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How does the nurse expect the urine that is collected for a routine urinalysis to appear?
- A. Tea-colored
- B. Pale yellow
- C. Goldless
- D. Light pink
Correct Answer: B
Rationale: In diabetes insipidus, the urine is typically dilute and pale yellow due to the large volume of water excreted.
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The nurse is teaching a client to self-administer insulin. The instructions should include teaching the client to:
- A. inject the needle at a 90-degree angle into the muscle.
- B. vigorously massage the area after injecting the insulin.
- C. rotate injection sites.
- D. keep the open bottle of insulin in the refrigerator.
Correct Answer: C
Rationale: Rotating injection sites prevents lipodystrophy and ensures consistent insulin absorption. Insulin is injected subcutaneously, not into muscle, and massaging can alter absorption.
Based on the knowledge that clients with Cushing's syndrome heal slowly, which nursing measure is most appropriate during the client's postoperative period?
- A. Monitoring infusion of I.V. antibiotics
- B. Removing tape toward the incision site
- C. Increasing the client's dietary protein intake
- D. Covering the wound with gauze
Correct Answer: C
Rationale: Increased dietary protein supports tissue repair and healing in Cushing's syndrome.
The client is admitted to rule out Cushing's syndrome. Which laboratory tests should the nurse anticipate being ordered?
- A. Plasma drug levels of quinidine, digoxin, and hydralazine.
- B. Plasma levels of ACTH and cortisol.
- C. A 24-hour urine for metanephrine and catecholamine.
- D. Spot urine for creatinine and white blood cells (WBCs).
Correct Answer: B
Rationale: ACTH and cortisol levels diagnose Cushing’s by confirming hypercortisolism. Other tests assess unrelated conditions (e.g., pheochromocytoma, renal function).
The nurse is assessing the client who has type 2 DM. Which findings indicate to the nurse that the client is experiencing HHNS? Select all that apply.
- A. Serum osmolality 364 mOsm/kg
- B. Blood glucose level 160 mg/dL
- C. Very dry mucous membranes
- D. Blood pressure of 90/42 mm Hg
- E. Urine output 500 mL past 8 hours
Correct Answer: A,C,D
Rationale: A serum osmolality of 364 mOsm/kg, very dry mucous membranes, and a BP of 90/42 indicate HHNS due to elevated osmolality, dehydration, and hypotension from osmotic diuresis.
The male client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to cancer of the lung tells the nurse he wants to discontinue the fluid restriction and does not care if he dies. Which action by the nurse is an example of the ethical principle of autonomy?
- A. Discuss the information the client told the nurse with the health-care provider and significant other.
- B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions.
- C. Notify the health-care provider of the client's wishes and give the client fluids as desired.
- D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.
Correct Answer: C
Rationale: Notifying the HCP and respecting the client’s fluid request honors autonomy. Sharing with others violates confidentiality, explaining risks is beneficence, and covertly giving water is unethical.