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NUR 504 (Surgery) EXAM 3 MULTIPLE CHOICE QUIZBANK WITH EXPLANATIONS A+ GRADED.
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NUR 504 (Surgery) EXAM 3 MULTIPLE CHOICE QUIZBANK WITH EXPLANATIONS A+ GRADED.
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NUR 504 (Surgery) EXAM 3 MULTIPLECHOICE QUIZBANK WITH
EXPLANATIONS A+ GRADED.
The nurse is caring for a client who is diagnosed with diabetes insipidus (DI).
For what
common complication will the nurse monitor?
a. Hypertension
b. Bradycardia
c. Dehydration
d. Pulmonary embolus
ANS: C
The client who has DI has fluid loss through excessive urination. Decreased
fluid volume, or
dehydration, is manifested by tachycardia, hypotension, and possibly
elevated temperature.
Pulmonary embolism (PE) could possible as a clot in the lower extremity
(caused by
dehydration) could fragment and travel to the lungs.
A client is being treated for diabetes insipidus (DI) with synthetic
vasopressin (desmopressin).
What is the priority health teaching that the nurse provides regarding drug
therapy?
a. The need to check the client's urinary specific gravity.
,b. The need to take blood pressure at least twice a day.
c. The need to monitor blood glucose every day.
d. The need to weigh every day and report weight gain.
ANS: D
The client with DI who takes lifelong hormone replacement will need to
report significant
weight gain to monitor for water toxicity. Water toxicity causes headache,
vomiting, and acute
confusion.
A nurse is reviewing care for a client who has syndrome of inappropriate
antidiuretic hormone (SIADH) with assistive personnel. What statement by
the AP indicates understanding of this client's care?
a. "I will weigh the client carefully before breakfast and compare with
yesterday's weight."
b. "I will encourage plenty of fluids to promote urination and prevent
dehydration."
c. "I will teach the client not to select high-sodium or salty foods on the
menu."
d. "I will assess the client's mucous membranes and skin for signs of
dehydration."
ANS: A
The client with SIADH usually has a fluid restriction, not an increase in
fluids. It is the role of
the RN rather than AP to perform assessments and provide health teaching.
The AP needs to
weigh the client daily and report a significant weight changes.
,The nurse is preparing to give tolvaptan for a client who has syndrome of
inappropriate antidiuretic hormone (SIADH). For which potentially life-
threatening adverse effect would
the nurse monitor?
a. Increased intracranial pressure
b. Myocardial infarction
c. Rapid-onset hypernatremia
d. Bowel perforation
ANS: C
Tolvaptan has a black box warning that rapid increases in serum sodium
levels have been
associated with central nervous system demyelination that can lead to
serious complications
and death.
A client is admitted with a possible diagnosis of diabetes insipidus (DI).
What assessment findings would the nurse expect? (Select all that apply.)
a. Hypotension
b. Increased urinary output
c. Concentrated urine
d. Decreased thirst
e. Poor skin turgor
f. Bradycardia
ANS: A, B, E
, The client who has DI has excessive urination and dehydration. Clients who
are dehydrated
have decreased blood pressure, increased pulse (tachycardia), and poor
skin turgor. The urine
is dilute with a low specific gravity.
The nurse is planning health teaching for a client starting on levothyroxine.
What health
teaching about this drug would the nurse include?
a. The need to take the drug when the client feels fatigued and weak.
b. The need to report chest pain and dyspnea when starting the drug.
c. The need to check blood pressure and pulse every day.
d. The need to rotate injection sites when giving self the drug.
ANS: B
Levothyroxine is a replacement hormone for clients who have
hypothyroidism and is taken
orally for life. Vital signs do not have to be checked every day, but the client
should report
any chest pain and dyspnea when first starting the drug.
A nurse assesses a client who is recovering from a subtotal thyroidectomy
and observes the
development of stridor. What is the priority action for the nurse to take?
a. Apply oxygen via nasal cannula at 2 L/min.
b. Document the finding and assess the client hourly.
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