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A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?
- A. Glucose in the urine
- B. Albumin in the urine
- C. Highly dilute urine
- D. Leukocytes in the urine
Correct Answer: C
Rationale: Patients with diabetes insipidus produce an enormous daily output of very dilute, water-like urine with a specific gravity of 1.001 to 1.005. The urine contains no abnormal substances such as glucose or albumin. Leukocytes in the urine are not related to the condition of diabetes insipidus, but would indicate a urinary tract infection, if present in the urine.
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A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?
- A. Do you feel any muscle twitches or spasms?
- B. Do you feel flushed or sweaty?
- C. Are you experiencing any dizziness or lightheadedness?
- D. Are you having any pain that seems to be radiating from your bones?
Correct Answer: A
Rationale: As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.
A patient with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the patient to improve the patients nutritional intake. What foods should a patient with Cushing syndrome eat to optimize health? Select all that apply.
- A. Foods high in vitamin D
- B. Foods high in calories
- C. Foods high in protein
- D. Foods high in calcium
- E. Foods high in sodium
Correct Answer: A,C,D
Rationale: Foods high in vitamin D, protein, and calcium are recommended to minimize muscle wasting and osteoporosis. Referral to a dietitian may assist the patient in selecting appropriate foods that are also low in sodium and calories.
The nurse is assessing a patient diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?
- A. Hair loss
- B. Moon face
- C. Bulging eyes
- D. Fatigue
Correct Answer: C
Rationale: Clinical manifestations of the endocrine disorder Graves disease include exophthalmos (bulging eyes) and fine tremor in the hands. Graves disease is not associated with hair loss, a moon face, or fatigue.
The physician has ordered a fluid deprivation test for a patient suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?
- A. Temperature and oxygen saturation
- B. Heart rate and BP
- C. Breath sounds and bowel sounds
- D. Color, warmth, movement, and sensation of extremities
Correct Answer: B
Rationale: The fluid deprivation test is carried out by withholding fluids for 8 to 12 hours or until 3% to 5% of the body weight is lost. The patients condition needs to be monitored frequently during the test, and the test is terminated if tachycardia, excessive weight loss, or hypotension develops. Consequently, BP and heart rate monitoring are priorities over the other listed assessments.
You are developing a care plan for a patient with Cushing syndrome. What nursing diagnosis would have the highest priority in this care plan?
- A. Risk for injury related to weakness
- B. Ineffective breathing pattern related to muscle weakness
- C. Risk for loneliness related to disturbed body image
- D. Autonomous dysreflexia related to neurologic changes
Correct Answer: A
Rationale: The nursing priority is to decrease the risk of injury by establishing a protective environment. The patient who is weak may require assistance from the nurse in ambulating to prevent falls or bumping corners or furniture. The patients breathing will not be affected and autonomic dysreflexia is not a plausible risk. Loneliness may or may not be an issue for the patient, but safety is a priority.