Nokea
The nurse is providing discharge instructions to a client who has chronic diabetes insipidus (DI). Which of the following client statements would indicate a correct understanding of the discharge instructions?
- A. I will need to drink no more than $800 \mathrm{ml}$ per day.
- B. I will need to weigh myself at the same time every day.
- C. I should increase salty snacks in my diet.
- D. I need to log my daily fluid intake.
Correct Answer: B, D
Rationale: DI causes excessive urination; daily weighing and logging fluid intake monitor fluid balance. Fluid restriction and salty snacks are inappropriate and worsen dehydration.
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The nurse is caring for a client scheduled for an adrenalectomy after being diagnosed with pheochromocytoma. Which preoperative clinical data is essential for the nurse to monitor?
- A. intake and output
- B. blood glucose
- C. vital signs
- D. hemoglobin and hematocrit
Correct Answer: C
Rationale: Pheochromocytoma causes catecholamine surges, leading to hypertension and tachycardia. Monitoring vital signs is critical preoperatively to manage these fluctuations and ensure stability.
The nurse is creating a teaching plan for a client diagnosed with pheochromocytoma. Which statement, if made by the client, would require follow-up?
- A. It will be very important to reduce the stress in my life.
- B. This condition may cause my glucose to decrease.
- C. I will need to monitor my blood pressure closely.
- D. If I feel tired, it is okay for me to have an energy drink.
- E. Diuretics will be prescribed to help eliminate the fluid I may retain.
Correct Answer: B, D, E
Rationale: Pheochromocytoma causes catecholamine excess, raising glucose, not lowering it. Energy drinks can worsen hypertension and are unsafe. Diuretics are not standard; fluid retention is not typical. Stress reduction and BP monitoring are appropriate.
The nurse is preparing to administer metformin to a client with diabetes mellitus (type two). Which of the following laboratory test results should the nurse monitor during the therapy?
- A. white blood cell (WBC) count
- B. vitamin B12 level
- C. serum uric acid level
- D. thyroid-stimulating hormone (TSH) level
Correct Answer: B
Rationale: Metformin can cause vitamin B12 deficiency over time, requiring monitoring. WBC, uric acid, and TSH are not primarily affected by metformin.
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 is caring for a client who reports diarrhea, unintentional weight loss, and nervousness. The primary healthcare provider (PHCP) orders a thyroid panel, and the nurse understands the client is at the highest risk for
- A. Myxedema
- B. Bell's palsy
- C. Grave's disease
- D. Cushing syndrome
Correct Answer: C
Rationale: Diarrhea, weight loss, and nervousness suggest hyperthyroidism, with Graves' disease as the most common cause due to thyroid overstimulation. Myxedema and Cushing's have opposite symptoms, and Bell's palsy is unrelated.