A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for?

Radioimmunoassay

Magnetic resonance imaging (MRI)

Radioactive iodine uptake test

Nuclear scan

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Radioimmunoassay measures hormone levels, such as ADH, but is not the initial test for a suspected pituitary tumor. It may confirm hormonal deficiencies but cannot visualize structural abnormalities like tumors, which are better assessed by imaging techniques like MRI, making it a secondary diagnostic tool in this context.

Choice B reason: Magnetic resonance imaging (MRI) is the initial test for a suspected pituitary tumor. It provides detailed images of the pituitary gland, identifying structural abnormalities like tumors that may cause diabetes insipidus by disrupting ADH production. MRI is non-invasive and highly sensitive for detecting pituitary lesions, guiding further management.

Choice C reason: Radioactive iodine uptake tests assess thyroid function, not pituitary tumors. These tests are used for thyroid disorders like hyperthyroidism, which are unrelated to diabetes insipidus or pituitary pathology. They do not visualize the pituitary gland or confirm structural causes of ADH deficiency.

Choice D reason: A nuclear scan, such as a bone or thyroid scan, is not used to diagnose pituitary tumors. It assesses other conditions, like bone metastases or thyroid activity, but lacks specificity for pituitary imaging. MRI is the preferred modality for visualizing pituitary abnormalities causing diabetes insipidus.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: A chest radiograph evaluates lung or cardiac issues but is not the first test for symptoms of tiredness, coldness, and shortness of breath with tachycardia. These suggest anemia, and a CBC directly assesses hemoglobin and red blood cell counts, making it more relevant than imaging for initial evaluation.

Choice B reason: An ECG assesses cardiac rhythm and ischemia, useful for tachycardia, but it does not address the underlying cause of fatigue, coldness, and dyspnea. These symptoms suggest anemia, and a CBC is needed to confirm low hemoglobin before evaluating cardiac function with an ECG.

Choice C reason: A complete blood count (CBC) is the most appropriate test, as tiredness, coldness, shortness of breath, and tachycardia suggest anemia. A CBC measures hemoglobin, hematocrit, and red blood cell indices, identifying anemia’s presence and type, guiding further diagnostic and therapeutic interventions for the client’s symptoms.

Choice D reason: Antibiotics treat infections, but tiredness, coldness, dyspnea, and tachycardia point to anemia, not infection. Without fever or infection signs, antibiotics are inappropriate. A CBC is needed to confirm anemia as the cause, making it the priority over empirical antibiotic therapy.

A. Consult with the health care provider about discontinuing heparin B. Increase the heparin infusion by 100 units per hour C. Begin treatment with the prescribed warfarin (Coumadin) D. Continue with the present infusion rate of heparin

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Consulting the provider about discontinuing heparin is critical, as the client’s laboratory findings show a significant platelet drop (170,000 to 70,000/mm3), suggesting heparin-induced thrombocytopenia (HIT). HIT involves immune-mediated platelet destruction, increasing thrombosis risk. Stopping heparin prevents further platelet decline and thrombotic complications, making this the most urgent action.

Choice B reason: Increasing the heparin infusion is dangerous, as the platelet drop suggests HIT, where heparin triggers platelet activation and clotting. Further heparin administration could worsen thrombocytopenia and increase thrombosis risk, leading to severe complications like pulmonary embolism or stroke, making this action contraindicated.

Choice C reason: Beginning warfarin is inappropriate without addressing the platelet drop, likely due to HIT. Warfarin does not reverse thrombocytopenia and may increase bleeding risk in a thrombocytopenic patient. Heparin must be stopped first, and alternative anticoagulants considered, making warfarin initiation premature and risky.

Choice D reason: Continuing the current heparin rate is unsafe, as the significant platelet decline indicates possible HIT. Maintaining heparin could exacerbate platelet destruction and thrombosis risk, leading to life-threatening complications. Consulting the provider to discontinue heparin and investigate HIT is the priority to ensure patient safety.

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A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the health care provider to order?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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