Nokea
The client is admitted to the medical unit with a diagnosis of rule-out diabetes insipidus (DI). Which instructions should the nurse teach regarding a fluid deprivation test?
- A. The client will be asked to drink 100 mL of fluid as rapidly as possible and then will not be allowed fluid for 24 hours.
- B. The client will be administered an injection of antidiuretic hormone (ADH), and urine output will be measured for four (4) to six (6) hours.
- C. The client will have nothing by mouth (NPO), and vital signs and weights will be done hourly until the end of the test.
- D. An IV will be started with normal saline, and the client will be asked to try to hold the urine in the bladder until a sonogram can be done.
Correct Answer: C
Rationale: The fluid deprivation test involves NPO status with hourly vitals and weights to assess urine concentration, diagnosing DI. Other options describe incorrect procedures.
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Using the Dietary Exchange Plan for a 1,500 calorie diet in the chart below, which item is appropriate for the diabetic client to have in the midafternoon?
- A. An 8-oz carton of milk
- B. Two stream careers
- C. A medium apple
- D. A 2-oz slice of turkey
Correct Answer: C
Rationale: The midafternoon snack in the exchange plan includes one fruit serving, making a medium apple appropriate.
Which nursing assessment is most helpful in evaluating the status of a client with Addison's disease?
- A. Blood pressure
- B. Bowel sounds
- C. Breath sounds
- D. Heart sounds
Correct Answer: A
Rationale: Hypotension is a key sign of Addison's disease due to decreased aldosterone and cortisol.
The unlicensed assistive personnel (UAP) complains to the nurse she has filled the water pitcher four (4) times during the shift for a client diagnosed with a closed head injury and the client has asked for the pitcher to be filled again. Which intervention should the nurse implement first?
- A. Tell the UAP to fill the pitcher with ice cold water.
- B. Instruct the UAP to start measuring the client's I&O.
- C. Assess the client for polyuria and polydipsia.
- D. Check the client's BUN and creatinine levels.
Correct Answer: C
Rationale: Frequent water pitcher refills suggest polydipsia and polyuria, symptoms of diabetes insipidus post-head injury, requiring assessment. I&O, labs, and refilling follow.
A woman with newly diagnosed Type I diabetes mellitus says she wants to have children. She asks if she will be able to have children and if they will be normal. What is the best answer for the nurse to give?
- A. Women with diabetes should not get pregnant because it is very difficult to control diabetes during pregnancy.'
- B. Babies born to diabetic mothers are very apt to have severe and noncorrectable birth defects.'
- C. You should be able to safely have a baby if you go to your doctor regularly during pregnancy.'
- D. You should consult carefully with a geneticist before getting pregnant to determine how to prevent your baby from developing diabetes.'
Correct Answer: C
Rationale: With regular medical care, women with Type 1 diabetes can have safe pregnancies, minimizing risks to the baby.
A woman with hypothyroidism asks the nurse why the doctor told her she cannot have a sedative. The nurse's response is based on which of the following facts?
- A. Sedatives potentiate thyroid replacement medication.
- B. Clients with hypothyroidism have increased susceptibility to all sedative drugs.
- C. Sedatives will have a paradoxical effect on clients with hypothyroidism.
- D. Sedatives would cause fluid retention and hypernatremia.
Correct Answer: B
Rationale: Hypothyroidism increases sensitivity to sedatives, risking excessive sedation or respiratory depression.