ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 50 : Caring for Clients With Disorders of the Endocrine System Questions
Question 1 of 5
The nurse is caring for a client who has developed diabetes insipidus. The cause is unknown, and the physician has ordered a diagnostic test to determine if the cause is nephrogenic or neurogenic. What test will the nurse prepare the client for?
Correct Answer: B
Rationale: A fluid deprivation test can diagnose diabetes insipidus (DI) and differentiate neurogenic DI from nephrogenic DI. The other tests listed are nonspecific tests that help support diagnosis.
Question 2 of 5
A client has been diagnosed with nephrogenic diabetes insipidus (DI), and the physician is initiating treatment. What medication does the nurse prepare to administer for this client?
Correct Answer: D
Rationale: The physician prescribes a thiazide diuretic, such as hydrochlorothiazide. The thiazide acts at the proximal convoluted tubule, leaving less fluid for excretion in the distal convoluted tubules, the portion affected by nephrogenic diabetes insipidus (DI). Consequently, the client excretes water, but the total volume is less than in an untreated state. The other diuretics listed do not work on the proximal convoluted tubule and would not be effective in treatment.
Question 3 of 5
What intervention can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss?
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.
Question 4 of 5
A client with syndrome of inappropriate antidiuretic hormone (SIADH) is severely hyponatremic. What IV fluids would the nurse anticipate administering to this client?
Correct Answer: A
Rationale: Severe hyponatremia is treated with IV administration of a 3% hypertonic sodium chloride solution. The other answers will not provide the amount of sodium required to correct the hyponatremia.
Question 5 of 5
The nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH). The nurse notices that the client has become confused and extremely short of breath, and crackles are heard when lungs are auscultated. What is the first action by the nurse?
Correct Answer: B
Rationale: The nurse closely monitors fluid intake and output and vital signs. The nurse carefully assesses LOC and immediately reports any changes to the physician. The nurse checks closely for signs of fluid overload (confusion, dyspnea, pulmonary congestion, hypertension) and hyponatremia (weakness, muscle cramps, anorexia, nausea, diarrhea, irritability, headache, weight gain without edema). Laying the client flat would increase the shortness of breath and would deoxygenate the client. The nurse cannot administer a diuretic without the physician's order. Suctioning of the client will not clear the airway at this time.