A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should the nurse identify as an indication of a therapeutic response to the medication?
Increase in serum sodium
Decrease in urine output
Increase in heart rate
Decrease in blood pressure
The Correct Answer is B
A. Increase in serum sodium: Desmopressin, a synthetic form of vasopressin, works to decrease urine output and increase water reabsorption in the kidneys. Therefore, a therapeutic response to desmopressin would not result in an increase in serum sodium; rather, it would aim to normalize serum sodium levels by reducing excessive urine output.
B. Decrease in urine output: The primary therapeutic goal of desmopressin in the treatment of diabetes insipidus is to decrease urine output by increasing water reabsorption in the kidneys. Therefore, a decrease in urine output would indicate a positive response to the medication.
C. Increase in heart rate: Desmopressin primarily affects kidney function by increasing water reabsorption and does not typically have a direct effect on heart rate. Therefore, an increase in heart rate would not be a manifestation of a therapeutic response to desmopressin.
D. Decrease in blood pressure: Desmopressin works to increase water reabsorption in the kidneys and does not typically cause significant changes in blood pressure. Therefore, a decrease in blood pressure would not be a manifestation of a therapeutic response to desmopressin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Urinary retention: While urinary retention can be a complication of epidural anesthesia, it is not the priority finding in this scenario. The priority is to address potential complications that can lead to maternal or fetal compromise.
B. Leg weakness: Leg weakness can occur as a side effect of epidural anesthesia but is not the priority finding in this scenario unless it is severe and compromises the client's ability to
mobilize or push during labor.
C. Hypotension: Hypotension is a common complication of epidural anesthesia due to sympathetic blockade, which can lead to decreased venous return and subsequent maternal
hypotension. Maternal hypotension can compromise uteroplacental perfusion, leading to fetal distress. Therefore, addressing hypotension promptly is the priority to prevent adverse maternal and fetal outcomes.
D. Temperature 39°C (102.2°F): While fever should be monitored and addressed, it is not the priority finding in this scenario unless it indicates an infection, which would require further assessment and intervention. However, maternal hypotension poses a more immediate risk to both the mother and the fetus during labor.

Correct Answer is B
Explanation
A. Insomnia: Pioglitazone is not typically associated with insomnia as an adverse effect.
Insomnia is more commonly associated with stimulant medications or certain medical conditions.
B. Fluid retention: Pioglitazone, a thiazolidinedione, can cause fluid retention as an adverse effect. This can lead to peripheral edema and exacerbation of heart failure, particularly in
susceptible individuals. Monitoring for signs and symptoms of fluid retention, such as peripheral edema and weight gain, is essential.
C. Tinnitus: Tinnitus is not a commonly reported adverse effect of pioglitazone. Tinnitus is more commonly associated with medications such as certain antibiotics, NSAIDs, and ototoxic drugs.
D. Orthostatic hypotension: Orthostatic hypotension is not typically associated with pioglitazone.
It is more commonly associated with medications that affect blood pressure regulation, such as antihypertensives and alpha-blockers.
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