A nurse caring for a client with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?

Glucose in the urine

Highly dilute urine

Leukocytes in the urine

Albumin in the urine

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Glucose in the urine, or glycosuria, is not characteristic of diabetes insipidus, which results from antidiuretic hormone (ADH) deficiency, impairing water reabsorption in the kidneys’ collecting ducts. Glycosuria is typically seen in diabetes mellitus, where elevated blood glucose exceeds the renal threshold, leading to glucose excretion. This is unrelated to the water balance issue in diabetes insipidus.

Choice B reason: Highly dilute urine is a hallmark of diabetes insipidus due to insufficient ADH, which normally facilitates water reabsorption in the renal collecting ducts. Without ADH, the kidneys produce large volumes of dilute urine with low osmolality and specific gravity, reflecting the inability to concentrate urine and conserve water, leading to polyuria.

Choice C reason: Leukocytes in the urine indicate urinary tract infection or inflammation, not diabetes insipidus. This condition involves hormonal dysregulation of water balance, not immune or infectious processes in the urinary tract. Leukocyturia would suggest a separate pathology, such as cystitis, rather than the expected dilute urine output of diabetes insipidus.

Choice D reason: Albumin in the urine, or proteinuria, suggests glomerular damage, as seen in conditions like nephrotic syndrome. Diabetes insipidus is a disorder of water regulation due to ADH deficiency, not affecting protein filtration in the kidneys. Thus, albuminuria is not an expected finding, as the condition does not impair glomerular barrier function.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Sickle cell anemia is an inherited disorder caused by a genetic mutation in the hemoglobin gene, leading to abnormal hemoglobin (HbS). This causes red blood cells to sickle under stress, triggering hemolysis. The autosomal recessive inheritance pattern makes it a classic example of an inherited hemolytic anemia with chronic hemolysis.

Choice B reason: Hypersplenism is not an inherited disorder but a condition where an enlarged spleen sequesters and destroys red blood cells, causing anemia. It results from secondary causes like liver disease or portal hypertension, not genetic mutations, making it an acquired cause of hemolytic anemia.

Choice C reason: Cold agglutinin disease is typically acquired, often due to infections or autoimmune disorders, causing antibodies to agglutinate red blood cells at low temperatures, leading to hemolysis. While rare congenital forms exist, it is not primarily inherited, unlike sickle cell anemia’s genetic basis.

Choice D reason: Autoimmune hemolytic anemia is usually acquired, caused by autoantibodies attacking red blood cells, leading to hemolysis. It is associated with conditions like lupus or infections, not genetic mutations. Unlike sickle cell anemia, it lacks an inherited genetic component as its primary etiology.

A. Pale thick skin B. Moon face C. Weight loss D. Hypotension

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Pale thick skin is not a typical effect of long-term corticosteroid use. Corticosteroids cause skin thinning due to reduced collagen production, leading to fragile, atrophic skin prone to bruising. Thick skin is more associated with conditions like scleroderma, not the catabolic effects of corticosteroids on skin tissue.

Choice B reason: Moon face is a classic sign of long-term corticosteroid use, resulting from fat redistribution to the face due to glucocorticoid-induced lipolysis and lipogenesis. Excess cortisol promotes fat deposition in the face and trunk, creating a rounded facial appearance, a hallmark of Cushing syndrome or iatrogenic corticosteroid effects.

Choice C reason: Weight loss is not expected with long-term corticosteroid use. Corticosteroids increase appetite and promote fat redistribution, leading to weight gain, particularly in the trunk and face. Weight loss may occur in conditions like Addison’s disease, where cortisol is deficient, not in hypercortisolism states.

Choice D reason: Hypotension is not a common effect of corticosteroids. They can cause fluid retention and increased blood volume due to mineralocorticoid activity, potentially leading to hypertension. Hypotension is more associated with adrenal insufficiency, where cortisol and aldosterone deficiencies reduce vascular tone and fluid balance.

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A nurse caring for a client with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which type of hemolytic anemia is categorized as an inherited disorder?

Correct Answer is A

Explanation

A client receiving long-term treatment with high-dose corticosteroids is expected to exhibit which of the following?

Correct Answer is B

Explanation

The nurse providing care for a client with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk?

A client who has experienced an ischemic stroke has been admitted to the medical unit. The client’s family is adamant that the client remain on bed rest to hasten recovery and to conserve energy. What principle of care should inform the nurse’s response to the family?

A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client’s diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client’s diet allows for easy swallowing?

A client had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The client takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this client at risk for?

A nurse is caring for a client with Cushing’s syndrome. Which interventions would the nurse include in the client’s plan of care? (Select all that apply)

Nursing care during the immediate recovery period from an ischemic stroke should normally prioritize which intervention?

The nurse is reviewing plans of care for several clients. The nurse recognizes which client is most at risk for developing disseminated intravascular coagulation (DIC)?

The health care provider has ordered a fluid deprivation test for a client suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?