Question

A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

Answer 1

Correct Answers:

Dehydration

Rationale :

🔷 Low ADH in diabetes insipidus → kidneys can’t concentrate urine, causing massive water loss.

🔷 Marked polyuria leads to hypovolemia, dry mucous membranes, and dehydration.

🔷 Polydipsia occurs but may not keep up with free-water losses, so dehydration persists.

🔷 Urine specific gravity is low (very dilute), supporting volume loss rather than hyperglycemia.

🔷 Serum sodium often rises (hypernatremia) from free-water deficit, reinforcing dehydration risk.

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Answer 2

Correct Answers:

Moist, clammy skin
Blurred vision
Tachycardia

Rationale :

🔶 Sympathetic surge in hypoglycemia triggers tachycardia and autonomic symptoms.

🔶 Adrenergic activation causes diaphoresis → skin becomes moist, clammy.

🔶 Neuroglycopenia impairs retinal/brain function → blurred vision and confusion may follow.

🔶 Polydipsia/polyuria point to hyperglycemia, not hypoglycemia (helps differentiate).

🔶 Rapid recognition is critical to prevent seizures and loss of consciousness from low glucose.

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Answer 3

Correct Answers:

The client runs 4 miles outdoors every afternoon.

Rationale :

💎 Excessive exercise → sweat and fluid losses increase risk of lithium retention and toxicity.

💎 Sodium depletion from sweat enhances lithium reabsorption in the proximal tubule.

💎 Heat plus running intensifies dehydration, compounding serum lithium elevation.

💎 A stable salt and fluid intake is crucial for safe lithium levels.

💎 Client education stresses avoiding factors that alter hydration or sodium balance.

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Answer 4

Correct Answers:

Walk with the client at a gradually slower pace.

Rationale :

◈ This therapeutic technique meets the client’s anxiety level while providing structure.

◈ Walking alongside models calm behavior and prevents escalation.

◈ It avoids confrontation while gently guiding the client toward de-escalation.

◈ Maintains safety by keeping client under observation without restricting autonomy.

◈ Supports therapeutic communication and helps client regain self-control.

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Answer 5

Correct Answers:

Chvostek's sign

Rationale :

❖ After thyroid surgery, parathyroid injury can cause hypocalcemia.

❖ Chvostek’s sign (facial twitch with nerve tap) confirms neuromuscular irritability.

❖ Tingling around lips, hands, feet indicates early tetany from low calcium.

❖ Nurses should also monitor for Trousseau’s sign and laryngospasm risk.

❖ Prompt calcium replacement prevents life-threatening airway compromise.

Pictorial: Yes — bedside illustrations of Chvostek’s and Trousseau’s signs.

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Answer 6

Correct Answers:

Dialysis disequilibrium

Rationale :

🔹 First dialysis causes rapid solute removal, creating osmotic gradient shifts in the brain.

🔹 Water moves into brain cells → cerebral edema manifests as headache, nausea, restlessness.

🔹 Most likely in clients with very high BUN before first session.

🔹 Prevented by slower, shorter initial dialysis sessions.

🔹 Severe cases may require mannitol or other osmotic therapy.

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Answer 7

Correct Answers:

Restricting fluid intake
Time constraints
Restricting foods high in potassium, sodium, and phosphorus

Rationale :

♦ Fluid restriction prevents fluid overload and hypertension between dialysis sessions.

♦ Time constraints (frequent, lengthy treatments) significantly disrupt daily lifestyle.

♦ Dietary restrictions reduce risks of arrhythmias, edema, and renal bone disease.

♦ Air travel and driving are possible with planning; the main burden is strict diet + schedule.

♦ Nurses emphasize adherence to enhance quality of life and prevent complications.

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Answer 8

Correct Answers:

Administer antibiotics.

Rationale :

✳ Acute glomerulonephritis often follows strep infection; antibiotics treat the underlying cause.

✳ Increased fluids can worsen hypertension and edema; avoid unless dehydration present.

✳ Encourage rest to conserve energy and reduce metabolic stress.

✳ Daily weights are more accurate than weekly to track subtle fluid retention.

✳ Monitoring BP, urine output, and edema prevents life-threatening complications.

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Answer 9

Correct Answers:

0.9% sodium chloride IV bolus

Rationale :

✔️ Restores intravascular volume rapidly to correct dehydration caused by osmotic diuresis in DKA.

✔️ Isotonic fluids are the first-line intervention before insulin administration.

✔️ Prevents circulatory collapse and hypotension, both common in severe hyperglycemia.

✔️ Dextrose solutions are not given until glucose lowers to ~250 mg/dL.

✔️ Oral hypoglycemics and glucocorticoids are not used in acute DKA management.

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Answer 10

Correct Answers:

Dehydration

Rationale :

✦ Lack of fluid intake leads to concentrated urine, increasing the risk of mineral crystallization.

✦ Dehydration promotes supersaturation of calcium oxalate, uric acid, and cystine—major stone components.

✦ Clients with renal calculi are always encouraged to increase hydration.

✦ Obesity is a risk factor but dehydration is the strongest immediate trigger.

✦ Iron deficiency and proteinuria do not directly cause stones.

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QLexNursing

1 :
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

2 :
A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)

3 :
A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

4 :
A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting, and now the client is pacing up and down the corridors of the unit. Which of the following actions should the nurse take?

5 :
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess?

6 :
A nurse is caring for a client following his first hemodialysis treatment. The client reports a headache, nausea, and restlessness. The nurse should identify these findings as manifestations of which of the following complications?

7 :
A nurse is caring for a client who has end-stage kidney disease who will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact quality of life?(Select All that Apply.)

8 :
A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?

9 :
A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

10 :
A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

QLexNursing

1 : A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

2 : A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)

3 : A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

4 : A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting, and now the client is pacing up and down the corridors of the unit. Which of the following actions should the nurse take?

5 : A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess?

6 : A nurse is caring for a client following his first hemodialysis treatment. The client reports a headache, nausea, and restlessness. The nurse should identify these findings as manifestations of which of the following complications?

7 : A nurse is caring for a client who has end-stage kidney disease who will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact quality of life?(Select All that Apply.)

8 : A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?

9 : A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

10 : A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

1 :
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

2 :
A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)

3 :
A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

4 :
A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting, and now the client is pacing up and down the corridors of the unit. Which of the following actions should the nurse take?

5 :
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess?

6 :
A nurse is caring for a client following his first hemodialysis treatment. The client reports a headache, nausea, and restlessness. The nurse should identify these findings as manifestations of which of the following complications?

7 :
A nurse is caring for a client who has end-stage kidney disease who will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact quality of life?(Select All that Apply.)

8 :
A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?

9 :
A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

10 :
A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?