Nokea
What intervention can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss?
- A. Come to the clinic for IV fluid therapy daily.
- B. Limit the fluid intake at night.
- C. Consume adequate amounts of fluid.
- D. Weigh daily.
Correct Answer: C
Rationale: The nurse teaches the client to consume sufficient fluid to control thirst and to compensate for urine loss. The client will not be required to come in daily for IV fluid therapy. The client should not limit fluid intake at night if thirst is present. Weighing daily will not control thirst or compensate for urine loss.
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Which group of clients should not receive potassium iodide?
- A. Those who are allergic to corticosteroids
- B. Those who are pregnant
- C. Those taking medications such as cough medicines
- D. Those who are allergic to seafood
Correct Answer: D
Rationale: Potassium iodide should not be administered to anyone who is allergic to seafood, which is also high in iodine. Clients who take corticosteroids or cough medicines and those who are pregnant would be appropriate candidates for potassium iodide therapy.
A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly?
- A. A pituitary tumor
- B. A decrease in release in the growth hormone
- C. A decrease in the glucose level
- D. An increase in cerebral edema
Correct Answer: A
Rationale: When the overgrowth is from a tumor, headaches caused by pressure on the sella turcica, a bony depression in which the pituitary gland rests, are common. There is actually an increase in the secretion of the growth hormone. The headaches would not be caused by decreases in glucose levels. The client does not have cerebral edema.
A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called?
- A. Hypophysectomy
- B. Hysteroscopy
- C. Thyroidectomy
- D. Ablation
Correct Answer: A
Rationale: The treatment of choice is surgical removal of the pituitary gland (transsphenoidal hypophysectomy) through a nasal approach. The surgeon may substitute an endoscopic technique using microsurgical instruments to reduce surgical trauma. A hysteroscopy is a gynecologic procedure. The thyroid gland is not involved for a surgical procedure. Ablation is not a removal of the pituitary gland.
The instructor is teaching a group of students about Simmonds disease. The instructor determines that additional instruction is necessary when the students identify which hormone as being involved?
- A. Growth hormone
- B. Luteinizing hormone
- C. Adrenocorticotropic hormone
- D. Oxytocin
Correct Answer: D
Rationale: Oxytocin is a hormone of the posterior pituitary gland and would not be involved. Simmonds disease affects all hormones of the anterior pituitary: GH (bones and muscles), adrenocorticotropic hormone (ACTH, adrenals), thyroid-stimulating hormone (TSH, thyroid), follicle-stimulating hormone (FSH, ovaries and testes), luteinizing hormone (LH, ovaries), interstitial cell-stimulating hormone (ICSH (LH), testes), and prolactin (breasts).
A client is suspected of having acromegaly. What definitive diagnostic testing is the most reliable method of confirming acromegaly?
- A. A serum glucose level
- B. Glucose tolerance test in combination with a GH measurement
- C. Growth hormone levels
- D. Bone radiographs
Correct Answer: B
Rationale: A glucose tolerance test in combination with a GH measurement is the most reliable method of confirming acromegaly. Ingestion of a bolus of glucose should lower GH levels, but GH levels remain elevated in persons with acromegaly. Increased blood levels of IGF-1 can also indicate acromegaly in nonpregnant women, they typically have IGF-1 levels two to three times higher than normal in pregnant women. A serum glucose level is not an indicator of acromegaly. Growth hormone levels and bone radiographs may support the diagnosis but are not reliable indicators.