Nursing Elites

1. A client with diabetes insipidus is receiving desmopressin therapy. The nurse should monitor for which of the following potential side effects?

• A. Hyponatremia
• B. Hypernatremia
• C. Hypokalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used to treat diabetes insipidus, can cause the retention of water without sodium, leading to dilutional hyponatremia. This occurs because desmopressin increases water reabsorption in the kidneys without affecting sodium levels. Hypernatremia (choice B) is unlikely because desmopressin does not cause excessive sodium retention. Hypokalemia (choice C) and hypercalcemia (choice D) are not typically associated with desmopressin therapy for diabetes insipidus.

2. Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia?

• A. Acromegaly
• B. Type 1 diabetes mellitus
• C. Hypothyroidism
• D. Deficient growth hormone

Correct answer: A

Rationale: The correct answer is Acromegaly. Jemma's symptoms of large hands, hoarse voice, and snoring are indicative of acromegaly, a disorder caused by excessive growth hormone production. Acromegaly can lead to insulin resistance, which can result in hyperglycemia. Choice B, Type 1 diabetes mellitus, is unlikely in this case as the symptoms and presentation are more suggestive of acromegaly. Choice C, Hypothyroidism, typically presents with different symptoms such as weight gain, fatigue, and cold intolerance, not consistent with Jemma's symptoms. Choice D, Deficient growth hormone, would not lead to the signs and symptoms observed in Jemma, as her condition is characterized by excessive growth hormone production.

3. The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?

• A. Serum calcium.
• B. Serum phosphorus.
• C. Serum potassium.
• D. Serum sodium.

Correct answer: C

Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.

4. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

• A. Antidiuretic hormone (ADH)
• B. Thyroid-stimulating hormone (TSH)
• C. Follicle-stimulating hormone (FSH)
• D. Luteinizing hormone (LH)

Correct answer: A

Rationale: Diabetes insipidus is a condition characterized by a deficiency of antidiuretic hormone (ADH). ADH plays a crucial role in regulating water balance by controlling the amount of water reabsorbed by the kidneys. Options B, C, and D are incorrect as they are not associated with diabetes insipidus. TSH (thyroid-stimulating hormone) is responsible for regulating thyroid function, while FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are involved in reproductive functions.

5. A nurse caring for a client with hypocalcemia would expect to note which of the following changes on the electrocardiogram?

• A. Widened T wave
• B. Prominent U wave
• C. Prolonged QT interval
• D. Shortened ST segment

Correct answer: C

Rationale: In hypocalcemia, a decreased level of calcium can lead to a prolonged QT interval on the ECG due to its role in myocardial repolarization. A widened T wave (Choice A) is typically seen in hyperkalemia. A prominent U wave (Choice B) is associated with hypokalemia. A shortened ST segment (Choice D) is not a typical ECG finding in hypocalcemia.

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