A 52-year-old patient is admitted to the hospital with symptoms of confusion, headache, and muscle cramps. Laboratory tests reveal the following findings: serum sodium 120 mEq/L, serum osmolality 260 mOsm/kg, urine osmolality 500 mOsm/kg, and urine sodium 40 mEq/L. What is the most likely diagnosis based on these laboratory findings?
Diabetes Insipidus
Adrenal insufficiency
Hyperaldosteronism
Syndrome of inappropriate Antidiuretic Hormone (SIADH)
The Correct Answer is D
Choice A Reason:
Diabetes Insipidus (DI) is characterized by excessive urination and thirst due to a deficiency of antidiuretic hormone (ADH) or a renal insensitivity to ADH. Patients with DI typically present with hypernatremia (high serum sodium) and low urine osmolality, which contrasts with the findings of low serum sodium and high urine osmolality in this patient.
Choice B Reason:
Adrenal insufficiency can cause hyponatremia and hyperkalemia due to a deficiency in aldosterone and cortisol. However, it usually presents with low serum osmolality and low urine sodium, which does not align with the patient’s laboratory results of high urine osmolality and elevated urine sodium.
Choice C Reason:
Hyperaldosteronism leads to increased sodium reabsorption and potassium excretion, resulting in hypernatremia and hypokalemia. This condition does not match the patient’s findings of hyponatremia and high urine osmolality.
Choice D Reason:
Syndrome of inappropriate Antidiuretic Hormone (SIADH) is characterized by excessive release of ADH, leading to water retention, hyponatremia, and concentrated urine. The patient’s laboratory results of low serum sodium, low serum osmolality, high urine osmolality, and elevated urine sodium are consistent with SIADH. This condition causes the kidneys to reabsorb water, diluting the blood and concentrating the urine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Increased appetite is not typically associated with anemia. Anemia generally leads to symptoms related to decreased oxygen-carrying capacity of the blood, such as fatigue, weakness, and shortness of breath. Increased appetite is more commonly linked to other conditions, such as hyperthyroidism or certain metabolic disorders.
Choice B Reason:
Fatigue is a common and significant symptom of anemia. When hemoglobin levels are low, the body’s tissues do not receive adequate oxygen, leading to feelings of tiredness and exhaustion. This is because hemoglobin is responsible for transporting oxygen from the lungs to the rest of the body. In anemia, the reduced oxygen delivery results in decreased energy levels and persistent fatigue.
Choice C Reason:
Weight gain is not typically associated with anemia. In fact, some forms of anemia, such as those caused by chronic diseases or malnutrition, may lead to weight loss rather than gain. Weight gain can be associated with other health issues, such as hypothyroidism or fluid retention, but not directly with anemia.
Choice D Reason:
Hypertension is not a common manifestation of anemia. Anemia usually leads to symptoms like pallor, shortness of breath, and fatigue due to the reduced oxygen-carrying capacity of the blood. Hypertension, or high blood pressure, is more commonly associated with cardiovascular diseases, kidney disorders, or endocrine conditions.
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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