The health care provider has ordered a fluid deprivation test for a client suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?

Color, warmth, movement, and sensation of extremities

Breath sounds and bowel sounds

Heart rate and blood pressure

Temperature and oxygen saturation

Answer and Explanation

The Correct Answer is C

Choice A reason: Assessing color, warmth, movement, and sensation of extremities is relevant for neurological or vascular conditions, not a fluid deprivation test. This test induces dehydration to evaluate ADH function, which primarily affects fluid status and cardiovascular parameters, not peripheral limb function, making these assessments less critical for monitoring during the test.

Choice B reason: Breath and bowel sounds are not prioritized during a fluid deprivation test. The test assesses the body’s ability to concentrate urine under dehydration stress, primarily impacting fluid and cardiovascular status. Respiratory and gastrointestinal functions are not directly affected by short-term fluid restriction in diagnosing diabetes insipidus.

Choice C reason: Heart rate and blood pressure are critical during a fluid deprivation test, as dehydration from fluid restriction can cause hypovolemia, leading to tachycardia and hypotension. Monitoring these parameters ensures patient safety and detects cardiovascular responses to fluid loss, which are key to evaluating the severity of diabetes insipidus.

Choice D reason: Temperature and oxygen saturation are secondary in a fluid deprivation test. Dehydration may cause slight temperature changes, but these are not primary indicators. Oxygen saturation remains stable unless severe hypovolemia leads to shock, which is rare in a controlled setting, making these assessments less critical than cardiovascular monitoring.

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Correct Answer is D

Explanation

Reasoning:

Choice A reason: Iron deficiency anemia causes fatigue and anemia due to low iron, reducing hemoglobin synthesis. However, it does not typically cause neutropenia, thrombocytopenia, or left upper quadrant pain. Bruising may occur, but the triad of pancytopenia and recent infections points more strongly to bone marrow failure.

Choice B reason: Hemolytic anemia involves red blood cell destruction, causing anemia and fatigue, but neutropenia and thrombocytopenia are not typical. Left upper quadrant pain may suggest splenomegaly, but the full pancytopenia and infection history align better with bone marrow suppression than hemolytic processes alone.

Choice C reason: Sickle cell anemia causes hemolytic anemia and pain from vaso-occlusion, potentially in the spleen (left upper quadrant). However, it does not typically cause neutropenia or thrombocytopenia. The client’s pancytopenia and recurrent infections suggest a broader bone marrow issue, not specific to sickle cell disease.

Choice D reason: Aplastic anemia is characterized by bone marrow failure, leading to pancytopenia (anemia, neutropenia, thrombocytopenia), causing fatigue, bruising, and infection susceptibility. Left upper quadrant pain may indicate splenomegaly or bleeding. The history of recurrent infections supports neutropenia from bone marrow suppression, making this the most likely diagnosis.

A. Systolic blood pressure greater than 70 mm Hg B. Stable level of consciousness C. Urine output greater than or equal to 30 mL/hour D. Decreased bleeding

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Systolic blood pressure above 70 mm Hg is a goal in hypovolemia but is not the most specific outcome for DIC-related bleeding. While low blood pressure reflects fluid loss, addressing bleeding directly prevents further volume depletion, making reduced bleeding a more targeted and measurable outcome.

Choice B reason: A stable level of consciousness is important but not directly tied to deficient fluid volume from bleeding in DIC. Altered consciousness may result from cerebral ischemia or hyponatremia, but reducing bleeding is the primary goal to stabilize fluid volume and prevent further hemodynamic compromise.

Choice C reason: Urine output of 30 mL/hour or more indicates adequate renal perfusion but is a secondary outcome in DIC-related bleeding. While it reflects fluid status, directly addressing bleeding through interventions like transfusions or clotting factor replacement is more specific to correcting the underlying fluid volume deficit.

Choice D reason: Decreased bleeding is the most appropriate outcome for deficient fluid volume in DIC, as bleeding from mucosal and venipuncture sites directly causes volume loss. Reducing hemorrhage through platelet or factor replacement stabilizes fluid volume, preventing hypovolemia and its complications, making this the most measurable and relevant outcome.

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The health care provider has ordered a fluid deprivation test for a client suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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