Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
Chamberlain University-Illinois NR 575
1. A 25-year-old male patient is admitted to the intensive Answer:2. Order serum sodium, urine-specific gravity.
care unit after a motor vehicle collision resulting in an Rationale: This scenario suggests a diagnosis of diabetes insipidus, for which
isolated severe traumatic brain injury causing elevated serum sodium and urine specific gravity will aid in the diagnosis.
intracranial pressure. He is on a ventilator and minimally
responsive. On the second day of hospitalization, he has
increasing vasopressor requirements and hourly urine
output of 400 mL. To address this problem, the nurse
practitioner would:
1. Order a fluid restriction.
2. Order serum sodium, urine-specific gravity.
3. Order 24-hour urine protein and creatinine.
4. Order a stat noncontrast computed tomography of the
head.
Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
, Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
2. A 25-year-old male patient is admitted to the intensive 1. Order 2 mcg desmopressin (DDAVP) intravenously (IV) and 1 L 0.9% saline.
care unit after a motor vehicle collision resulting in an Rationale: This patient has central diabetes insipidus from pituitary compression.
isolated severe traumatic brain injury causing elevated Treatment involves urgent administration of desmopressin and fluids to attenuate
intracranial pressure. He is on a ventilator and minimally the hypernatremia.
responsive. On the second day of hospitalization, he has
increasing vasopressor requirements and hourly urine
output of 400 mL. His serum sodium increased from 146
to 155 in the last 6 hours and urine specific gravity (SG) is
1.001. To address this problem, the nurse practitioner
would:
1. Order 2 mcg desmopressin (DDAVP) intravenously (IV)
and 1 L 0.9% saline.
2. Increase maintenance fluids from 75 to 150 mL/hr and
repeat sodium and SG in 6 hours.
3. Order 2 mcg DDAVP IV and fluid restriction.
4. Calculate the free water deficit and order free water
via nasogastric tube.
3. A 68-year-old 70-kg male patient with a history of 3. Institute a fluid restriction.
tobacco abuse was admitted with dyspnea. A chest x-ray Rationale: The syndrome of inappropriate antidiuretic hormone is commonly
revealed a pulmonary mass, flattened bilateral caused by pulmonary disease and malignancy. First-line treatment is a fluid
diaphragm, and no pulmonary edema. He is alert and restriction in the absence of symptoms such as seizure, mental status change, and
breathing comfortably after being started on 4 L of falls.
oxygen via nasal cannula. His initial sodium is 128 mEq/L.
Based on the nurse practitioner's knowledge of the
probable diagnosis, how would the nurse practitioner
correct his sodium?
1. Start 3% saline at 75 mL/hr.
2. Start 0.9% saline at 1000 mL/hr.
3. Institute a fluid restriction.
4. Order 40 mg furosemide and repeat sodium in 8 hours.
4. A 55-year-old female patient with a history of type 2 4. Insulin(R) infusion with target glucose 140 to 180 mg/dL.
diabetes and diverticulitis is admitted to the intensive Rationale: Preferred insulin route in the intensive care unit setting is intravenous
care unit following laparotomy for colectomy. She infusion with a target of 140 to 180 mg/dL to avoid hypoglycemic complications.
remains intubated and requires norepinephrine at 0.06 Vasoconstriction and edema of subcutaneous tissue can alter absorption.
mcg/kg/min to maintain a mean arterial pressure greater
than 65 mmHg despite adequate intraoperative fluid
resuscitation. Her blood glucose is 220 mg/dL. The nurse
practitioner's initial glucose management strategy will
entail starting:
1. Insulin(R) infusion with target glucose less than 120
mg/dL.
2. Insulin(R) subcutaneous (SQ) sliding scale with target
glucose 140 to 180 mg/dL.
3. Insulin(R) SQ sliding scale with target glucose less than
120 mg/dL.
4. Insulin(R) infusion with target glucose 140 to 180 mg/dL.
Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
Chamberlain University-Illinois NR 575
1. A 25-year-old male patient is admitted to the intensive Answer:2. Order serum sodium, urine-specific gravity.
care unit after a motor vehicle collision resulting in an Rationale: This scenario suggests a diagnosis of diabetes insipidus, for which
isolated severe traumatic brain injury causing elevated serum sodium and urine specific gravity will aid in the diagnosis.
intracranial pressure. He is on a ventilator and minimally
responsive. On the second day of hospitalization, he has
increasing vasopressor requirements and hourly urine
output of 400 mL. To address this problem, the nurse
practitioner would:
1. Order a fluid restriction.
2. Order serum sodium, urine-specific gravity.
3. Order 24-hour urine protein and creatinine.
4. Order a stat noncontrast computed tomography of the
head.
Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
, Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
2. A 25-year-old male patient is admitted to the intensive 1. Order 2 mcg desmopressin (DDAVP) intravenously (IV) and 1 L 0.9% saline.
care unit after a motor vehicle collision resulting in an Rationale: This patient has central diabetes insipidus from pituitary compression.
isolated severe traumatic brain injury causing elevated Treatment involves urgent administration of desmopressin and fluids to attenuate
intracranial pressure. He is on a ventilator and minimally the hypernatremia.
responsive. On the second day of hospitalization, he has
increasing vasopressor requirements and hourly urine
output of 400 mL. His serum sodium increased from 146
to 155 in the last 6 hours and urine specific gravity (SG) is
1.001. To address this problem, the nurse practitioner
would:
1. Order 2 mcg desmopressin (DDAVP) intravenously (IV)
and 1 L 0.9% saline.
2. Increase maintenance fluids from 75 to 150 mL/hr and
repeat sodium and SG in 6 hours.
3. Order 2 mcg DDAVP IV and fluid restriction.
4. Calculate the free water deficit and order free water
via nasogastric tube.
3. A 68-year-old 70-kg male patient with a history of 3. Institute a fluid restriction.
tobacco abuse was admitted with dyspnea. A chest x-ray Rationale: The syndrome of inappropriate antidiuretic hormone is commonly
revealed a pulmonary mass, flattened bilateral caused by pulmonary disease and malignancy. First-line treatment is a fluid
diaphragm, and no pulmonary edema. He is alert and restriction in the absence of symptoms such as seizure, mental status change, and
breathing comfortably after being started on 4 L of falls.
oxygen via nasal cannula. His initial sodium is 128 mEq/L.
Based on the nurse practitioner's knowledge of the
probable diagnosis, how would the nurse practitioner
correct his sodium?
1. Start 3% saline at 75 mL/hr.
2. Start 0.9% saline at 1000 mL/hr.
3. Institute a fluid restriction.
4. Order 40 mg furosemide and repeat sodium in 8 hours.
4. A 55-year-old female patient with a history of type 2 4. Insulin(R) infusion with target glucose 140 to 180 mg/dL.
diabetes and diverticulitis is admitted to the intensive Rationale: Preferred insulin route in the intensive care unit setting is intravenous
care unit following laparotomy for colectomy. She infusion with a target of 140 to 180 mg/dL to avoid hypoglycemic complications.
remains intubated and requires norepinephrine at 0.06 Vasoconstriction and edema of subcutaneous tissue can alter absorption.
mcg/kg/min to maintain a mean arterial pressure greater
than 65 mmHg despite adequate intraoperative fluid
resuscitation. Her blood glucose is 220 mg/dL. The nurse
practitioner's initial glucose management strategy will
entail starting:
1. Insulin(R) infusion with target glucose less than 120
mg/dL.
2. Insulin(R) subcutaneous (SQ) sliding scale with target
glucose 140 to 180 mg/dL.
3. Insulin(R) SQ sliding scale with target glucose less than
120 mg/dL.
4. Insulin(R) infusion with target glucose 140 to 180 mg/dL.
Adult-Gerontology Acute Care Nurse Practitioner Certification ENDOCRINE Q&S 100% Accurate
