In reviewing admission orders for a patient admitted with SIADH, the nurse should question which order?

IV 3% NS at 10 mL/hr

Seizure precautions

Fluid restriction of 1000 mL/day

Sodium-restricted diet

Answer and Explanation

The Correct Answer is A

A. In SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion), the body retains excessive water, leading to dilutional hyponatremia (low sodium levels). Administering hypertonic saline (3% NS) can exacerbate the condition by rapidly increasing sodium levels, which may cause demyelination of neurons (a condition called osmotic demyelination syndrome). Hypertonic saline is typically only used in severe hyponatremia with neurologic symptoms and should be carefully monitored.
B. Seizure precautions are appropriate in SIADH due to the risk of seizures from severe hyponatremia, which can lead to cerebral edema and neurological compromise.
C. Fluid restriction of 1000 mL/day is appropriate in SIADH to manage the dilutional hyponatremia by preventing further fluid retention.
D. A sodium-restricted diet is also recommended in SIADH to avoid further dilution of sodium levels and prevent worsening of hyponatremia.

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Correct Answer is B

Explanation

A. 4 oz diet soda: This is incorrect. Diet soda contains no sugar and will not raise the client's blood glucose level. Although it may provide some hydration, it won't address the hypoglycemia.
B. 4 oz skim milk: This is the correct choice. Skim milk contains both lactose (a sugar) and protein, which can help raise the blood glucose and stabilize it over a longer period. This is a suitable option for treating mild hypoglycemia.
C. Graham crackers: While graham crackers contain carbohydrates, they are not the most immediate or efficient choice in this case. They are slower to digest and may not raise the blood glucose level as quickly as the combination of sugar and protein found in milk.
D. 1 tsp sugar: This is not the best option. While sugar can raise blood glucose, it is a fast-acting form of carbohydrate that may not sustain the client's blood glucose for a longer period. A more balanced option, such as milk, would provide both rapid and sustained glucose elevation.

A. Place the patient in a lateral recovery position for better drainage of the secretions. B. Activate the rapid-response team. C. Keep monitoring the oxygen saturation and respiratory rate. D. Increase the humidification of the patient's oxygen.

Correct Answer is A

Explanation

A. Placing the patient in a lateral recovery position is the best immediate action. This position helps facilitate drainage of secretions, especially after a laryngectomy, which can reduce the risk of aspiration and airway obstruction. The blood-tinged mucus may be due to recent surgery and should be monitored for changes.
B. The activation of the rapid-response team may be necessary if the patient’s condition worsens or becomes critical, but there is no indication of an acute life-threatening event based on the blood-tinged mucus alone.
C. Monitoring the oxygen saturation and respiratory rate is important, but it is a secondary concern compared to providing a position that promotes drainage and prevents aspiration.
D. Increasing humidification of the oxygen may help keep the airway moist, but the immediate priority should be ensuring proper positioning to allow secretion drainage and prevent aspiration.

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In reviewing admission orders for a patient admitted with SIADH, the nurse should question which order?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?

Correct Answer is B

Explanation

After observing blood-tinged mucous when suctioning a patient who has just arrived on the medical-surgical unit after a laryngectomy, which action by the nurse is best?

Correct Answer is A

Explanation

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