Nokea
The nurse is caring for the client with SIADH. Which interventions should the nurse plan to implement? Select all that apply.
- A. Obtain the weight near the same time each morning.
- B. Place the client on a fluid-restricted diet as prescribed.
- C. Prepare to give a 500-mL NaCl intravenous fluid bolus.
- D. Administer furosemide intravenously as prescribed.
- E. Monitor for hyperactive reflexes and heightened alertness.
Correct Answer: A,B,D
Rationale: Daily weights monitor fluid retention, fluid restriction treats hyponatremia, and furosemide addresses fluid overload in SIADH.
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The nurse is discussing complications of chronic pancreatitis with a client diagnosed with the disease. Which complication should the nurse discuss with the client?
- A. Diabetes insipidus (DI).
- B. Crohn's disease.
- C. Narcotic addiction.
- D. Peritonitis.
Correct Answer: C
Rationale: Chronic pancreatitis often requires long-term pain management, risking narcotic addiction. DI, Crohn’s, and peritonitis are unrelated complications.
Preoperatively, which information is most important to teach the client before the subtotal thyroidectomy?
- A. Techniques for changing positions
- B. Reasons for performing leg exercises
- C. The necessity for daily dressing changes
- D. Postoperative use of the incentive spirometer
Correct Answer: D
Rationale: Using an incentive spirometer postoperatively helps prevent respiratory complications after thyroidectomy.
Which documentation finding provides the best indication that the client has successfully avoided an adrenal (addisonian) crisis after surgery?
- A. The client's pedal edema has lessened.
- B. Capillary blood glucose level is within normal limits.
- C. Vital signs are within preoperative ranges.
Correct Answer: C
Rationale: Stable vital signs indicate the absence of adrenal crisis, characterized by hypotension and shock.
After the test, the nurse provides the client with instructions. Which statement of the nurse is most accurate?
- A. You must remain isolated until the radiation level decreases sufficiently.
- B. You're free to go without further precautionary instructions.
- C. You must follow special precautions for a short period of time.
- D. You'll be given an antidote to reduce the radioactivity level.
Correct Answer: C
Rationale: A radioactive iodine uptake test involves low levels of radiation, requiring short-term precautions such as avoiding close contact with others.
The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement?
- A. Increase the regular insulin IV drip.
- B. Check the client's urine for ketones.
- C. Provide the client with a therapeutic diabetic meal.
- D. Notify the HCP to obtain an order to decrease insulin.
Correct Answer: D
Rationale: A glucose drop from 780 to 300 mg/dL requires HCP notification to adjust insulin, preventing hypoglycemia. Increasing insulin, checking ketones, or meals are inappropriate.