Question

A patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would the nurse expect?

Answer 1

Correct Answers:

Decreased serum sodium

Rationale :

💎 SIADH causes excessive release of antidiuretic hormone, leading to water retention and dilutional hyponatremia.

💎 Serum sodium decreases because excess water dilutes sodium concentration in the blood.

💎 Patients often present with neurologic symptoms such as headache, confusion, or seizures when sodium drops significantly.

💎 This is considered an initial laboratory finding and should be closely monitored to prevent complications.

💎 Prompt recognition helps initiate fluid restriction and other measures to correct sodium levels.

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Answer 2

Correct Answers:

Hypothyroidism

Rationale :

♦ Low T3 and T4 with elevated TSH indicates primary hypothyroidism, where the thyroid gland is underactive.

♦ Symptoms such as weight gain, fatigue, dry skin, and constipation are classic signs.

♦ Puffy face and cold intolerance further support the diagnosis.

♦ The pituitary gland increases TSH production to stimulate the underactive thyroid.

♦ Early detection prevents progression to myxedema coma, a severe complication.

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Answer 3

Correct Answers:

Increasing serum sodium levels

Rationale :

🔷 In Addison’s disease, treatment aims to restore electrolyte balance, particularly correcting low sodium.

🔷 Successful therapy with glucocorticoids/mineralocorticoids increases sodium levels.

🔷 Sodium improvement indicates reduced adrenal insufficiency and better aldosterone function.

🔷 Monitoring electrolytes helps assess therapy effectiveness and prevent crisis.

🔷 It also reduces the risk of hypotension from sodium loss.

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Answer 4

Correct Answers:

Jaundice
Spider angiomas
Lethargic
Abdomen moderately distended
Dark amber urine
3+ pitting edema

Rationale :

🟢 Jaundice occurs due to buildup of bilirubin from impaired liver function.

🟢 Spider angiomas are dilated capillaries seen in chronic liver disease.

🟢 Lethargy reflects buildup of toxins like ammonia affecting the brain.

🟢 Abdominal distension often results from ascites caused by portal hypertension.

🟢 Dark amber urine is due to increased bilirubin excretion in urine.

🟢 3+ pitting edema results from hypoalbuminemia and fluid retention.

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Answer 5

Correct Answers:

Heparin works right away, but warfarin takes several days to prevent clots.

Rationale :

⚫ Heparin has an immediate anticoagulant effect when given IV.

⚫ Warfarin takes 3–5 days to reach therapeutic effect due to clotting factor half-life.

⚫ Both are given together until INR is therapeutic, then heparin is stopped.

⚫ This bridging therapy prevents clot extension or new clot formation during warfarin onset.

⚫ Educating patients prevents confusion and improves compliance.

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Answer 6

Correct Answers:

Suction set up
Oxygen mask
Side-rail pads

Rationale :

🔴 Suction setup is essential to clear airway secretions during or after seizures.

🔴 Oxygen mask ensures adequate oxygenation postictally.

🔴 Side-rail pads protect from injury during seizure activity.

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Answer 7

Correct Answers:

Patient stopped taking the prednisone abruptly 2 days ago.

Rationale :

🟠 Abruptly stopping high-dose prednisone risks acute adrenal insufficiency.

🟠 The adrenal glands need time to resume cortisol production after prolonged suppression.

🟠 Symptoms can include hypotension, weakness, and shock.

🟠 Gradual tapering prevents life-threatening adrenal crisis.

🟠 This is the most urgent finding to report to the provider.

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Answer 8

Correct Answers:

Unilateral edema
Calf pain

Rationale :

💎 Unilateral edema occurs due to venous obstruction from the clot, causing pooling of blood and swelling in the affected limb. This is one of the most common local signs of a DVT.

💎 Calf pain results from inflammation of the vein (thrombophlebitis) and tissue irritation around the clot. Pain is usually localized and worsens with walking or dorsiflexion of the foot.

💎 These symptoms occur because the clot impairs venous return, leading to increased venous pressure and tissue congestion in the affected extremity.

💎 Early identification of these findings is crucial to prevent pulmonary embolism, a life-threatening complication of DVT.

💎 Other signs may include warmth and erythema over the affected area, but unilateral swelling and pain remain the most classic.

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Answer 9

Correct Answers:

Hemoglobin (Hgb) of 6.9g/dL (normal 14-18g/dL)

Rationale :

💠 A hemoglobin level below 7 g/dL is severe anemia.

💠 Low Hgb reduces oxygen delivery, causing fatigue and palpitations.

💠 Severe anemia can lead to tissue hypoxia and organ damage.

💠 Transfusion may be required to restore oxygen-carrying capacity.

💠 This explains the patient’s resting symptoms.

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Answer 10

Correct Answers:

Hepatic encephalopathy

Rationale :

🟡 Elevated ammonia impairs brain function in cirrhosis.

🟡 Ammonia buildup occurs due to liver’s inability to detoxify it.

🟡 Symptoms include confusion, asterixis, and altered LOC.

🟡 Lactulose is often used to lower ammonia by promoting excretion.

🟡 Early recognition prevents progression to coma.

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Med sur MCA 3 Exam 3

No.

1 :
A patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would the nurse expect?

3 :
Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency (Addison's Disease)?

4 :
Which assessment findings are consistent with cirrhosis? Select all that apply

6 :
A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room?

7 :
Which information obtained by the nurse in the clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

9 :
An adult male is experiencing increased fatigue and occasional palpitations at rest. Which laboratory data would the nurse identify as consistent with these symptoms?

10 :
Elevated serum ammonia level causes which complication of cirrhosis?

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Med sur MCA 3 Exam 3

No.

1 : A patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would the nurse expect?

3 : Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency (Addison's Disease)?

4 : Which assessment findings are consistent with cirrhosis? Select all that apply

6 : A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room?

7 : Which information obtained by the nurse in the clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

9 : An adult male is experiencing increased fatigue and occasional palpitations at rest. Which laboratory data would the nurse identify as consistent with these symptoms?

10 : Elevated serum ammonia level causes which complication of cirrhosis?

1 :
A patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would the nurse expect?

3 :
Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency (Addison's Disease)?

4 :
Which assessment findings are consistent with cirrhosis? Select all that apply

6 :
A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room?

7 :
Which information obtained by the nurse in the clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

9 :
An adult male is experiencing increased fatigue and occasional palpitations at rest. Which laboratory data would the nurse identify as consistent with these symptoms?

10 :
Elevated serum ammonia level causes which complication of cirrhosis?