Question

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?

Answer 1

Correct Answers:

Restrict fluid intake to 1,000 ml, per day.

Rationale :

🔷 In SIADH, excess ADH leads to water retention and dilutional hyponatremia.

🔷 Restricting fluids helps prevent worsening of hyponatremia and cerebral edema.

🔷 Sodium level of 123 mEq/L is critically low and requires urgent fluid restriction.

🔷 A low sodium diet would worsen sodium levels further and is contraindicated.

🔷 Hypertonic fluids or loop diuretics may be ordered, but fluid restriction is foundational.

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Answer 2

Correct Answers:

"Your average blood sugar is high."

Rationale :

🔷 Hemoglobin A1C reflects average blood glucose over 2–3 months.

🔷 A result of 9% is significantly above the recommended target of <7% for diabetics.

🔷 This indicates chronic hyperglycemia, not just after meals.

🔷 Helps assess long-term glycemic control, not day-to-day fluctuations.

🔷 Education should focus on lifestyle, medication adherence, and monitoring.

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Answer 3

Correct Answers:

Encouraging the client to drink 2 to 3 L of water daily

Rationale :

🔷 In COPD, hydration helps loosen thick bronchial secretions.

🔷 This facilitates airway clearance and reduces risk of infection.

🔷 Positioning helps but does not directly thin secretions.

🔷 Clients often avoid fluids; active encouragement is required.

🔷 Mucolytics and chest physiotherapy are helpful but fluids are first-line support.

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Answer 4

Correct Answers:

"Maintain stable blood glucose levels."

Rationale :

🔷 Long-term complications like retinopathy and nephropathy are linked to poor glycemic control.

🔷 Maintaining blood glucose levels within target range helps preserve microvascular health.

🔷 A1C monitoring and consistent treatment adherence are essential.

🔷 Stable glucose reduces risk of retinal hemorrhage and kidney damage.

🔷 Foot checks and eye exams are important but are screening, not prevention.

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Answer 5

Correct Answers:

The hematocrit (Hct)

Rationale :

🔷 Epoetin alfa stimulates red blood cell production in clients with chronic kidney disease.

🔷 A rising hematocrit indicates a therapeutic response.

🔷 Other labs like ESR or WBC are unrelated to erythropoiesis.

🔷 Hct levels are monitored regularly to avoid overcorrection and HTN.

🔷 The goal is to reduce anemia-related fatigue and need for transfusions.

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Answer 6

Correct Answers:

1370

Rationale :

🔷 Total Output:

• Voided = 400 + 350 = 750 mL

• Chest tube = 175 − 155 = 20 mL

• NG tube = 575 mL

• JP Drain = 25 mL

🔷 750 + 20 + 575 + 25 = 1370 mL

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Answer 7

Correct Answers:

Elevated blood pressure

Rationale :

🟢 Pheochromocytoma is a tumor of the adrenal medulla that causes excessive catecholamine secretion.

🟢 The hallmark sign is episodic hypertension, often severe and resistant to treatment.

🟢 Other symptoms may include palpitations, headaches, and sweating due to sympathetic overactivity.

🟢 Elevated BP is a life-threatening complication that can lead to stroke or heart failure.

🟢 Early detection is critical for surgical removal and symptom control.

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Answer 8

Correct Answers:

Gentamicin

Rationale :

🟢 Gentamicin is an aminoglycoside antibiotic known for its nephrotoxic potential, especially in clients with kidney impairment.

🟢 It accumulates in renal tissue, potentially leading to acute tubular necrosis.

🟢 Renal dosing adjustments are critical to avoid worsening CKD.

🟢 Other nephrotoxic medications should be avoided when possible.

🟢 Monitoring BUN, creatinine, and drug levels is essential during therapy.

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Answer 9

Correct Answers:

Coagulation disorder

Rationale :

🟢 A kidney biopsy involves puncturing renal tissue, making bleeding a major risk.

🟢 A coagulation disorder increases the chance of uncontrolled bleeding during or after the procedure.

🟢 Coagulation profiles must be corrected or biopsy delayed if abnormal.

🟢 Platelets and clotting factors are assessed beforehand.

🟢 This is a contraindication until the bleeding risk is minimized.

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Answer 10

Correct Answers:

Keep the drainage system below the level of the client's chest at all times.

Rationale :

🟢 This prevents backflow of fluid or air into the pleural space, which could cause a pneumothorax.

🟢 Maintaining gravity-based drainage ensures efficient fluid removal.

🟢 The system must always be upright and below chest to function properly.

🟢 Transport plans should accommodate this positioning.

🟢 Clamping or disconnecting can risk lung collapse or increase infection risk.

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RN Capstone week 9 Exam

No.

1 :
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?

2 :
A nurse is reviewing a client's laboratory results and sees that their hemoglobin A1C is 9%. Which of the following statements from the nurse is appropriate?

4 :
A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?

5 :
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

7 :
A nurse is caring for a client with a pheochromocytoma. Which assessment finding will the nurse expect for this client?

8 :
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?

9 :
A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as a contraindication for this diagnostic test?

10 :
A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?

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RN Capstone week 9 Exam

No.

1 : 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?

2 : A nurse is reviewing a client's laboratory results and sees that their hemoglobin A1C is 9%. Which of the following statements from the nurse is appropriate?

4 : A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?

5 : A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

7 : A nurse is caring for a client with a pheochromocytoma. Which assessment finding will the nurse expect for this client?

8 : 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?

9 : A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as a contraindication for this diagnostic test?

10 : A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?

1 :
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?

2 :
A nurse is reviewing a client's laboratory results and sees that their hemoglobin A1C is 9%. Which of the following statements from the nurse is appropriate?

4 :
A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?

5 :
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

7 :
A nurse is caring for a client with a pheochromocytoma. Which assessment finding will the nurse expect for this client?

8 :
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?

9 :
A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as a contraindication for this diagnostic test?

10 :
A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?