Nokea
The nurse is caring for a client newly diagnosed with diabetic nephropathy. The nurse anticipates a prescription for which medication?
- A. Ciprofloxacin
- B. Enalapril
- C. Sevelamer
- D. Epoetin alfa
Correct Answer: B
Rationale: Enalapril, an ACE inhibitor, slows diabetic nephropathy progression by reducing intraglomerular pressure. Ciprofloxacin treats infections, sevelamer manages hyperphosphatemia, and epoetin alfa treats anemia, none of which are primary for nephropathy.
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The nurse is caring for a client who presents with hyperglycemia. Which of the following findings are expected?
- A. Blurred vision
- B. Increased urinary output
- C. Cool and clammy skin
- D. Tachycardia
- E. Orthostatic hypotension
Correct Answer: A, B, D
Rationale: Hyperglycemia causes blurred vision (osmotic lens changes), increased urination (osmotic diuresis), and tachycardia (dehydration response). Cool, clammy skin is typical of hypoglycemia, and orthostatic hypotension is less specific.
The nurse is caring for a client newly diagnosed with diabetes mellitus (type one). It would be essential to educate the client to
- A. check their hemoglobin A1C level every three months.
- B. rotate injection sites for insulin administration.
- C. examine their feet with a mirror daily.
- D. recognize the symptoms of hypoglycemia.
Correct Answer: A, B, C, D
Rationale: HbA1C monitors control, rotation prevents lipohypertrophy, foot checks prevent ulcers, and recognizing hypoglycemia symptoms ensures timely treatment in type 1 diabetes.
The nurse is performing an assessment on a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment findings would support the diagnosis of SIADH?
- A. Peripheral edema
- B. Excessive urine production
- C. Normal or slightly increased blood pressure
- D. Low urine specific gravity
Correct Answer: A, C
Rationale: SIADH causes water retention, leading to edema and normal or slightly elevated BP from fluid overload. Urine is concentrated (high specific gravity), not low, and output is reduced, not excessive.
The nurse is planning care for a client following bilateral adrenalectomy. The nurse should anticipate a prescription for which postoperative medication?
- A. Pantoprazole
- B. Propylthiouracil (PTU)
- C. Propranolol
- D. Hydrocortisone
Correct Answer: D
Rationale: Bilateral adrenalectomy removes adrenal glands, necessitating lifelong hydrocortisone replacement to provide glucocorticoids and prevent adrenal insufficiency. Pantoprazole, PTU, and propranolol are not indicated for this purpose.
The nurse is assessing a client with pheochromocytoma. Which of the following would be an expected finding?
- A. hyperglycemia
- B. hypertension
- C. ataxia
- D. oliguria
- E. headache
Correct Answer: A, B, E
Rationale: Pheochromocytoma releases catecholamines, causing hyperglycemia, hypertension, and headaches. Ataxia and oliguria are not typical findings.