NSG 6435 Exam Questions with
answers graded A+
You are reviewing the labs below for a client with a brain tumor. based on these labs, what should
you monitor for?
Serum osmolality: 305 mOsm/kg
Urine osmolality: 85 mOsm/kg
Urine specific gravity: 1.045
Na: 152
a. dehydration
b. fluid overload
c. hypertension
d. crackles in lungs - ANS✅✅A
Rationale: Na is elevated which indicates dehydration; diabetes insipidus present
normal serum osmolality: 285-295
normal urine osmolality: 100-900 (UA); 500-800 (24-hour specimen)
normal urine specific gravity: 1.005-1.025
The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What
manifestation should the nurse expect to find?
a. Decreased body weight
B. Increased plasma osmolality
C. Decreased urinary output
d. Increased serum sodium levels - ANS✅✅C
Rationale: SIADH retains water.. so increased weight, decreased osmolality, decreased UOP, and
decreased Na
During care of the patient with SIADH, what should the nurse do?
,a. Monitor neurologic status at least every 2 hours
b. Teach the patient receiving treatment with diuretics to restrict sodium intake.
c. Keep the head of the bed elevated to prevent antidiuretic hormone (ADH) release.
d. Notify the HCP if the patient's blood pressure decreases more than 20 mm Hg from baseline. -
ANS✅✅A
Rationale: A-patient is at risk for decreased LOC r/t cerebral edema caused by hyponatremia; B-loop
diuretics may further increase Na loss, patient might need to supplement; C-should keep HOB flat or
less than 10 degrees to prevent ADH release; D-should be done, but unlikely, more likely to see
hypertension r/t hypervolemia
In a patient with central (neurogenic) diabetes insipidus, the administration of ADH during a water
deprivation test will result in what?
a. Decrease in body weight
b. Decrease in blood pressure
c. Increase in urinary output
d. Increase in urine osmolality - ANS✅✅D
A patient with diabetes insipidus is treated with nasal desmopressin acetate (DDAVP). The nurse
determines that the drug is not having an adequate therapeutic effect when the patient experiences
which of the following?
a. headache and weight gain.
b. a urine specific gravity of 1.002.
c. nasal irritation and nausea.
d. an oral intake greater than urinary output. - ANS✅✅B
When caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect the
treatment to include?
a. Fluid restriction
b. Thiazide diuretics
,c. A high-sodium diet
d. metformin (Glucophage) - ANS✅✅B
Rationale: A-fluid restriction in SIADH; C-sodium should be restriction; D-hyperglycemia is not
present in DI unless D5W causes it
Interpret these ABG results
pH: 7.31
CO2: 52
HCO3: 26
O2: 68
a. respiratory alkalosis
b. respiratory acidosis
c. metabolic alkalosis
d. metabolic acidosis - ANS✅✅B
Rationale: pH is acidic, CO2 is high, HCO3 is normal
normal pH: 7.35-7.45
normal CO2: 35-45
normal HCO3: 22-26
normal O2: 60-100
Interpret these ABG results
pH: 7.31
CO2: 52
HCO3: 26
O2: 68
a. uncompensated
, b. partially compensated
c. fully compensated - ANS✅✅A
Rationale: pH is acidic; if fully compensated, pH will be in a normal range; if partially compensated,
both CO2 and HCO3 will be high or low depending (indicates compensation)
Interpret these ABG results
pH: 7.46
CO2: 32
HCO3: 22
O2: 81
a. respiratory alkalosis
b. respiratory acidosis
c. metabolic alkalosis
d. metabolic acidosis - ANS✅✅A
Rationale: pH is alkalotic, CO2 is low, HCO3 is normal
Interpret these ABG results
pH: 7.29
CO2: 36
HCO3: 17
O2: 138
a. respiratory alkalosis
b. respiratory acidosis
c. metabolic alkalosis
d. metabolic acidosis - ANS✅✅D
Rationale: pH is acidic, HCO3 is low, CO2 is normal
answers graded A+
You are reviewing the labs below for a client with a brain tumor. based on these labs, what should
you monitor for?
Serum osmolality: 305 mOsm/kg
Urine osmolality: 85 mOsm/kg
Urine specific gravity: 1.045
Na: 152
a. dehydration
b. fluid overload
c. hypertension
d. crackles in lungs - ANS✅✅A
Rationale: Na is elevated which indicates dehydration; diabetes insipidus present
normal serum osmolality: 285-295
normal urine osmolality: 100-900 (UA); 500-800 (24-hour specimen)
normal urine specific gravity: 1.005-1.025
The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What
manifestation should the nurse expect to find?
a. Decreased body weight
B. Increased plasma osmolality
C. Decreased urinary output
d. Increased serum sodium levels - ANS✅✅C
Rationale: SIADH retains water.. so increased weight, decreased osmolality, decreased UOP, and
decreased Na
During care of the patient with SIADH, what should the nurse do?
,a. Monitor neurologic status at least every 2 hours
b. Teach the patient receiving treatment with diuretics to restrict sodium intake.
c. Keep the head of the bed elevated to prevent antidiuretic hormone (ADH) release.
d. Notify the HCP if the patient's blood pressure decreases more than 20 mm Hg from baseline. -
ANS✅✅A
Rationale: A-patient is at risk for decreased LOC r/t cerebral edema caused by hyponatremia; B-loop
diuretics may further increase Na loss, patient might need to supplement; C-should keep HOB flat or
less than 10 degrees to prevent ADH release; D-should be done, but unlikely, more likely to see
hypertension r/t hypervolemia
In a patient with central (neurogenic) diabetes insipidus, the administration of ADH during a water
deprivation test will result in what?
a. Decrease in body weight
b. Decrease in blood pressure
c. Increase in urinary output
d. Increase in urine osmolality - ANS✅✅D
A patient with diabetes insipidus is treated with nasal desmopressin acetate (DDAVP). The nurse
determines that the drug is not having an adequate therapeutic effect when the patient experiences
which of the following?
a. headache and weight gain.
b. a urine specific gravity of 1.002.
c. nasal irritation and nausea.
d. an oral intake greater than urinary output. - ANS✅✅B
When caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect the
treatment to include?
a. Fluid restriction
b. Thiazide diuretics
,c. A high-sodium diet
d. metformin (Glucophage) - ANS✅✅B
Rationale: A-fluid restriction in SIADH; C-sodium should be restriction; D-hyperglycemia is not
present in DI unless D5W causes it
Interpret these ABG results
pH: 7.31
CO2: 52
HCO3: 26
O2: 68
a. respiratory alkalosis
b. respiratory acidosis
c. metabolic alkalosis
d. metabolic acidosis - ANS✅✅B
Rationale: pH is acidic, CO2 is high, HCO3 is normal
normal pH: 7.35-7.45
normal CO2: 35-45
normal HCO3: 22-26
normal O2: 60-100
Interpret these ABG results
pH: 7.31
CO2: 52
HCO3: 26
O2: 68
a. uncompensated
, b. partially compensated
c. fully compensated - ANS✅✅A
Rationale: pH is acidic; if fully compensated, pH will be in a normal range; if partially compensated,
both CO2 and HCO3 will be high or low depending (indicates compensation)
Interpret these ABG results
pH: 7.46
CO2: 32
HCO3: 22
O2: 81
a. respiratory alkalosis
b. respiratory acidosis
c. metabolic alkalosis
d. metabolic acidosis - ANS✅✅A
Rationale: pH is alkalotic, CO2 is low, HCO3 is normal
Interpret these ABG results
pH: 7.29
CO2: 36
HCO3: 17
O2: 138
a. respiratory alkalosis
b. respiratory acidosis
c. metabolic alkalosis
d. metabolic acidosis - ANS✅✅D
Rationale: pH is acidic, HCO3 is low, CO2 is normal
