Question

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

Answer 1

Correct Answers:

Urine output of 175 ml in the past 8 hrs

Rationale :

✍️ A urine output of less than 30 mL/hr over several hours indicates oliguria and possible worsening renal function.

✍️ For 8 hours, the expected minimum output is at least 240 mL; thus, 175 mL is significantly low.

✍️ This can signal acute kidney injury or fluid retention, requiring immediate provider notification.

✍️ Prompt recognition prevents electrolyte imbalances, acidosis, or volume overload.

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Answer 2

Correct Answers:

Thyroid stimulating hormone (TSH)

Rationale :

👉 In primary hypothyroidism, the thyroid gland fails to produce sufficient T3 and T4, triggering the pituitary to secrete more TSH.

👉 As a result, TSH is elevated, while T3 and T4 are decreased.

👉 Elevated TSH is the most sensitive indicator for detecting primary thyroid failure.

👉 This lab pattern helps differentiate between primary and secondary hypothyroidism.

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Answer 3

Correct Answers:

Decreased deep tendon reflexes

Rationale :

✳️ Hyperkalemia in chronic kidney disease leads to neuromuscular manifestations like muscle weakness and reduced reflexes.

✳️ It alters resting membrane potential, impairing nerve transmission and muscle contraction.

✳️ Without treatment, it may progress to flaccid paralysis or cardiac arrhythmias.

✳️ Monitoring potassium is critical to prevent life-threatening cardiac events.

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Answer 4

Correct Answers:

Oliguria

Rationale :

✔️ In SIADH, excess ADH causes water retention, leading to concentrated urine and low output (oliguria).

✔️ This condition results in dilutional hyponatremia, not hypernatremia or dehydration.

✔️ Common triggers include head trauma, tumors, or surgery like craniotomy.

✔️ Monitoring urine output helps guide fluid management and prevent fluid overload or cerebral edema.

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Answer 5

Correct Answers:

Restrict fluid intake to 1,000 mL per day.

Rationale :

💎 Clients with SIADH and a low sodium level (123 mEq/L) are at risk for seizures and cerebral edema due to fluid retention.

💎 Fluid restriction is the primary treatment to prevent further dilution of sodium and reduce complications.

💎 Hypertonic saline and vasopressin antagonists may be used in severe cases.

💎 Increasing sodium in the diet or giving desmopressin would worsen hyponatremia in this context.

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Answer 6

Correct Answers:

Have the client breath into a paper bag.

Rationale :

⪼ Metabolic alkalosis is typically not treated with paper bag breathing. This method is for respiratory alkalosis caused by hyperventilation.

⪼ However, the question asks what action to take for metabolic alkalosis, and none of the other options are appropriate:

⪼ Seizure precautions and sodium bicarbonate are not relevant here; breathing slowly helps in respiratory not metabolic conditions.

⪼ This question may be flawed, but if interpreting "alkalosis" as respiratory due to hyperventilation symptoms, paper bag is the best among flawed choices.

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Answer 7

Correct Answers:

Vancomycin

Rationale :

▧ Vancomycin is a nephrotoxic antibiotic, especially in clients with pre-existing renal impairment.

▧ It can cause acute tubular necrosis, and dosing must be carefully monitored using trough levels.

▧ Chronic kidney disease patients require renal dosing adjustments.

▧ Other listed meds are generally safe in renal clients, but vancomycin poses significant risk.

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Answer 8

Correct Answers:

Lung cancer

Rationale :

▲▲ SIADH is often caused by ectopic ADH production, commonly seen in small cell lung cancer.

▲▲ It may also be triggered by head trauma, CNS infections, or certain medications.

▲▲ The condition leads to hyponatremia and fluid retention.

▲▲ Lung cancer screening is essential when SIADH appears with no obvious cause.

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Answer 9

Correct Answers:

Have the client breath into a paper bag.

Rationale :

↪ Respiratory alkalosis is commonly caused by hyperventilation, which leads to excessive CO₂ loss.

↪ Rebreathing exhaled CO₂ via a paper bag helps restore acid-base balance.

↪ Other options like insulin or bicarbonate are not indicated unless there's an underlying metabolic cause.

↪ The paper bag method is effective for short-term correction of respiratory alkalosis.

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Answer 10

Correct Answers:

Dehydration

Rationale :

⪢ Diabetes insipidus (DI) causes profound polyuria, leading to fluid volume deficit and dehydration.

⪢ Classic signs include dry mucous membranes, hypotension, tachycardia, and elevated sodium levels.

⪢ Polyphagia and hyperglycemia are more associated with diabetes mellitus.

⪢ Monitoring for dehydration and electrolyte imbalance is a nursing priority in DI.

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QLexNursing

1 :
A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

2 :
A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. Which of the following laboratory values should the nurse anticipate an elevation of?

3 :
A nurse is assessing a client who has chronic kidney disease. Which of the following findings is a manifestation of hyperkalemia?

4 :
A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate?

5 :
A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

6 :
A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

7 :
A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

8 :
A nurse is collecting the medical history from a client who has manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH?

9 :
A nurse is caring for a client who has respiratory alkalosis and is hyper ventilating Which of the following actions should the nurse take?

10 :
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

QLexNursing

1 : A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

2 : A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. Which of the following laboratory values should the nurse anticipate an elevation of?

3 : A nurse is assessing a client who has chronic kidney disease. Which of the following findings is a manifestation of hyperkalemia?

4 : A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate?

5 : A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

6 : A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

7 : A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

8 : A nurse is collecting the medical history from a client who has manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH?

9 : A nurse is caring for a client who has respiratory alkalosis and is hyper ventilating Which of the following actions should the nurse take?

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

1 :
A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

2 :
A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. Which of the following laboratory values should the nurse anticipate an elevation of?

3 :
A nurse is assessing a client who has chronic kidney disease. Which of the following findings is a manifestation of hyperkalemia?

4 :
A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate?

5 :
A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

6 :
A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

7 :
A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

8 :
A nurse is collecting the medical history from a client who has manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH?

9 :
A nurse is caring for a client who has respiratory alkalosis and is hyper ventilating Which of the following actions should the nurse take?

10 :
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?