Nokea
The nurse is caring for a client who has developed diabetes insipidus. The cause is unknown, and the physician has ordered a diagnostic test to determine if the cause is nephrogenic or neurogenic. What test will the nurse prepare the client for?
- A. Urine specific gravity
- B. Fluid deprivation test
- C. Urine osmolality
- D. Serum osmolality
Correct Answer: B
Rationale: A fluid deprivation test can diagnose diabetes insipidus (DI) and differentiate neurogenic DI from nephrogenic DI. The other tests listed are nonspecific tests that help support diagnosis.
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A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?
- A. Glaucoma
- B. Corneal abrasions
- C. Retinal detachment
- D. Pressure on the optic nerve
Correct Answer: D
Rationale: Partial blindness may result from pressure on the optic nerve. Glaucoma does not occur suddenly, and the client did not report injury to suspect corneal abrasions or retinal detachment.
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.
Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor?
- A. Administer prescribed corticosteroids carefully.
- B. Handle body fluids carefully.
- C. Monitor the respiratory status.
- D. Administer the prescribed medications at the same time each day.
Correct Answer: B
Rationale: The nurse handles body fluids carefully to prevent spread of contamination. Corticosteroids are not prescribed for thyroid tumor. Monitoring the respiratory status and administering prescribed medicines at the same time each day are unrelated to the care of a client receiving RAI.
A client is scheduled for a hypophysectomy for the management of a pituitary tumor. What is the nurse priority when caring for this client? Select all that apply.
- A. Assure the client that he will make it through the surgery without any difficulty.
- B. Help the client cope with changes in physical appearance.
- C. Pace activities to accommodate the client's fatigue.
- D. Relieve discomfort from headaches, abdominal distention, and skeletal pain.
- E. Encourage self-care and activities as client's endurance permits.
Correct Answer: B,C,D,E
Rationale: Until the client has surgery or receives radiation treatment, nursing priorities include helping the client cope with changes in physical appearance; pacing activities to accommodate the client's fatigue; and relieving discomfort from headaches, abdominal distention resulting from organ enlargement, and skeletal pain. Assuring the client that he will make it through the surgery without any difficulty is not appropriate as it dismisses the client's concerns and does not address specific care priorities.
A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly?
- A. A pituitary tumor
- B. A decrease in release in the growth hormone
- C. A decrease in the glucose level
- D. An increase in cerebral edema
Correct Answer: A
Rationale: When the overgrowth is from a tumor, headaches caused by pressure on the sella turcica, a bony depression in which the pituitary gland rests, are common. There is actually an increase in the secretion of the growth hormone. The headaches would not be caused by decreases in glucose levels. The client does not have cerebral edema.