candidate for surgical intervention at this time. What medication should the nurse administer to the client?
- A. Levothyroxine
- B. Spironolactone
- C. Propylthiouracil
- D. Propranolol
Correct Answer: C
Rationale: Antithyroid drugs, such as propylthiouracil and methimazole, are given to block the production of thyroid hormone preoperatively or for long-term treatment for clients who are not candidates for surgery or radiation treatment. Levothyroxine would increase the level of thyroid and be contraindicated in this client. Spironolactone is a diuretic and does not have the action of blocking production of thyroid hormone, and neither does propranolol, which is a beta-blocker.
A client with syndrome of inappropriate antidiuretic hormone (SIADH) is severely hyponatremic. What IV fluids would the nurse anticipate administering to this client?
- A. 3% hypertonic sodium chloride solution
- B. Lactated Ringer's solution
- C. 5% dextrose in water
- D. 0.9% sodium chloride solution
Correct Answer: A
Rationale: Severe hyponatremia is treated with IV administration of a 3% hypertonic sodium chloride solution. The other answers will not provide the amount of sodium required to correct the hyponatremia.
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as resulting in which condition?
- A. Gigantism
- B. Dwarfism
- C. Acromegaly
- D. Simmonds disease
Correct Answer: A
Rationale: When oversecretion of GH occurs before puberty, gigantism results. Dwarfism occurs when secretion of GH is insufficient during childhood. Oversecretion of GH during adulthood results in acromegaly. An absence of pituitary hormonal activity causes Simmonds disease.
The nurse is teaching a client who is to receive lypressin nasal spray as treatment for neurogenic diabetes insipidus about administration. Which client statement indicates the need for additional teaching?
- A. I'll inhale fully after spraying the drug.'
- B. If my nose gets irritated, I'll call my physician.'
- C. I should hold the spray container upright.'
- D. While sitting up, I'll place the nozzle in my nostril.'
Correct Answer: A
Rationale: When administering lypressin nasal spray, the client should not inhale the drug. Calling the physician if he or she experiences nasal irritation, holding the container upright, and placing the nozzle in the nostril while sitting up are appropriate.