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Which of the following outcomes would indicate successful treatment of diabetes insipidus?
- A. Fluid intake of less than 2,500mL
- B. Blood pressure of 90/50mmHg
- C. Pulse rate of 126 beats/min
- D. Urine output of more than 200mL/hour
Correct Answer: A
Rationale: Successful treatment of diabetes insipidus is indicated when the patient's excessive urination (polyuria) and thirst (polydipsia) are controlled. One of the primary goals of treatment is to achieve fluid balance by reducing urine output and, consequently, decreasing the excessive thirst. When the fluid intake is less than 2,500mL, it suggests that the patient's excessive thirst has decreased, indicating successful management of the condition. Monitoring and managing fluid intake are crucial in the treatment of diabetes insipidus to prevent dehydration and electrolyte imbalances. A lower fluid intake is a positive indicator that the treatment is effectively addressing the increased urine output characteristic of diabetes insipidus.
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A 4 years old boy presents with low grade fever and malaise. Throat examination reveals a grayish white membrane which is tightly adherent and bleeds on an attempt to remove. The most likely diagnosis is:
- A. Acute Follicular tonsillitis
- B. Diphtheria
- C. Herpetic infection
- D. Infectious mononucleosis
Correct Answer: B
Rationale: Diphtheria causes a characteristic grayish-white membrane in the throat that bleeds when removed, along with systemic symptoms like fever and malaise.
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.
Mr. Dela Isla said he cannot comprehend what the nurse was saying. He suffers from:
- A. Insomnia
- B. Agnosia
- C. Aphraxia
- D. Aphasia
Correct Answer: D
Rationale: Aphasia is a communication disorder that affects a person's ability to understand and/or produce language. In this case, Mr. Dela Isla's inability to comprehend what the nurse was saying suggests a possible impairment in his language comprehension abilities, pointing towards aphasia as the most likely condition. Symptoms of aphasia can vary depending on the type and severity of the condition, but the common feature is difficulty with language tasks such as speaking, understanding speech, reading, and writing. Insomnia is a sleep disorder characterized by difficulty falling asleep or staying asleep, agnosia is a sensory perception disorder, and apraxia involves difficulty with performing purposeful movements.
Which of the following actions should the nurse take to maintain patient safety when ambulating a patient for the first time postoperatively?
- A. Use one person to assist patient.
- B. Use two people to assist patient.
- C. Encourage patient to "dangle" self 1 hour before ambulation.
- D. Give narcotic 15 minutes before ambulation.
Correct Answer: B
Rationale: When ambulating a patient for the first time postoperatively, it is crucial to ensure patient safety by using two people to assist the patient. This helps in providing adequate support and stability, especially if the patient is weak, dizzy, or at risk of falling. Having two people allows for better control over the patient's movement and reduces the risk of accidents or falls during ambulation. Additionally, having an extra person provides assistance in case the patient becomes unsteady or requires immediate support.
A client with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty six-hours later, the client's urine output suddenly rises above 200mL/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse's suspicion of diabetes insipidus?
- A. Above-normal urine and serum osmolality levels
- B. Below-normal urine and serum osmolality levels
- C. Above-normal urine osmolality level, below-normal serum osmolality level
- D. Below- normal urine osmolality level, above-normal serum osmolality level
Correct Answer: B
Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to adequately concentrate urine, leading to excessive dilute urine production. In diabetes insipidus, both urine and serum osmolality levels are typically below normal due to the dilution of urine. When urine output suddenly rises above 200mL/hour in a client with severe head trauma, it may indicate diabetes insipidus, especially if the urine and serum osmolality levels are below normal. This abnormality in osmolality levels is due to the impaired ability of the kidneys to concentrate urine, resulting in decreased urine osmolality and subsequent dilution of the serum osmolality.