A patient is experiencing syndrome of inappropriate antidiuretic hormone secretion (SIADH). What does the nurse expect that the lab work will show?

High cortisol

Serum hypernatremia

Increased serum osmolality

Serum hyponatremia

Answer and Explanation

The Correct Answer is D

Choice A reason: High cortisol is not associated with SIADH. Cortisol excess occurs in conditions like Cushing’s syndrome, causing hyperglycemia and hypertension. SIADH involves excessive antidiuretic hormone, leading to water retention and dilutional hyponatremia, not cortisol elevation. Cortisol levels are unrelated to the pathophysiology of SIADH and would not be expected in lab results.

Choice B reason: Serum hypernatremia is incorrect, as SIADH causes water retention due to excessive antidiuretic hormone, diluting sodium levels. This leads to hyponatremia, not hypernatremia. Hypernatremia occurs in conditions like diabetes insipidus with water loss. SIADH’s mechanism of water retention lowers serum sodium, making this choice inconsistent with the condition.

Choice C reason: Increased serum osmolality is not expected in SIADH. Excessive antidiuretic hormone causes water retention, decreasing serum osmolality due to dilution. Normal or low osmolality triggers further ADH release, perpetuating hyponatremia. High osmolality is seen in dehydration or hypernatremia, not SIADH, where the opposite occurs due to water overload.

Choice D reason: Serum hyponatremia is characteristic of SIADH, where excessive antidiuretic hormone causes water retention, diluting serum sodium (normal: 135–145 mEq/L). This leads to hyponatremia, often below 135 mEq/L, causing symptoms like confusion or seizures. Lab results in SIADH typically show low sodium and low serum osmolality, confirming this as the expected finding.

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Correct Answer is ["A","C","D"]

Explanation

Choice A reason: Hypotension is a hallmark of myxedema coma, as severe hypothyroidism slows metabolism, reducing cardiac output and vascular tone. This leads to low blood pressure, contributing to shock. Fluid retention and hyponatremia may exacerbate hypotension, making it a critical symptom requiring urgent thyroid hormone replacement and supportive care.

Choice B reason: Tachycardia is not typical in myxedema coma. Severe hypothyroidism causes bradycardia due to decreased metabolic rate and cardiac output. Tachycardia is seen in hyperthyroidism or other conditions like sepsis. Myxedema coma presents with slowed physiological processes, making tachycardia inconsistent with this life-threatening hypothyroid state.

Choice C reason: Hypothermia is a classic symptom of myxedema coma, as hypothyroidism impairs thermogenesis and metabolic rate, leading to decreased body temperature. This can drop to life-threatening levels, exacerbating altered consciousness and organ dysfunction. Hypothermia reflects the systemic slowdown of metabolic processes, requiring urgent warming and thyroid hormone administration.

Choice D reason: Hypoventilation is common in myxedema coma due to reduced respiratory drive from severe hypothyroidism. Decreased metabolism and central nervous system depression lead to shallow, slow breathing, causing hypercapnia and acidosis. This respiratory compromise is a critical feature, necessitating ventilatory support alongside thyroid hormone replacement to reverse the coma.

Choice E reason: Hyperactivity is not associated with myxedema coma. Severe hypothyroidism causes lethargy, confusion, and decreased consciousness due to slowed metabolism and cerebral hypoperfusion. Hyperactivity is seen in hyperthyroidism, not hypothyroidism. Myxedema coma presents with profound sluggishness, making this symptom inconsistent with the patient’s clinical presentation.

A. Diarrhea B. Abdominal guarding C. Hyperactive bowel sounds D. Ecchymosis in the flank E. Black, tarry stools F. Left upper quadrant pain with radiation to the back

Correct Answer is ["B","D","F"]

Explanation

Choice A reason: Diarrhea is not a primary feature of acute pancreatitis. While gastrointestinal symptoms like nausea and vomiting occur due to pancreatic inflammation, diarrhea is less common. Pancreatitis typically causes reduced bowel motility from inflammation or ileus, leading to constipation rather than diarrhea, which is more associated with other conditions like gastroenteritis.

Choice B reason: Abdominal guarding is a classic sign of acute pancreatitis, as inflammation causes severe epigastric or left upper quadrant pain, leading to involuntary muscle tensing to protect the area. This response results from peritoneal irritation or pancreatic enzyme leakage, making it a key physical finding in assessing pancreatitis severity and guiding treatment.

Choice C reason: Hyperactive bowel sounds are not typical in acute pancreatitis. Inflammation often causes an ileus, leading to diminished or absent bowel sounds due to reduced gastrointestinal motility. Hyperactive sounds suggest conditions like bowel obstruction, not pancreatitis, where the inflammatory process slows peristalsis, making this finding inconsistent with the diagnosis.

Choice D reason: Ecchymosis in the flank (Grey Turner’s sign) is a hallmark of severe acute pancreatitis, indicating retroperitoneal hemorrhage from pancreatic enzyme leakage or necrosis. Blood tracks to the flank, causing bruising. This sign reflects significant disease severity, often requiring intensive care, and is a critical finding in pancreatitis assessment.

Choice E reason: Black, tarry stools (melena) indicate upper gastrointestinal bleeding, not typically associated with acute pancreatitis. While severe pancreatitis may rarely cause bleeding, melena is more common in conditions like peptic ulcers. Pancreatitis symptoms focus on pain, nausea, and bruising, not gastrointestinal bleeding, making this finding unlikely.

Choice F reason: Left upper quadrant pain radiating to the back is a classic symptom of acute pancreatitis. Pancreatic inflammation causes severe epigastric pain that often radiates to the back due to the pancreas’s retroperitoneal location. This pain pattern, often described as boring or constant, is a key diagnostic feature of pancreatitis.

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A patient is experiencing syndrome of inappropriate antidiuretic hormone secretion (SIADH). What does the nurse expect that the lab work will show?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. Which symptoms are consistent with this life-threatening event? (Select all that apply)

Correct Answer is ["A","C","D"]

Explanation

A patient admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? (Select all that apply)

Correct Answer is ["B","D","F"]

Explanation

The nurse analyzes the laboratory results of a patient with hemophilia. The nurse understands that which result will most likely be abnormal in this patient?

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