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NUR 443 EXAM QUESTIONS AND ANSWERS 2024/2025
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NUR 443 EXAM QUESTIONS AND ANSWERS 2024/2025
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NUR 443 EXAM QUESTIONS ANDANSWERS 2024/2025
In this condition excess secretion of antidiuretic hormone, and the resultant water
retention, leads to dilutional hyponatremia (serum Na+ < 135 mmol/L), serum
hypoosmolality osmolality (< 280 mOsm/kg) and concentrated urine. Dilutional
hyponatremia leads to worsening neurologic symptoms as the hyponatremia
progresses. Fluid restriction is a priority treatment strategy. - Answer-Syndrome of
Inappropriate Antidiuretic Hormone (SIADH)
This condition manifests as a hypermetabolic state. Patients experience anxiety,
difficulty sleeping, poor heat tolerance, diarrhea, tachycardia, and weight loss. Grave's
disease is the most common cause in the United States -
Answer-Hyperthyroidism/thyrotoxicosis
In this condition there is hyposecretion of corticosteroids resulting in hypoglycemia,
orthostatic hypotension, hyponatremia and hyperkalemia. In the crisis state,
hypovolemia hyponatremia and hyperkalemia from mineral corticoid deficiency and
hypotension and hypoglycemia from loss of glucocorticoid can progress to shock and
death. - Answer-Addison's disease
In this condition excess glucocorticoid leads to weight gain with truncal obesity, striae,
moon face, and buffalo hump, thin extremities with muscle wasting, delayed wound
healing, thin skin, easy bruising, bronze skin tones, osteoporosis, hyperglycemia, mood
disturbances, insomnia, psychosis, depressed immune and inflammatory responses,
and risk for emboli. Excess mineral corticoid leads to Na and H2O retention,
hypertension, and hypokalemia. When the cause is a pituitary tumor, treatment is
transsphenoidal removal of the tumor. If the pituitary is surgically removed, the patient
will require lifelong hormone replacement therapy - Answer-Cushing's syndrome
Worldwide the most common cause of this disorder is iodine deficiency. In the United
States, the most common cause is an autoimmune process. Physical manifestations
include coarse hair, hoarse voice. dry skin, myxedema (puffiness around the eyes),
delayed reflexes, mental sluggishness, cold intolerance, constipation, bradycardia, and
heart failure - Answer-hypothyroidism
This is a condition caused by posterior pituitary hypo-functioning (deficient ADH
secretion). Clinical manifestations include massive polyuria, up to 20 liters per day of
dilute urine (urine specific gravity of 1.005 or less), leading to hypovolemia, dehydration,
increased serum sodium and increased serum osmolality. Patients may experience
severe dehydration and hypovolemic shock if fluid intake is insufficient to make up for
urinary losses. - Answer-Diabetes Insipidus
, Patients with ______ need plenty of access to water to make up for urinary losses. -
Answer-DI
Demeclocycline (Declomycin) may be prescribed for patients with this disorder. The
purpose of the demeclocycline is to reduce the renal response to ADH - Answer-SIADH
Clinical manifestations of this condition primarily result from an increased metabolic rate
and increased sensitivity to sympathetic nervous system stimulation and include
nervousness, increased sweating, heat intolerance, palpitations, tachycardia, dyspnea,
fatigue, weight loss, tremor, exophthalmos. - Answer-Hyperthyroidism
In the U.S., the most common cause of this disorder is autoimmune destruction of the
thyroid gland. - Answer-hypothyroidism
Treatment of this condition includes lifelong exogenous replacement of glucocorticoid
with hydrocortisone and possibly lifelong replacement of mineral corticoid (the patient
may only require replacement with glucocorticoid if enough mineral corticoid is spared).
- Answer-Addison's disease
EKG changes seen in the crisis state of this condition include peaked T waves,
widening QRS complex, prolonged PR interval. These changes reflect hyperkalemia
and may progress to asystole. Cardiac monitoring is essential. - Answer-Addisonian
crisis
Common manifestations of this disorder include fatigue, cold dry skin, hoarseness, hair
loss, constipation, and cold intolerance. Weight gain is common due to a decreased
metabolic rate. The patient may be fatigued or lethargic and may exhibit personality and
mental status changes and appear depressed. The patient may exhibit signs of
myxedema puffiness around eyes and cheeks (myxedema). Cardiac effects include
decreased cardiac contractility and decreased cardiac output resulting in low exercise
tolerance and shortness of breath. The patient is predisposed to atherosclerosis. -
Answer-hypothyroidism
cold intolerance - Answer-hypothyroidism
Because patients with this disorder may already be mentally sluggish, sedatives should
be avoided. - Answer-hypothyroidism
An ideal diet for a patient experiencing clinical manifestations of this disorder include
high calorie, high CHO, high PRO, low fiber and low caffeine. - Answer-Hyperthyroidism
Management of this disorder depends on the severity of the hyponatremia. For mild
symptoms and serum sodium greater than 125 mEq/L (or mmol/L) the patient may only
need fluid restriction of 800 - 1000 ml/day. - Answer-SIADH
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