Nokea
The nurse is caring for a patient with possible syndrome of inappropriate antidiuretic hormone (SIADH). The patient is confused and reports a headache, muscle cramps, and twitching. Which of the following initial laboratory results should the nurse anticipate?
- A. Elevated hematocrit
- B. Decreased serum sodium
- C. Increased serum chloride
- D. Low urine specific gravity
Correct Answer: B
Rationale: When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. Urine will be more concentrated with a higher specific gravity. The serum chloride level will usually decrease along with the sodium level.
You may also like to solve these questions
The nurse is providing preoperative teaching for a patient scheduled for a hypophysectomy for treatment of a pituitary adenoma. Which of the following instructions should the nurse include in patient teaching?
- A. Cough and deep breathe every 2 hours postoperatively
- B. Bed rest for the first 24 hours after the surgery
- C. Be positioned flat with sandbags at the head postoperatively
- D. Have a NG tube after the surgery
Correct Answer: D
Rationale: The patient should be taught that they will have a NG tube after surgery. It is not necessary to remain on bed rest after this surgery. Coughing is discouraged because it may cause leakage of cerebrospinal fluid (CSF) from the suture line. The head of the bed should be elevated 30 degrees to reduce pressure on the sella turcica and decrease the risk for headaches.
The nurse is caring for a patient with a diagnosis of Cushing's syndrome. Which of the following data should the nurse anticipate finding during the admission assessment?
- A. Persistently low blood pressure
- B. Bronzed appearance of the skin
- C. Decreased axillary and pubic hair
- D. Purplish red streaks on the abdomen
Correct Answer: D
Rationale: Purplish-red striae on the abdomen are a common clinical manifestation of Cushing's syndrome. Hypotension and bronzed-appearing skin are manifestations of Addison's disease. Decreased axillary and pubic hair occur with androgen deficiency.
The nurse is caring for a patient with hyperthyroidism who is being treated with radioactive iodine (RAI) at the clinic. Which of the following information should the nurse provide to the patient prior to discharge?
- A. Symptoms of hyperthyroidism should be relieved in about a week.
- B. Hypothyroidism may occur as the RAI therapy takes effect.
- C. Discontinue the antithyroid medications taken before the radioactive therapy.
- D. Teach radioactive precautions to use with urine, stool, and other body secretions.
Correct Answer: B
Rationale: There is a high incidence of postradiation hypothyroidism after RAI, and the patient should be monitored for symptoms of hypothyroidism. RAI has a delayed response, with the maximum effect not seen for 2-3 months, and the patient will continue to take antithyroid medications during this time. The therapeutic dose of radioactive iodine is low enough that no radiation safety precautions are needed.
Which of the following information should the nurse include when teaching a patient about use of somatropin?
- A. The medication will improve vaginal dryness.
- B. Inject the medication subcutaneously every day.
- C. Blood glucose levels will decrease when taking the medication.
- D. Stop taking the medication if swelling of the hands or feet occurs.
Correct Answer: B
Rationale: Somatropin is injected subcutaneously on a daily basis, preferably in the evening. The patient will need to continue on somatropin for life. If swelling or other adverse effects occur, the health care provider should be notified. Growth hormone will increase blood glucose levels.
The nurse is caring for a patient with symptoms of diabetes insipidus who has been admitted to the hospital for evaluation and treatment. Which of the following nursing diagnoses is best for this patient?
- A. Insomnia related to frequent waking at night to void
- B. Impaired gas exchange related to fluid retention in lungs
- C. Excess fluid volume related to intake greater than output
- D. Risk for impaired skin integrity related to generalized edema
Correct Answer: A
Rationale: Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema, excess fluid volume, and fluid retention are not expected.