Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?
- A. Fluid intake is less than 2,500 ml/day
- B. Urine output measures more than 200 ml/hour
- C. Blood pressure is 90/50 mm Hg
- D. The heart rate is 126 beats/minute
Correct Answer: A
Rationale: The correct outcome indicating effective treatment of diabetes insipidus in a male client is a fluid intake of less than 2,500 ml/day. In diabetes insipidus, excessive urination causes increased fluid intake to compensate for the fluid loss. By effectively managing the condition, the client's fluid intake should decrease. Choices B, C, and D do not directly reflect the effectiveness of treatment for diabetes insipidus. Increased urine output (choice B) may indicate inadequate control of the condition, while low blood pressure (choice C) and a high heart rate (choice D) are not specific indicators of effective treatment for diabetes insipidus.
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The nurse and an unlicensed nursing assistant are caring for a group of clients. Which nursing intervention should the nurse perform?
- A. Measure the client's output from the indwelling catheter.
- B. Record the client's intake and output on the I & O sheet.
- C. Instruct the client on appropriate fluid restrictions.
- D. Provide water for a client diagnosed with diabetes insipidus.
Correct Answer: C
Rationale: Instructing the client on appropriate fluid restrictions is a nursing intervention that requires professional judgment and should be performed by the nurse. In this scenario, the nurse should provide education regarding fluid restrictions based on the client's individual needs. Measuring the client's output from the indwelling catheter (choice A) and recording intake and output (choice B) can be tasks delegated to the unlicensed nursing assistant. Providing water for a client diagnosed with diabetes insipidus (choice D) is not appropriate as these clients often require careful fluid management to prevent complications.
A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse the hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
- A. Phentolamine (Regitine)
- B. Methyldopa (Aldomet)
- C. Mannitol (Osmitrol)
- D. Felodipine (Plendil)
Correct Answer: A
Rationale: In a hypertensive crisis due to pheochromocytoma, the appropriate medication to administer is Phentolamine (Regitine), an alpha-adrenergic blocker. Phentolamine acts quickly to block the effects of excess catecholamines that are released in pheochromocytoma, helping to rapidly lower blood pressure. Methyldopa (Aldomet) is an alpha-2 adrenergic agonist used for chronic hypertension, not for acute crises like pheochromocytoma. Mannitol (Osmitrol) is an osmotic diuretic used to reduce intracranial pressure and treat cerebral edema, not indicated for hypertensive crises. Felodipine (Plendil) is a calcium channel blocker used for chronic management of hypertension, not for acute hypertensive crises like those seen in pheochromocytoma.
Nurse managers need several qualities to be effective. A nurse manager is working hard to fully understand how patient outcomes are measured on the unit and how budget changes could impact patient outcomes. Which of the following qualities does this best describe?
- A. Leadership
- B. Business sense
- C. Clinical expertise
- D. Financial management
Correct Answer: B
Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?
- A. Hypernatremia
- B. Hypotension
- C. Decreased urine output
- D. Polyuria
Correct Answer: C
Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.
A client with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which of the following complications?
- A. Hypernatremia
- B. Hyponatremia
- C. Hyperkalemia
- D. Hypercalcemia
Correct Answer: B
Rationale: The correct answer is B: Hyponatremia. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention in the body. This causes dilutional hyponatremia, where the sodium levels in the blood become abnormally low. Option A, Hypernatremia, is incorrect because SIADH does not cause elevated sodium levels. Option C, Hyperkalemia, is incorrect as SIADH does not directly affect potassium levels. Option D, Hypercalcemia, is also incorrect as SIADH does not impact calcium levels.
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