Nokea
The nurse is caring for a client who presents with a blood glucose level of 45 mg/dL (2.4975 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. Which of the following findings are expected?
- A. Blurred vision
- B. Increased urinary output
- C. Cool and clammy skin
- D. Palpitations
- E. Orthostatic hypotension
- F. Paresthesias
Correct Answer: C, D, F
Rationale: Hypoglycemia causes sympathetic activation (cool, clammy skin; palpitations) and neurological symptoms (paresthesias). Blurred vision and increased urination are more typical of hyperglycemia, and orthostatic hypotension is less directly related.
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The nurse has obtained a prescription for desmopressin to treat diabetes insipidus (DI). The nurse understands that it is essential to monitor the clients
- A. serum sodium level.
- B. serum glucose.
- C. serum magnesium level.
- D. serum calcium level.
Correct Answer: A
Rationale: Desmopressin treats diabetes insipidus by reducing water excretion, risking hyponatremia. Monitoring serum sodium is essential. Glucose, magnesium, and calcium are not primarily affected.
The nurse is reviewing the diet of the client with hypoparathyroidism. The nurse understands that the client should be on what type of diet?
- A. High-calorie, low-calcium diet
- B. Low-calcium, low-phosphorus diet
- C. High-phosphorus, low-calcium diet
- D. High-calcium, low-phosphorus diet
Correct Answer: D
Rationale: Hypoparathyroidism reduces PTH, lowering calcium. A high-calcium, low-phosphorus diet compensates, as high phosphorus can further bind calcium.
The nurse has received an order to prepare a client for a water deprivation test. The nurse understands that this test is used to diagnose
- A. hyperthyroidism
- B. pheochromocytoma
- C. diabetes insipidus (DI)
- D. syndrome of inappropriate antidiuretic hormone (SIADH)
Correct Answer: C
Rationale: The water deprivation test diagnoses diabetes insipidus by assessing the body's ability to concentrate urine without fluid intake, distinguishing it from SIADH or other conditions.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse recognizes that SIADH can be caused by which condition?
- A. Small cell lung cancer
- B. Tumor on the adrenal medulla
- C. Inflammation in the nephron
- D. Beta cell destruction in the pancreas
Correct Answer: A
Rationale: SIADH results from excess ADH, often caused by small cell lung cancer, which can ectopically produce ADH. Adrenal tumors, nephron inflammation, and beta cell issues do not typically cause SIADH.
A post-adrenalectomy client is admitted to the intensive care unit and is on intravenous hydrocortisone. Which nursing intervention should be included in the client's plan of care?
- A. Monitor blood glucose levels frequently
- B. Keep the client supine for 24 hours
- C. Discontinue hydrocortisone once vital signs become stable
- D. Educate the client on how to properly clean the wound at home
Correct Answer: A
Rationale: Adrenalectomy removes cortisol production; hydrocortisone replacement can raise glucose. Frequent monitoring prevents hyperglycemia. Keeping supine is unnecessary, discontinuation risks adrenal crisis, and wound care education is premature in ICU.