CLO3: Final Unit Examination (MedSurg2)

Which of the following patients is the best candidate for surgical repair of a ruptured Achilles tendon? 40-year-old male in good general health 80-year-old inactive male 55-year-old diabetic female 68-year-old female with peripheral vascular disease

40-year-old male in good general health

The nurse is teaching the client about home blood glucose monitoring. Which of the following glucose measurements indicates impending hypoglycemia? 59 mg/dL 108 mg/dL 75 mg/dL 119 mg/dL

59 mg/dL CBG of lower than 70mg/dL is considered as hypoglycemia

An appropriate technique for the nurse to implement for the client who is being cast is to: Maintain the extremity below heart level Fold the stockinette or padding over the outer cast edges Apply ice to the top of the cast Handle the wet cast with the fingertips

Fold the stockinette or padding over the outer cast edges

The nurse teaches a client about heat and cold treatments to manage arthritis pain. Which of the following client statements indicates that the client still has a knowledge deficit? "Ten to 15 minutes per application is the maximum time for cold applications." "Heat producing liniments can be used with other heat devices" "With heat, I should apply it for no longer than 20 minutes at a time." "I can use heat and cold as often as I want."

"Heat producing liniments can be used with other heat devices" Heat-producing liniment can produce a burn if used with other heat devices that could intensify the heat reaction. Heat and cold can be used as often as the client desires. However, each application of heat should not exceed 20 minutes, and each application of cold should not exceed 10 to 15 minutes. Application for longer periods results in the opposite of the intended effect: vasoconstriction instead of vasodilation with heat, and vasodilation instead of vasoconstriction with cold.

A patient with DM comes to the clinic for a regular 3-month follow-up appointment. The nurse notes several small bandages covering cuts on the patient's hands. The patient says, "I'm so clumsy. I'm always cutting my finger cooking or burning myself on the iron." Which of the following responses by the nurse would be most appropriate? "Why don't you have your children do the cooking and ironing?" "You really should be fine as long as you take your daily medication." "Wash all wounds in isopropyl alcohol." "Keep all cuts clean and covered."

"Keep all cuts clean and covered." Proper and careful first-aid treatment is important when a client with diabetes has a skin cut or laceration. The skin should be kept supple and as free of organisms as possible. Washing and bandaging the cut will accomplish this. Washing wounds with alcohol is too caustic and drying to the skin. Having the children help is an unrealistic suggestion and does not educate the client about proper care of wounds. Tight control of blood glucose levels through adherence to the medication regimen is vitally important; however, it does not mean that careful attention to cuts can be ignored. Test-taking Strategy: Infection control measures, especially in patients who have diabetes, should be noted. Their poor healing ability is one of the most important factors to consider in providing immediate care.

Acromegaly is produced by an over-secretion of: TSH ACTH GH FSH

GH (Growth Hormone) In most cases, acromegaly is caused by over-secretion of growth hormone (GH) produced by a benign tumor of the pituitary gland. The pituitary gland is a small gland located at the base of the brain that produces many hormones. In a small number of cases, malignant tumors of other organs (pancreas, adrenal, lung) may be the source of excess GH.

Appropriate nursing diagnoses for a client with with hypothyroidism would probably include which of the following? Imbalanced Nutrition: Less Than Body Requirements related to hypermetabolism. Risk for injury (corneal abrasion) related to incomplete closure of eyelid. Activity intolerance related to fatigue associated with the disorder. Deficient Fluid Volume related to diarrhea.

Activity intolerance related to fatigue associated with the disorder.

For cast removal, the nurse correctly instructs the client that: An enzyme wash may be applied to intact skin. Aggressive range-of-motion exercises will be performed after removal. Discomfort will be felt from the cast saw. The skin will be scrubbed very well after the removal.

An enzyme wash may be applied to intact skin.

For a client in traction who has skeletal pins, a nurse should: Do both pin sites at the same time, with the same swab and solution. Use povidone-iodine to cleanse the pin site. Use hydrogen peroxide as a rinse before a dressing is applied. Apply antiseptic ointment and cover with a split dressing.

Apply antiseptic ointment and cover with a split dressing.

An appropriate technique for the nurse to implement for a client being placed in traction is to: Shave the hair off the area where the traction is to be place Assess the neurovascular status every 1 to 2 hours for the first day Apply a traction boot tightly Drop the weights after the traction is attached

Assess the neurovascular status every 1 to 2 hours for the first day

A client, who is suspected of having Pheochromocytoma, complains of sweating, palpitation and headache. Which assessment is essential for the nurse to make first? Hand grips Pupil reaction Blood glucose Blood pressure

Blood pressure Pheochromocytoma is a tumor of the adrenal medulla that causes an increase secretion of catecholamines that can elevate the blood pressure.

A client with Addison's disease is admitted to the medical unit. The nurse diagnose the client with Deficient Fluid Volume related to inadequate fluid intake and fluid loss secondary to inadequate adrenal hormone secretion. As the client's oral intake increases, which of the following fluids would be most appropriate? Water and eggnog Coffee and milk shakes Bouillon and juice Mild and diet soda

Bouillon and juice Electrolyte imbalances associated with Addison's disease include hypoglycemia, hyponatremia, and hyperkalemia. Salted bouillon and fruit juices provide glucose and sodium to replenish these deficits. Diet soda does not contain sugar. Water could cause further sodium dilution. Coffee's diuretic effect would aggravate the fluid deficit. Milk contains potassium and sodium.

A female patient has hirsutism, hyperglycemia, obesity, muscle wasting, and increased circulating levels of ACTH.The most likely cause of her symptoms is: Pituitary Adenoma Pheochromocytoma Cushing's disease Addison's disease

Cushing's disease This woman has the classic symptoms of a primary elevation of adrenocorticotropic hormone (ACTH) [Cushing's disease]. Elevation of ACTH stimulates overproduction of glucocorticoids and androgens. Treatment with pharmacologic doses of glucocorticoids would produce similar symptoms, except that circulating levels of ACTH would be low because of negative feedback suppression at both the hypothalamic [corticotropin-releasing hormone (CRH)] and anterior pituitary (ACTH) levels. Addison's disease is caused by primary adrenocortical insufficiency. Although a patient with Addison's disease would have increased levels of ACTH (because of the loss of negative feedback inhibition), the symptoms would be of glucocorticoid deficit, not excess. Hypophysectomy would remove the source of ACTH. A pheochromocytoma is a tumor of the adrenal medulla that secretes catecholamines.

A client with a fracture develops compartment syndrome. Which of the following signs should alert the nurse to impending organ failure? Crackles Dark, scanty urine Jaundice Generalized edema

Dark, scanty urine The client with compartment syndrome may release myoglobin from damaged muscle cells into the circulation. This becomes trapped in the renal tubules, resulting in dark, scanty urine, possibly leading to acute renal failure. Crackles may suggest respiratory complications; jaundice suggests liver failure; and generalized edema may suggest heart failure. However, these are not associated with compartment syndrome.

The client's blood gases shows diabetic acidosis. The nurse should expect: Increased pH Decreased HCO3 Decreased PO2 Increased PCO2

Decreased HCO3

Maria is diagnosed with diabetic ketoacidosis (DKA) and is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis? Increased respiration and an increase in pH Decreased urine output Comatose state Elevated blood glucose level and a low plasma bicarbonate

Elevated blood glucose level and a low plasma bicarbonate

A 21-year-old male is nervous on his first job interview. The client manifests palpitation, diaphoresis and SOB. Which of the following elements is responsible for this: Epinephrine Somatostatin Aldosterone Vasopressin

Epinephrine

Glucose is an important in a cell because this is primarily used for: Building of Amino Acids Protein Synthesis Formation of Ketones Extraction of Energy

Extraction of Energy Glucose catabolism is the main pathway for cellular energy production.

The following are true about hormone Aldosterone except: Its' main effect is the reabsorption of Na Hyperkalemia is associated with hyperactivity of this hormone It is a mineralocorticoid Hypertension may be a manifestation of hyperactivity

Hyperkalemia is associated with hyperactivity of this hormone

Which of the following are the imminent findings in hypoparathyroidism: Hypoglycemia Hypokalemia Hyperphosphatemia Hypercalcemia

Hyperphosphatemia

Nurse Trisha is admitting Josh who is diagnosed with diabetes mellitus. She should expect the following symptoms during an assessment, except: Hypoglycemia Dry mouth Increased Urine Output Ketonuria

Hypoglycemia Hypoglycemia does not occur in type 2 diabetes unless the patient is on insulin therapy or taking other diabetes medication.

When Assessing a client for neurologic impairment after a total hip replacement. Which of the following would indicate impairment in the affected extremity? Decreased distal pulse Diminished capillary refill Inability to move Coolness to the touch

Inability to move

When teaching a client newly diagnosed with primary Addison's disease, the nurse should explain that the disease results from? Insufficient secretion of growth hormone (GH) Dysfunction of the hypothalamic pituitary Idiopathic atrophy of the adrenal gland Oversecretion of the adrenal medulla.

Insufficient secretion of growth hormone (GH)

A 29 year old female client with untreated diabetes mellitus may lapse into a coma because of acidosis. This acidosis is directly caused by an increased concentration in the serum of: Lactic acid Glutamic acid Glucose Ketones

Ketones Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks down fat into ketones to employ as a fuel source.

Which of the following should the nurse assess when completing the history and physical examination of a client diagnosed with Osteoarthritis? Anemia Weight loss Osteoporosis Local joint pain

Local joint pain Osteoarthritis is a degenerative joint disease with local manifestations such as local joint pain, unlike rheumatoid arthritis, which has systemic manifestation such as anemia and osteoporosis. Weight loss occurs in rheumatoid arthritis, whereas most clients with osteoarthritis are overweight.

A client has uncontrolled diabetes and gangrene of the left great toe. Which of the following findings is expected? Warmth in the foot Loss of hair on the lower leg Thin, soft toenails Edema around the ankle

Loss of hair on the lower leg

Older adult client with a hip fracture. Which of the following chronic health problems would the nurse be least likely to assess in the client? Pulmonary disease Cardiac decompensation Hypertension Multiple sclerosis

Multiple sclerosis

The client has just had a total knee replacement for severe osteoarthritis. Which of the following assessment findings should suspect possible nerve damage? Numbness Bleeding Dislocation Pinkness

Numbness The nurse should suspect nerve damage if numbness is present. However, whether the damage is short-term and related to edema or long-term and related to permanent nerve damage would not be clear at this point. The nurse needs to continue to assess the client's neurovascular status, including pain, pallor, pulselessness, paresthesia, and paralysis (the five P's). Bleeding would suggest vascular damage or hemorrhage. Dislocation would suggest malalignment. Pink color would suggest adequate circulation to the area. Numbness would suggest neurologic damage.

Which of the following is a method to relieve pressure on the back for people whose work requires prolonged standing? Place one foot on small stool or box Stand on one foot at a time Bend over occasionally to flex back Sit occasionally with legs straight out

Place one foot on small stool or box

Following a total joint replacement, which of the following complications has the greatest likelihood of occurring? Polyuria Wound evisceration Intussusception of the bowel Deep vein thrombosis (DVT)

Polyuria

The client with DM says, "if I could just avoid what you call carbohydrates in my diet, guess I would be okay." The nurse should base the response to this comment on the knowledge that diabetes affects metabolism of which of the following? Protein and carbohydrates only Proteins, sugar and carbohydrates Proteins, fats and carbohydrates Sugar and Carbohydrates

Proteins, fats and carbohydrates Diabetes mellitus is a multifactorial, systemic disease associated with problems in the metabolism of all food types. The client's diet should contain appropriate amounts of all three nutrients, plus adequate minerals and vitamins

A nurse in the medical ward should expect a client with hypothyroidism to inform which health concerns? Puffiness of the face and hands Nervousness and tremors Enlargement of the thyroid Increased appetite and weight loss

Puffiness of the face and hands Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).

What is the greatest risk in the immediate postoperative period to patients who suffer orthopedic trauma requiring reconstructive surgery of the lower extremities? Fat embolism Septicemia Gas gangrene Pulmonary embolism

Pulmonary embolism

A 50 year old female adult client with a chronic hyperparathyroidism is admitted to the hospital due to non compliance to medication. Based on initial assessment findings, A nurse formulates the nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add? Related to exhaustion secondary to bone pain and fracture Related to bone demineralization resulting in fractures Related to fracture secondary to a increased bone density Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces

Related to bone demineralization resulting in fractures Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This, in turn, may diminish calcium stores in the bone, causing bone demineralization and setting the stage for pathologic fractures and a risk for injury. Hyperparathyroidism doesn't accelerate the metabolic rate. A decreased thyroid hormone level, not an increased parathyroid hormone level, may cause edema and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore, it isn't associated with tetany.

Balong, a 40 year old male client is admitted due to the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? Encourage small frequent feeding and use oresol Administering glucose-containing I.V. fluids as ordered Restricting fluids Infusing I.V. fluids volume per volume replacement

Restricting fluids Restricting fluids; To reduce water retention in a client with the SIADH, the nurse should restrict fluids. Administering fluids by any route would further increase the client's already heightened fluid load.

The nurse observes that a female client has asymmetry of the shoulder, hips, and the tail/hem of her dress. The nurse suspects that the client maybe presenting with which of the following disorder? Scoliosis Degenerative disc disease A fractured tibia Congenital hip dislocation

Scoliosis A classic sign of scoliosis is the asymmetrical dress or skirt hem caused by unevenness of the affected shoulder and hip, due to a lateral curvature of the spine. The spinal deformity causes the asymmetry. Congenital hip dislocation is diagnosed during infancy. Signs of a fractured tibia would include painful ambulation, not unevenness of the shoulder and hip. Degenerative disc disease is typically experienced by older adults and causes a uniform decline in height.

Marie, a 35-year-old female client who is treated for Cushing's syndrome, As a nurse you would expect a decline in: Serum glucose level Bone mineralization Menstrual flow Hair loss

Serum glucose level Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is common in Cushing's syndrome; therefore, with successful treatment, abnormal hair growth also declines. Osteoporosis occurs in Cushing's syndrome; therefore, with successful treatment, bone mineralization increases. Amenorrhea develops in Cushing's syndrome. With successful treatment, the client experiences a return of menstrual flow, not a decline in it.

A client has an intracapsular hip fracture. The nurse should conduct a focused assessment to detect? Absence of pain in the fracture area Muscle flaccidity Internal rotation Shortening of the affected leg

Shortening of the affected leg With an intracapsular hip fracture, the affected leg is shorter than the unaffected leg because of the muscle spasms and external rotation. The client also experiences severe pain in the region of the fracture.

An expected outcome of cast application that the nurse evaluates is: Tingling and numbness distal to the cast Slight edema, soreness, and limitation of range of motion Skin irritation at the cast edges Decreased capillary refill and pallor

Slight edema, soreness, and limitation of range of motion

A Nurse is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment, the client reports that he's impotent and says he's concerned about its effect on his marriage. In planning this client's care, the most appropriate intervention would be to: Encourage the client to ask questions about personal sexuality. Provide support for the spouse or significant other. Suggest referral to a sex counselor or other appropriate profession Provide time for privacy.

Suggest referral to a sex counselor or other appropriate profession Making appropriate referrals is a valid part of planning the client's care. The nurse normally does not provide sex counseling. While providing time for privacy and providing support for the spouse is important, it is not as important as referring the client to a sex counselor/appropriate professional.

A client with a fractured right femur has not had any immunizations since childhood. Which of the following biologic products should administer to provide the client with passive immunity for tetanus? Tetanus antitoxin Tetanus antigen Tetanus toxoid Tetanus vaccine

Tetanus antitoxin Passive immunity for tetanus is provided in the form of tetanus antitoxin or tetanus immune globulin. An antitoxin is an antibody to the toxin of an organism. Administering tetanus toxoid, antigen, or vaccine would provide active immunity by stimulating the body to produce its own antibodies.

The nurse is caring for a client with skeletal traction. It is most important that the nurse monitors which of the following? A. How the client is coping with immobilization. B. The pin site for unusual redness, swelling, purulent drainage, and foul odor. C. The distance between the client's hip and the traction. D. The number of times the client exercises the affected limb.

The pin site for unusual redness, swelling, purulent drainage, and foul odor. The pin in skeletal traction goes directly through the bone, making infection and osteomyelitis a major complication of skeletal trac-tion. The nurse must provide pin site care using aseptic technique to prevent infection. Although maintaining the traction, recording the client's exer-cise routine, and reporting the client's coping status are important, these actions are not the nurse's prior-ity in relation to the risk of osteomyelitis.

The nurse is admitting a client with hypoglycemia. The following signs and symptoms are present except: Diaphoresis Slurred Speech Thirst Weakness

Thirst Palpitations, an adrenergic symptom, occur as the glucose levels fall; the SNS is activated and epinephrine and norepinephrine are secreted causing this response. Diaphoresis is a SNS response that occurs as epinephrine and norepinephrine are released. Slurred speech is a neuroglycopenic symptom; as the brain receives insufficient glucose, the activity of the CNS becomes depressed.

Which hormone increases basal metabolic rate in the body? Somatostatin Parathyroid Hormone Thyroid Hormone Mineralocorticoids

Thyroid Hormone Increase basal metabolic rate. Thyroid hormones raise the basal metabolic rate (BMR), the rate of energy expenditure under standard or basal conditions (awake, at rest, and fasting). When BMR increases, cellular metabolism of carbohydrates, lipids, and proteins increases. Thyroid hormones increase BMR in several ways:

The nurse is monitoring a patient diagnosed with acromegaly who had a transsphenoidal hypophysectomy and currently recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Sudden High Grade Fever Hypertension Chvostek's sign Urine Output of 400 mL/hr

Urine Output of 400 mL/hr Acromegaly results from excess secretion of growth hormone, usually caused by a benign tumor on the anterior pituitary gland. Treatment is surgical removal of the tumor, usually with a sublingual transsphenoidal complete or partial hypophysectomy. The sublingual transsphenoidal approach is often through an incision in the inner upper lip at the gum line. Transsphenoidal surgery is a type of brain surgery and infection is a primary concern. Leukocytosis, or an elevated white count, may indicate infection. Diabetes insipidus is a possible complication of transsphenoidal hypophysectomy. In diabetes insipidus there is decreased secretion of antidiuretic hormone and clients excrete large amounts of dilute urine. Following transsphenoidal surgery, the nasal passages are packed and a dripper pad is secured under the nares. Clear drainage on the dripper pad is suggestive of a cerebrospinal fluid leak. The surgeon should be notified and the drainage should be tested for glucose. A cerebrospinal fluid leak increases the postoperative risk of meningitis. Anxiety is a nonspecific finding that is common to many disorders. Chvostek's sign is a test of nerve hyperexcitability associated with hypocalcemia and is seen as grimacing in response to tapping on the facial nerve. Chvostek's sign has no association with complications of sublingual transsphenoidal hypophysectomy.

A nurse is reviewing the data of a client with the diagnosis of diabetes insipidus. The nurse understands that which of the following is not the characteristic of this disorder? Serum Osmolality Decreases Urine-specific Gravity Increases Polydipsia Polyuria

Urine specific Gravity Increases

A 42 year old female client reports that she has gained weight and that her face and body are "rounder," while her legs and arms become thinner. A tentative diagnosis of Cushing's disease is made. When assessing this client, the nurse would expect to find: postural hypotension bruised areas on the skin decreased body hair muscle hypertrophy in the extremities

bruised areas on the skin skin bruising from increased skin and blood vessel fragility is a classic sign of Cushing's disease

During assessment of the patient with acromegaly, an expected result will be? slow metabolism an increase in height dry, irritated skin changes in appearance

changes in appearance the increased production of GH in acromegaly causes an increase in thickness and width of bones and enlargement of soft tissues, resulted in marked changes in facial features, oily and coarse skin, and speech difficulties. Height is not increased in adults with GH excess because the epiphyses of the bones are closed; infertility is not a common finding because GH is usually the only pituitary hormone involved in acromegaly

Which assessment finding would cause the nurse to suspect compartment syndrome in a client who received a long leg cast on the left leg 8 hours earlier and who complained of unrelenting pain that remained severe even after receiving pain medication? low-grade temperature and bilateral wheezing on lung auscultation dimished capillary refill and cyanotic nail beds on the left leg ability to insert two fingers into the distal and proximal portion of the cast warm, tender left calf and increased size of the left calf muscle

dimished capillary refill and cyanotic nail beds on the left leg Compartment syndrome is characterized by neurovascular compromise. Capillary refill should be less than 3 seconds.

Patient D is admitted to the hospital due to thyrotoxic crisis. During physical assessment of the patient, the nurse would expect to find? hoarseness and laryngeal stridor lethargy progressing to coma bulging eyeballs and cardiac arrhythmias elevated temperature and signs of CHF

elevated temperature and signs of CHF A hyperthyroid crisis results in marked manifestations of hyperthyroidism, with severe tachycardia, heart failure, shock, hyperthermia, agitation, nausea, vomiting, diarrhea, delirium, and coma. Although exopthalmus may be present in the patient with Grave's disease, it is not a significant factor in hyperthyroid crisis. Hoarseness and laryngeal stridor are characteristic of tetany of hypoparathyroidism, and lethargy progressing to coma is characteristic of myxedema coma, a complication of hypothyroidism.

Which of the common side effect of salicylates and NSAIDS used in the management of pain and swelling associated with rheumatoid arthritis? gastrointestinal distress anorexia dizziness weight loss

gastrointestinal distress

A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are only effective if the client: prefers to take insulin orally has type 1 diabetes has type 2 diabetes is pregnant and has type 2 diabetes.

has type 2 diabetes Oral antidiabetic agents are only effective in adult clients with type 2 diabetes. Oral antidiabetic agents aren't effective in type 1 diabetes. Pregnant and lactating women aren't prescribed oral antidiabetic agents because the effect on the fetus is uncertain.

In a patient with diabetes insipidus(DI), administration of vasopressin during a water deprivation test will result in a: increase urine output decrease serum osmolality increase of blood pressure decrease of body weight

increase of blood pressure

Which of the following assessment findings best describes thyroid storm? increased body temperature, decreased pulse, and increased blood pressure increased body temperature, decreased pulse, and decreased blood pressure increased body temperature, increased pulse, and decreased blood pressure increased body temperature, increased pulse, and increased blood pressure

increased body temperature, increased pulse, and increased blood pressure increased body temperature, increased pulse, and increased blood pressure Thyroid storm is characterized by SNS activation. Thyroid hormones potentiate effects of cathecolamines (epinephrine/norepinephrine). Therefore, all vital signs will be increased.

The nurse is taking care for a client with hyperthyroidism. Which of the following nursing interventions is not appropriate? keep environment warm provide rest periods instill isotonic eye drops as necessary provide several, small, well-balanced meals

keep environment warm

Which assessment finding would the nurse expect in a client diagnosed with osteomyelitis? petechiae over the chest and abnormal arterial blood gas results negative blood culture results and normal temperature hyperuricemia and pruritus leukocytosis and localized bone pain

leukocytosis and localized bone pain Clinical manifestations of osteomyelitis include signs and symptoms of sepsis and localized infection.

While taking care of a patient with syndrome of inappropriate ADH (SIADH), the nurse should: keep the head of bead elevated to prevent ADH release inform physician immediately if the patient's blood pressure decreases monitor neurologic status every 2H or more often if needed each the patient receiving treatment with diuretics to restrict sodium intake

monitor neurologic status every 2H or more often if needed the patient with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has marked dilutional hyponatremia and should be monitored for decreased neurologic function and convulsions every 2 hours. ADH release is reduced by keeping the head of the bed flat to increase left atrial filling pressure, and sodium intake is supplemented because of the hyponatremia and sodium loss caused by diuretics. A reduction in BP indicates a reduction in total fluid volume and is an expected outcome of treatment.

Which food would the nurse instruct the client with gouty arthritis to avoid when starting a low-purine diet? citrus fruits organ meats green vegetables fresh fish

organ meats A patient with gout should avoid foods high in PURINES. These include most red meats, organ meats (liver, kidneys, sweetbreads), alcohol (especially beer).

When caring for a male client with diabetes insipidus, nurse Juliet expects to administer: vasopressin calcium gluconate clofibrate furosemide

vasopressin Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes insipidus.

A 60 year old woman is diagnosed with hypothyroidism. Signs and symptoms of hypothyroidism include: diarrhea weight gain nausea tachycardia

weight gain