NSG 5002 A+ LEWIS CHAPTER 50 EXAM QUESTIONS
BANK WITH VERIFIED ANSWERS LATEST.
The nurse determines that demeclocycline (Declomycin) is effective for a patient
with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding
that the patient's
a. weight has increased.
b. urinary output is increased.
c. peripheral edema is decreased.
d. urine specific gravity is increased.
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules
and increases urine output. An increase in weight or an increase in urine specific gravity
indicates 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.
The nurse determines that additional instruction is needed for a 60-year-old
patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)
when the patient says which of the following?
a. "I need to shop for foods low in sodium and avoid adding salt to food."
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 diuretics cause potassium loss."
ANS: A
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.
A 56-year-old patient who is disoriented and reports a headache and muscle
cramps is hospitalized with possible syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse would expect the initial laboratory results to include
a(n)
a. elevated hematocrit.
, b. decreased serum sodium.
c. low urine specific gravity.
d. increased serum chloride.
ANS: B
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. Urine will be more concentrated with a higher
specific gravity. The serum chloride level will usually decrease along with the sodium
level.
An expected nursing diagnosis for a 30-year-old patient admitted to the hospital
with symptoms of diabetes insipidus is
a. excess fluid volume related to intake greater than output.
b. impaired gas exchange related to fluid retention in lungs.
c. sleep pattern disturbance related to frequent waking to void.
d. risk for impaired skin integrity related to generalized edema.
ANS: C
Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema, excess
fluid volume, and fluid retention are not expected.
A patient who had a subtotal thyroidectomy earlier today develops laryngeal
stridor and a cramp in the right hand upon returning to the surgical nursing unit.
Which collaborative action will the nurse anticipate next?
a. Suction the patient's airway.
b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation.
ANS: B
The patient's clinical manifestations of stridor and cramping are consistent with tetany
caused by hypocalcemia resulting from damage to the parathyroid glands during
surgery. Endotracheal intubation or tracheostomy may be needed if the calcium does
not resolve the stridor. Suctioning will not correct the stridor.
BANK WITH VERIFIED ANSWERS LATEST.
The nurse determines that demeclocycline (Declomycin) is effective for a patient
with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding
that the patient's
a. weight has increased.
b. urinary output is increased.
c. peripheral edema is decreased.
d. urine specific gravity is increased.
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules
and increases urine output. An increase in weight or an increase in urine specific gravity
indicates 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.
The nurse determines that additional instruction is needed for a 60-year-old
patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)
when the patient says which of the following?
a. "I need to shop for foods low in sodium and avoid adding salt to food."
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 diuretics cause potassium loss."
ANS: A
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.
A 56-year-old patient who is disoriented and reports a headache and muscle
cramps is hospitalized with possible syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse would expect the initial laboratory results to include
a(n)
a. elevated hematocrit.
, b. decreased serum sodium.
c. low urine specific gravity.
d. increased serum chloride.
ANS: B
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. Urine will be more concentrated with a higher
specific gravity. The serum chloride level will usually decrease along with the sodium
level.
An expected nursing diagnosis for a 30-year-old patient admitted to the hospital
with symptoms of diabetes insipidus is
a. excess fluid volume related to intake greater than output.
b. impaired gas exchange related to fluid retention in lungs.
c. sleep pattern disturbance related to frequent waking to void.
d. risk for impaired skin integrity related to generalized edema.
ANS: C
Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema, excess
fluid volume, and fluid retention are not expected.
A patient who had a subtotal thyroidectomy earlier today develops laryngeal
stridor and a cramp in the right hand upon returning to the surgical nursing unit.
Which collaborative action will the nurse anticipate next?
a. Suction the patient's airway.
b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation.
ANS: B
The patient's clinical manifestations of stridor and cramping are consistent with tetany
caused by hypocalcemia resulting from damage to the parathyroid glands during
surgery. Endotracheal intubation or tracheostomy may be needed if the calcium does
not resolve the stridor. Suctioning will not correct the stridor.
