A 45-year-old male patient presents to the emergency department with excessive thirst, frequent urination, and signs of dehydration. His laboratory results show low urine osmolality and high serum sodium levels. Based on this case scenario, which of the following management strategies would be appropriate for this patient? (Select All that Apply.)

Administer diuretics to increase urine output

Administer desmopressin

Administer intravenous hypotonic saline

Restrict fluid intake to reduce urine output

Administer hypertonic saline

Answer and Explanation

Correct Answer : B,C

Choice A Reason:

Administering diuretics to increase urine output is not appropriate in this scenario. Diuretics would exacerbate dehydration and further increase serum sodium levels by promoting additional water loss. This approach would worsen the patient’s condition rather than improve it.

Choice B Reason:

Administering desmopressin is a suitable intervention for this patient. Desmopressin is a synthetic analog of vasopressin (antidiuretic hormone) and is used to treat conditions like diabetes insipidus, which can cause symptoms such as excessive thirst, frequent urination, and dehydration. Desmopressin helps to reduce urine output and correct the imbalance of fluids and electrolytes.

Choice C Reason:

Administering intravenous hypotonic saline is appropriate for managing high serum sodium levels and dehydration. Hypotonic saline helps to lower serum sodium levels by diluting the blood and rehydrating the patient. This intervention addresses both the dehydration and the electrolyte imbalance effectively.

Choice D Reason:

Restricting fluid intake to reduce urine output is not appropriate in this case. Fluid restriction would worsen dehydration and could lead to further complications. The patient needs adequate fluid replacement to correct the dehydration and normalize serum sodium levels.

Choice E Reason:

Administering hypertonic saline is not suitable for this patient. Hypertonic saline would increase serum sodium levels further, exacerbating the hypernatremia. This intervention would be counterproductive and could lead to severe complications.

Nursing Test Bank

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Correct Answer is B

Explanation

Choice A Reason:

Resuming an exercise routine immediately after cochlear implant surgery is not advisable. Postoperative care guidelines typically recommend avoiding strenuous activities for a period of time to allow the surgical site to heal properly. Engaging in exercise too soon can increase the risk of complications such as bleeding or dislodging the implant.

Choice B Reason:

Eating soft foods is recommended after cochlear implant surgery to avoid putting strain on the surgical site and to ensure comfort while chewing. Soft foods are easier to manage and less likely to cause discomfort or disrupt the healing process. This choice is appropriate for promoting a smooth recovery.

Choice C Reason:

Washing your hair 24 hours after surgery is generally not recommended. Most postoperative care instructions advise keeping the surgical site dry for at least a few days to prevent infection and ensure proper healing. Washing the hair too soon can introduce bacteria to the incision site and increase the risk of complications.

Choice D Reason:

Lying on your back when sleeping is often recommended to avoid putting pressure on the surgical site. However, this instruction alone does not address the immediate dietary needs of the patient, which are crucial for comfort and recovery in the initial postoperative period.

A. Sedentary lifestyle B. Triglyceride level of 100 mg/dL C. Recent viral infection D. Blood glucose of 98 mg/dL

Correct Answer is A

Explanation

Choice A Reason:

A sedentary lifestyle is a significant risk factor for developing type 2 diabetes mellitus. Lack of physical activity can lead to obesity, which is a major contributor to insulin resistance. Regular physical activity helps to maintain a healthy weight, improve insulin sensitivity, and reduce the risk of developing type 2 diabetes.

Choice B Reason:

A triglyceride level of 100 mg/dL is within the normal range and is not considered a risk factor for type 2 diabetes. Elevated triglyceride levels (above 150 mg/dL) are associated with an increased risk of developing type 2 diabetes, but a level of 100 mg/dL does not indicate an increased risk.

Choice C Reason:

A recent viral infection is not a recognized risk factor for type 2 diabetes While certain viral infections can trigger autoimmune responses leading to type 1 diabetes, they are not linked to the development of type 2 diabetes, which is primarily influenced by lifestyle factors and genetics.

Choice D Reason:

A blood glucose level of 98 mg/dL is within the normal range for fasting blood glucose and does not indicate an increased risk for type 2 diabetes. Prediabetes is diagnosed when fasting blood glucose levels are between 100 and 125 mg/dL, and diabetes is diagnosed at levels of 126 mg/dL or higher. Therefore, a blood glucose level of 98 mg/dL is not a risk factor for type 2 diabetes.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is reinforcing teaching of a female client who has a family history of type 2 diabetes mellitus. The nurse should include which of the following risk factors for developing type 2 diabetes mellitus in the teaching?

Correct Answer is A

Explanation

A 55-year-old patient is diagnosed with Meniere’s disease. Which of the following symptoms is most characteristic of this condition?

A nurse is educating a patient on proper hearing aid care and maintenance. Which of the following statements should the nurse include in the teaching?

A 65-year-old patient presents to the emergency department with sudden onset of flashes of light, a shadow over the visual field, and floaters in their right eye. What is the most likely diagnosis?

A nurse is reinforcing teaching with a client who has been newly diagnosed with chronic open-angle glaucoma. Which of the following statements by the client indicates an understanding of the teaching?

An 18-year-old patient with a known history of sickle cell anemia presents to the emergency department with severe pain in the lower back and joints, fever, and signs of dehydration. What is the most appropriate initial nursing intervention?

A patient with acute lymphoblastic leukemia (ALL) is admitted for chemotherapy treatment. As part of the nursing management, which of the following interventions is most critical to prevent infection in this patient?