A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?

Desmopressin acetate

Spironolactone

Furosemide

Dopamine

Answer and Explanation

The Correct Answer is A

A. Desmopressin acetate: This synthetic form of antidiuretic hormone (ADH) reduces excessive urine output by increasing water reabsorption in the kidneys. It helps restore fluid balance and prevent dehydration in diabetes insipidus. Without treatment, continued polyuria can lead to severe dehydration and electrolyte imbalances.

B. Spironolactone: This potassium-sparing diuretic promotes sodium and water excretion by blocking aldosterone receptors. It is used to treat conditions like heart failure and hyperaldosteronism but would worsen polyuria and dehydration in diabetes insipidus.

C. Furosemide: This loop diuretic inhibits sodium and chloride reabsorption in the kidneys, leading to increased urine output. Administering it to a client with diabetes insipidus would further aggravate excessive fluid loss and the risk of dehydration.

D. Dopamine: This vasopressor is used to improve cardiac output and blood pressure in conditions like shock. It does not affect ADH levels or urine concentration and would not help manage the excessive diuresis seen in diabetes insipidus.

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Correct Answer is D

Explanation

A. Use fluticasone as needed for shortness of breath: Fluticasone is a corticosteroid used for long-term inflammation control in COPD, not for immediate symptom relief. Short-acting bronchodilators like albuterol are used for acute shortness of breath.

B. Limit fluid intake to 1 L per day: COPD clients benefit from adequate hydration (typically 2-3 L per day) to help thin mucus secretions and improve airway clearance. Restricting fluids can lead to thickened secretions and increased respiratory distress.

C. Avoid use of pursed-lip breathing: Pursed-lip breathing is encouraged for COPD clients to help reduce air trapping, improve oxygenation, and promote more effective exhalation. It is an essential technique for managing dyspnea.

D. Obtain a yearly influenza immunization: COPD clients are at higher risk of complications from respiratory infections. An annual influenza vaccine helps reduce the risk of severe illness and exacerbations, making it a crucial part of COPD management.

A. "Your provider would not prescribe this treatment if it weren't necessary." B. "Chemotherapy is your best chance for survival." C. "It is your decision whether to continue chemotherapy." D. "Why don't you want to continue treatment?"

Correct Answer is C

Explanation

A. "Your provider would not prescribe this treatment if it weren't necessary.": While the provider recommends treatment based on medical necessity, the decision to continue or discontinue chemotherapy ultimately lies with the client. This response does not acknowledge the client’s autonomy.

B. "Chemotherapy is your best chance for survival.": This response focuses on treatment efficacy rather than addressing the client's emotional and personal concerns. It may also create pressure rather than supporting the client’s decision-making process.

C. "It is your decision whether to continue chemotherapy.": This response is appropriate as it acknowledges the client’s autonomy and right to make healthcare decisions. It validates the client’s concerns while offering support without imposing an opinion.

D. "Why don't you want to continue treatment?": Asking "why" may make the client feel defensive or pressured to justify their decision. A more open-ended approach, such as "Can you tell me more about your concerns?" would be a better way to explore the client’s feelings.

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A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?

Nursing Test Bank

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