The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What manifestation should the nurse expect to find?

Correct Answer: B

Rationale: In the scenario of a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH), the nurse should expect to find decreased urinary output as the correct manifestation. SIADH is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention by the kidneys and decreased urine output. Option A, decreased body weight, is incorrect because SIADH causes water retention, not weight loss. Option C, increased plasma osmolality, is incorrect because SIADH leads to dilution of the blood, causing decreased plasma osmolality. Option D, increased serum sodium levels, is incorrect because in SIADH, the excessive water retention dilutes the blood, resulting in decreased serum sodium levels, a condition known as hyponatremia. Educationally, understanding the manifestations of SIADH is crucial for nurses to provide appropriate care to patients with this condition. By grasping the pathophysiology of SIADH and its effects on body fluid regulation, nurses can implement interventions to manage water balance and prevent complications related to fluid and electrolyte imbalances. This knowledge is essential in ensuring patient safety and promoting optimal outcomes in clinical practice.

Correct Answer: C

Rationale: The correct answer is C) It minimizes hypothalamic-pituitary-adrenal suppression. In this scenario, the patient with mild iatrogenic Cushing syndrome is on an alternate-day regimen of corticosteroid therapy. This regimen is designed to reduce the risk of suppressing the hypothalamic-pituitary-adrenal (HPA) axis. By providing corticosteroids on alternate days, the body has the opportunity to recover and produce its own cortisol on non-treatment days, thus minimizing the suppression of the HPA axis. Option A) It maintains normal adrenal hormone balance: This is incorrect because the alternate-day regimen does not necessarily maintain normal adrenal hormone balance as the patient is still receiving exogenous corticosteroids. Option B) It prevents ACTH release from the pituitary gland: This is incorrect because the alternate-day regimen does not prevent ACTH release; rather, it aims to minimize the suppression of the HPA axis. Option D) It provides a more effective therapeutic effect of the drug: This is incorrect because the alternate-day regimen is not about enhancing the therapeutic effect but rather about managing the side effects and risks associated with long-term corticosteroid therapy. Educational context: Understanding the rationale behind alternate-day corticosteroid therapy is crucial for nurses caring for patients with conditions requiring such treatment. By grasping the concept of minimizing HPA suppression, nurses can effectively educate patients on the importance of adherence to the prescribed regimen and help monitor for any signs of adrenal insufficiency or exacerbation of the underlying condition.

Correct Answer: A

Rationale: In Mr. Hanover's case of recovering from diabetic ketoacidosis, the correct action to prevent recurrence is option A: Notifying his physician if ketonuria persists for more than 12 hours. This is crucial because persistent ketonuria indicates ongoing metabolic imbalance, which can lead to a recurrence of diabetic ketoacidosis. By informing the physician promptly, appropriate adjustments can be made to prevent the condition from worsening. Option B, omitting fractional urines when under stress, is incorrect because monitoring urine output, especially for ketones, is essential in managing diabetes and detecting early signs of ketoacidosis. Omitting this step can lead to missed warning signs. Option C, decreasing insulin dosage when a fever is present, is also incorrect. During illness, the body's insulin requirements may actually increase due to the stress response. Decreasing insulin without medical guidance can exacerbate hyperglycemia and increase the risk of ketoacidosis. Option D, omitting insulin dose when vomiting is present, is incorrect as vomiting can lead to dehydration and further metabolic imbalances in individuals with diabetes. Omitting insulin can result in uncontrolled blood sugar levels, worsening the situation. Educationally, understanding the importance of close monitoring, early detection of warning signs, and timely communication with healthcare providers is vital in managing diabetes, especially in preventing life-threatening complications like diabetic ketoacidosis. Patients and caregivers must be educated on the significance of proactive management strategies to maintain optimal health and prevent diabetic emergencies.

Correct Answer: A

Rationale: The correct answer is option A) Your adrenal gland is producing too much hormone causing your blood sugar to increase and it is spilling into your urine. This response is accurate because it explains the possibility of high levels of hormones affecting blood sugar levels, leading to sugar spilling into the urine. This scenario is often seen in conditions like Cushing's syndrome where excess cortisol is produced, impacting blood sugar regulation. Option B is incorrect as it does not provide any educational value or explanation to Mrs. A. It deflects the question and misses an opportunity to educate the patient. Option C is incorrect as it attributes the urine sugar testing solely to the medicine for Cushing syndrome, which may not be the primary reason for the testing. Option D is incorrect as it refers to a problem with insulin production from the pancreas, which is not the main issue highlighted in the scenario. In an educational context, it is crucial for nurses to effectively communicate with patients about their health conditions and the reasons behind diagnostic tests. Understanding the link between hormone production, blood sugar levels, and urine testing can empower patients to take an active role in managing their health. By providing clear and informative responses, nurses can enhance patient understanding and promote better health outcomes.

Correct Answer: A

Rationale: The correct answer is A) Tachycardia, sweating, and tremors. Hyperthyroidism is characterized by an overactive thyroid gland, leading to an excess of thyroid hormones in the body. Tachycardia (increased heart rate), sweating, and tremors are classic symptoms of hyperthyroidism due to the heightened metabolic state caused by excess thyroid hormones. Option B) Fatigue, lethargy, and weight gain are actually symptoms seen in hypothyroidism, which is the opposite of hyperthyroidism. In hypothyroidism, there is an underactive thyroid gland leading to decreased metabolic activity and symptoms like fatigue, lethargy, and weight gain. Option C) Muscle twitching, tetany, and galactorrhea are not typical symptoms of hyperthyroidism. Muscle twitching and tetany can be seen in conditions like hypocalcemia, while galactorrhea is abnormal milk production and is often associated with issues related to the pituitary gland or hormonal imbalances, not specifically hyperthyroidism. Option D) Scotoma, alopecia, and hirsutism are not commonly associated with hyperthyroidism. Scotoma refers to a visual disturbance, alopecia is hair loss, and hirsutism is excessive hair growth, none of which are primary symptoms of hyperthyroidism. Understanding the signs and symptoms specific to hyperthyroidism is crucial for healthcare providers to accurately diagnose and treat patients. This question helps reinforce the importance of recognizing key clinical manifestations to differentiate between hyperthyroidism and other endocrine disorders.