A nurse is caring for a client with a urine specific gravity of less than 1.005, polyuria, and nocturia. The nurse recognizes that which of the following physiologic findings is the likely cause?

Increased insulin production

Increased adrenocorticotropic hormone (ACTH)

Low levels of T3, T4

Insufficient antidiuretic hormone (ADH)

Answer and Explanation

The Correct Answer is D

A. Increased insulin production would not cause polyuria and low specific gravity urine; rather, hyperglycemia from lack of insulin can cause high specific gravity due to glucose in urine.
B. Increased ACTH affects cortisol production but is not directly related to urine concentration or polyuria.
C. Low T3 and T4 levels are associated with hypothyroidism, which typically does not cause polyuria or decreased specific gravity.
D. Insufficient ADH, as seen in diabetes insipidus, leads to the inability to concentrate urine, resulting in a low specific gravity, polyuria, and nocturia due to excessive water loss.

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Correct Answer is B

Explanation

A. Lowering the client's legs is not effective in managing autonomic dysreflexia and may not alleviate the cause of the high blood pressure.
B. Checking for a full bladder is the priority because bladder distension is a common trigger for autonomic dysreflexia in clients with spinal cord injuries, and relieving it can reduce the severe hypertensive response.
C. Antihypertensives may be used if non-pharmacological measures fail, but addressing the cause is the first action.
D. Pain medication is not indicated as the immediate intervention for autonomic dysreflexia, as the priority is identifying and removing the trigger.

A. Serum Thyroxine B. Serum TSH C. Serum T3 D. Free T4

Correct Answer is B

Explanation

A. Serum thyroxine (T4) is typically decreased in primary hypothyroidism due to reduced thyroid hormone production.
B. In primary hypothyroidism, the thyroid gland fails to produce sufficient hormones, which leads to an increase in thyroid-stimulating hormone (TSH) as the pituitary gland tries to stimulate thyroid function. Elevated TSH is a common finding in primary hypothyroidism.
C. Serum T3 is usually decreased in primary hypothyroidism since the production of T3 and T4 is reduced.
D. Free T4 is typically low in primary hypothyroidism as the thyroid gland is underactive and not producing adequate levels of thyroid hormones.

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A nurse is caring for a client with a urine specific gravity of less than 1.005, polyuria, and nocturia. The nurse recognizes that which of the following physiologic findings is the likely cause?

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Naxlex Comprehensive Predictor Exams

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