A patient admitted with a small-cell lung carcinoma, is noted to have a significant decrease in urine output accompanied by shortness of breath, edema, and mental status changes. The nurse is aware that this clinical presentation is consistent with which disorder?
Diabetes insipidus
Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)
Myxedema Coma
Adrenal crisis
The Correct Answer is B
Rationale:
A. Diabetes insipidus causes polyuria and excessive thirst due to insufficient antidiuretic hormone (ADH) or renal response to ADH. The patient in this scenario has decreased urine output, which is the opposite of diabetes insipidus.
B. SIADH is a paraneoplastic syndrome commonly associated with small-cell lung carcinoma, where there is excessive ADH secretion, leading to water retention, hyponatremia, decreased urine output, edema, mental status changes, and sometimes respiratory symptoms. The patient’s oliguria, edema, and altered mental status are consistent with SIADH.
C. Myxedema coma is a severe form of hypothyroidism, presenting with hypothermia, bradycardia, hypotension, hypoventilation, and altered mental status. The patient’s small-cell lung carcinoma and urine retention are not consistent with this diagnosis.
D. Adrenal crisis involves hypotension, hyponatremia, hyperkalemia, dehydration, and shock due to adrenal insufficiency. While some electrolyte disturbances and mental status changes overlap, the low urine output with edema points more specifically to SIADH rather than adrenal crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Ensure that emergency equipment (code cart, defibrillator) are working properly is incorrect because while equipment readiness is important for patient safety, this is not the primary goal of a rapid response team (RRT).
B. Decrease critical care unit admissions is partially correct in that early intervention by an RRT can sometimes prevent deterioration that would require ICU transfer, but this is a secondary benefit, not the primary goal.
C. Increase hospital length of stay is incorrect because longer hospitalization is not an objective of RRTs. The focus is on patient safety, not prolonging stay.
D. Prevent cardiac and respiratory arrest is correct because the primary purpose of a rapid response team is to identify and intervene early in patients showing signs of clinical deterioration on general wards. By providing timely assessment, monitoring, and intervention, RRTs aim to prevent progression to life-threatening events such as cardiac or respiratory arrest, improving patient outcomes and safety.
Correct Answer is C
Explanation
Rationale:
A. Vascular spasm occurs first.
B. Coagulation is the final step, not the first.
C. Matches the physiological sequence of hemostasis.
Hemostasis is the process that stops bleeding following vascular injury, and it occurs in a specific sequence of steps:
- Vascular spasm – The immediate constriction of the blood vessel to reduce blood flow and limit blood loss. This is the first response to injury.
- Platelet plug formation – Platelets adhere to the exposed collagen of the damaged vessel, aggregate, and form a temporary plug.
- Coagulation (blood clotting) – The coagulation cascade is activated, leading to fibrin formation, which stabilizes the platelet plug and forms a durable blood clot.
D. Platelet plug formation occurs after vascular spasm, not before.
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