A client who is admitted to the hospital with a diagnosis of primary diabetes insipidus (DI) asks the nurse if they will need insulin therapy. Which response should the nurse provide?
Insulin is used to counteract excessive water loss by reducing the serum glucose level.
Daily dietary habits and glucose levels will be assessed to determine the need for insulin.
The treatment goal is to conserve water loss by maintaining normal serum glucose levels.
Diabetes insipidus is managed by balancing body fluids using vasopressin hormone therapy.
The Correct Answer is D
Choice A reason: Insulin reduces serum glucose in diabetes mellitus, not water loss in diabetes insipidus (DI). DI results from vasopressin deficiency, causing excessive urination. Insulin is irrelevant, as DI is a fluid balance disorder, not a glucose metabolism issue, making this response incorrect and misleading for the client.
Choice B reason: Assessing dietary habits and glucose levels pertains to diabetes mellitus, not diabetes insipidus. DI involves water loss due to vasopressin deficiency, not glucose dysregulation. This response misaligns with DI’s pathophysiology, as insulin or glucose monitoring is unnecessary, and vasopressin therapy is the standard treatment.
Choice C reason: Maintaining normal serum glucose is a goal for diabetes mellitus, not diabetes insipidus, which involves water loss from vasopressin deficiency. DI treatment focuses on fluid balance via vasopressin, not glucose control. This response is incorrect, as it conflates DI with an unrelated metabolic condition.
Choice D reason: Diabetes insipidus is managed with vasopressin (ADH) therapy to reduce excessive urination and conserve water, addressing the underlying deficiency. This response accurately explains DI’s treatment, distinguishing it from diabetes mellitus and clarifying that insulin is not needed, aligning with evidence-based endocrinology practice for fluid balance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Sodium bicarbonate levels affect acid-base balance, not cystic fibrosis (CF) secretions. CF results from defective sodium and chloride transport, causing thick mucus that impairs gas exchange. This choice is incorrect, as bicarbonate does not drive the respiratory issues or secretion buildup in CF pathophysiology.
Choice B reason: Excess potassium chloride is unrelated to cystic fibrosis. CF involves a CFTR gene mutation, disrupting sodium and chloride transport, leading to thick secretions. Potassium chloride does not cause mucus buildup or respiratory issues, making this an incorrect explanation for the child’s symptoms in CF.
Choice C reason: Increased sodium chloride content in sweat is a CF diagnostic marker, but it does not directly cause insufficient oxygen supply. Thick secretions from faulty ion transport obstruct airways, impairing gas exchange. This choice misrepresents the link between sodium chloride and CF’s respiratory pathophysiology.
Choice D reason: Cystic fibrosis results from a CFTR gene mutation, impairing sodium and chloride transport across cell membranes. This causes dehydrated, thick, sticky secretions that obstruct airways, leading to respiratory issues. This explanation accurately describes CF’s pathophysiological process, addressing the parents’ concerns about secretions and breathing difficulties.
Correct Answer is A
Explanation
Choice A reason: DIC involves widespread microthrombi formation and clotting factor consumption, leading to bleeding tendencies. Hematuria and hemoptysis reflect microvascular bleeding from depleted coagulation factors, common in sepsis-induced DIC. These findings align with DIC’s pathophysiology, where simultaneous clotting and hemorrhage occur, causing ecchymotic extremities, as seen in this client.
Choice B reason: Polyuria and productive cough are unrelated to DIC. Polyuria suggests renal or endocrine issues, and productive cough indicates respiratory infection. DIC causes bleeding and clotting abnormalities, not these symptoms. These findings do not support the pathophysiology of sepsis-induced DIC, which manifests as hemorrhagic tendencies like hematuria.
Choice C reason: Glucosuria and lethargy suggest diabetes or metabolic issues, not DIC. DIC involves coagulopathy, leading to bleeding or thrombosis, not glucose excretion or fatigue alone. These symptoms are unrelated to the microthrombi and bleeding diathesis of DIC, making them inconsistent with the client’s ecchymotic presentation.
Choice D reason: Frothy urine indicates proteinuria or renal disease, and anorexia is nonspecific. Neither directly relates to DIC’s coagulopathy, which causes bleeding (e.g., hematuria) due to clotting factor depletion. These findings do not support DIC’s pathophysiology, as they lack connection to the hemorrhagic or thrombotic features seen in
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