A patient has been diagnosed with a brain tumor that cannot be removed surgically. During each office visit, the nurse will be assessing the patient for syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessments would alert the clinic nurse that the patient may be developing this complication?

Correct Answer: A

Rationale: The correct answer is A: Complaints that his urine output is decreased, no edema noted in ankles, and increasing headache. Rationale: 1. Decreased urine output: SIADH leads to water retention, causing decreased urine output. 2. No edema in ankles: SIADH causes dilutional hyponatremia, not fluid overload like in other conditions causing edema. 3. Increasing headache: Due to cerebral edema from water retention, a common symptom of SIADH. Summary of incorrect choices: B: Elevated blood glucose levels, dry mucous membranes, and severe projectile vomiting - These are not typical signs of SIADH. C: Fever, diarrhea, and nausea - These symptoms are not specific to SIADH. D: Muscle cramps, pins and needles sensation around the mouth/lips, and unexplained bruising - These are not characteristic symptoms of SIADH.

Correct Answer: B

Rationale: The correct answer is B: The client is acidotic and has impaired platelet function. IV phosphate replacement helps correct acidosis by buffering excess hydrogen ions and restoring normal pH levels. Acidosis can impair platelet function, leading to bleeding disorders. A: The client has an accumulation of fluid in her peritoneal cavity - IV phosphate replacement does not directly address this issue. C: The client has an irregular heart rate and a thready pulse - IV phosphate replacement does not directly affect heart rate and pulse rhythm. D: The client has abdominal spasms and hyperactive reflexes - IV phosphate replacement does not directly address these symptoms.

Correct Answer: C

Rationale: The correct answer is C: Provide hypertonic saline slowly. In this scenario, the patient has hyponatremia (low serum sodium level), which can lead to neurological symptoms like confusion and muscle cramps. The treatment goal is to increase sodium levels gradually to avoid complications such as osmotic demyelination syndrome. Hypertonic saline is the appropriate choice as it will raise sodium levels effectively without causing rapid shifts that can be harmful. Isotonic saline (choice A) may not provide enough sodium correction, fluid restriction (choice B) may worsen symptoms, and encouraging high-sodium foods (choice D) may not be sufficient or controlled.

Correct Answer: D

Rationale: Fasting for two weeks will slow the metabolic rate as the body conserves energy, making weight loss harder and potentially causing health issues.

Correct Answer: C

Rationale: BMI = weight (kg) / height (m²). 180 lb = 81.65 kg, 5'11" = 1.803 m. 81.65 / (1.803²) ≈ 25.1.