front 1 new book | back 1 brunner & suddarth 14th ed |
front 2 You are caring for a patient who has a diagnosis of syndrome of
inappropriate antidiuretic hormone | back 2 Ans: D |
front 3 The home health nurse is performing a home visit for an oncology
patient discharged 3 days ago after | back 3 Ans: A |
front 4 A patient with a diagnosis of syndrome of inappropriate antidiuretic
hormone secretion (SIADH) is | back 4 Ans: B |
front 5 Diagnostic testing of an adult patient reveals renal glycosuria. The
nurse should recognize the need for | back 5 Ans: C |
front 6 What should the nurse suspect when hourly assessment of urine output
on a patient postcraniotomy | back 6 Ans: D |
front 7 When caring for a patient with increased ICP the nurse knows the
importance of monitoring for possible | back 7 Ans: A |
front 8 After a subarachnoid hemorrhage, the patients laboratory results
indicate a serum sodium level of less | back 8 Ans: D |
front 9 A patient is admitted through the ED with suspected St. Louis
encephalitis. The unique clinical feature | back 9 Ans: C |
front 10 new book | back 10 giddens 2nd ed |
front 11 The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What is the nurse’s best action? a. Encourage increased fluid and water intake b. Teach about risk for malignancies c. Monitor for changes in level of consciousness d. Assess labwork for potassium level changes | back 11 ANS: C As the name suggests, SIADH is a condition in which antidiuretic hormone (ADH) is secreted despite normal or low plasma osmolarity, resulting in water retention and dilutional hyponatremia. In response to increased plasma volume, aldosterone secretion increases and further contributes to sodium loss. Hyponatremia frequently manifests with changes in level of consciousness from confusion to coma. A large number of clinical conditions can cause SIADH including malignancies, pulmonary disorders, injury to the brain, and certain pharmacologic agents. Malignancies often lead to SIADH versus SIADH causing malignant conditions. Water intoxication can lead to hyponatremia, therefore water intake is restricted. The most affected electrolyte from SIADH is sodium versus potassium. REF: Page 132 OBJ: NCLEX® Client Needs Category: Physiological Integrity: Reduction of Risk Potential |
front 12 new book | back 12 ignatavicius 9th ed |
front 13 A nurse is caring for a client with meningitis. Which laboratory
values should the nurse monitor to identify | back 13 ANS: A, C |
front 14 A nurse cares for a client who possibly has syndrome of inappropriate
antidiuretic hormone (SIADH). The | back 14 ANS: B |
front 15 A nurse assesses clients with potential endocrine disorders. Which
clients are at high risk for | back 15 ANS: A, C, D, E |
front 16 A nurse assesses clients with potential endocrine disorders. Which
clients are at high risk for adrenal | back 16 ANS: A, B, D |
front 17 new book | back 17 lewis 7th- ch50 |
front 18 A patient with an antidiuretic hormone (ADH)-secreting small-cell cancer of the lung is treated with demeclocycline (Declomycin) to control the symptoms of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse determines that the demeclocycline is effective upon finding that the a. patient’s daily weight is stable. b. urine specific gravity is increased. c. patient’s urinary output is increased. d. peripheral edema is decreased. | back 18 Correct Answer: C Rationale: Demeclocycline blocks the action of ADH on the renal tubules and increases urine output. A stable body weight and an increase in urine specific gravity indicate that the SIADH is not corrected. Peripheral edema does not occur with SIADH; a sudden weight gain without edema is a common clinical manifestation of this disorder. Cognitive Level: Application Text Reference: p. 1295 Nursing Process: Evaluation NCLEX: Physiological Integrity |
front 19 When teaching a patient with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says, a. “I need to shop for foods that are low in sodium and avoid adding salt to foods.” b. “I should weigh myself daily and report any sudden weight loss or gain.” c. “I need to limit my fluid intake to no more than 1 quart of liquids a day.” d. “I will eat foods high in potassium because the diuretics cause potassium loss.” | back 19 Correct Answer: A Rationale: Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred. Cognitive Level: Application Text Reference: p. 1296 Nursing Process: Evaluation NCLEX: Health Promotion and Maintenance |
front 20 A patient is hospitalized with possible SIADH. The patient is confused and reports a headache, muscle cramps, and twitching. The nurse would expect the initial laboratory results to include a a. serum sodium of 125 mEq/L (125 mmol/L). b. hematocrit of 52%. c. blood urea nitrogen (BUN) of 22 mg/dl (11.5 mmol/L). d. serum chloride of 110 mEq/L (110 mmol/L). | back 20 Correct Answer: A Rationale: When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. The BUN is not helpful in diagnosis of SIADH and this BUN value is increased. The serum chloride level will usually decrease along with the sodium level. This chloride value is elevated. Cognitive Level: Application Text Reference: p. 1295 Nursing Process: Assessment NCLEX: Physiological Integrity |
front 21 A patient is admitted with possible SIADH. Which information obtained by the nurse is most important to communicate rapidly to the health care provider? a. The patient complains of a severe headache. b. The patient complains of severe thirst. c. The patient has a urine specific gravity of 1.025. d. The patient has a serum sodium level of 119 mEq/L. | back 21 Correct Answer: D Rationale: A serum sodium of less than 120 mEq/L increases the risk for complications such as seizures and needs rapid correction. The other data are not unusual for a patient with SIADH and do not indicate the need for rapid action. Cognitive Level: Application Text Reference: p. 1295 Nursing Process: Assessment NCLEX: Physiological Integrity |
front 22 When developing a plan of care for a patient with SIADH, which interventions will the nurse include? a. Encourage fluids to 2000 ml/day. b. Offer patient hard candies to suck on. c. Monitor for increased peripheral edema. d. Keep head of bed elevated to 30 degrees. | back 22 Correct Answer: B Rationale: Sucking on hard candies decreases thirst for patient on a fluid restriction. Patients with SIADH are on fluid restrictions of 800 to 1000 ml/day. Peripheral edema is not seen with SIADH. The head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and decrease ADH release. Cognitive Level: Application Text Reference: p. 1296 Nursing Process: Planning NCLEX: Physiological Integrity |
front 23 After receiving change-of-shift report about these four patients, which patient should the nurse assess first? a. A 22-year-old admitted with SIADH who has a serum sodium level of 130 mEq/L. b. A 31-year-old who has iatrogenic Cushing’s syndrome with a capillary blood glucose level of 244 mg/dl. c. A 53-year-old who has Addison’s disease and is due for a scheduled dose of hydrocortisone (Solu-Cortef). d. A 70-year-old who recently started levothyroxine (Synthroid) to treat hypothyroidism and has an irregular pulse of 134. | back 23 Correct Answer: D Rationale: Initiation of thyroid replacement in older adults may cause angina and cardiac dysrhythmias. The patient’s high pulse rate needs rapid investigation by the nurse to assess for and intervene with any cardiac problems. The other patients also require nursing assessment and/or actions but are not at risk for life-threatening complications. Cognitive Level: Application Text Reference: p. 1306 Nursing Process: Planning NCLEX: Physiological Integrity |
front 24 new book | back 24 lewis 9th ed |
front 25 The nurse determines that demeclocycline (Declomycin) is effective
for a patient with | back 25 ANS: B |
front 26 The nurse determines that additional instruction is needed for a
60-year-old patient with | back 26 ANS: A |
front 27 A 56-year-old patient who is disoriented and reports a headache and
muscle cramps is | back 27 ANS: B |
front 28 Which intervention will the nurse include in the plan of care for a
52-year-old male | back 28 ANS: B |
front 29 Which information is most important for the nurse to communicate
rapidly to the | back 29 ANS: D |
front 30 After receiving change-of-shift report about the following four
patients, which patient | back 30 ANS: B |