Nokea
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.
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The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory tests require careful monitoring?
- A. Potassium
- B. Sodium
- C. Glucose
- D. Magnesium
Correct Answer: B
Rationale: SIADH causes water retention, diluting sodium and risking hyponatremia. Close sodium monitoring prevents neurological complications like seizures or coma.
The nurse is assisting a client with their newly prescribed insulin pump. The nurse understands which insulin is commonly loaded into the pump?
- A. Rapid acting
- B. Ultra long-acting insulin
- C. Intermediate acting
- D. Long acting
Correct Answer: A
Rationale: Rapid-acting insulin, such as lispro or aspart, is used in insulin pumps to mimic physiological insulin delivery for basal and bolus dosing. Long-acting or intermediate-acting insulins are not suitable for pumps.
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.
The nurse is caring for a client diagnosed with a myxedema coma. The nurse should anticipate a prescription for which of the following medications?
- A. Levothyroxine
- B. Methimazole
- C. Tolvaptan
- D. Hydrochlorothiazide
- E. Hydrocortisone
Correct Answer: A,E
Rationale: Myxedema coma, a severe hypothyroidism emergency, requires levothyroxine to restore thyroid hormone levels and hydrocortisone to address potential adrenal insufficiency. Methimazole treats hyperthyroidism, and tolvaptan and hydrochlorothiazide manage fluid balance, not hypothyroidism.
The nurse is performing discharge teaching for a client with Graves' disease. Which of the following client statements indicates effective understanding?
- A. I will take my pulse daily and report a rate less than 60 beats/minute.
- B. I am going to add hot yoga to my exercise routine.
- C. I will increase the amount of fiber in my diet.
- D. I should tell my physician if my blood pressure's top number exceeds 140.
Correct Answer: D
Rationale: Graves' causes hypertension; reporting systolic BP >140 allows timely intervention. Bradycardia is not typical, hot yoga may worsen heat intolerance, and fiber is unrelated to Graves' management.