The nurse cares for clients in the outpatient clinic. Which client is MOST at risk for the syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

A client diagnosed with bipolar disorder receiving lithium carbonate (Lithobid).

A client diagnosed with renal artery stenosis receiving losartan (Cozaar).

A client diagnosed with lung cancer receiving vincristine (Oncovin).

A client diagnosed with hyperthyroidism receiving methimazole (Tapazole).

Answer and Explanation

The Correct Answer is C

Choice A reason: Lithium can cause nephrogenic diabetes insipidus, not SIADH, which involves excess ADH. Lung cancer is a known SIADH trigger, making this incorrect, as it’s unrelated to the syndrome compared to the high-risk client with cancer and vincristine therapy.

Choice B reason: Losartan treats hypertension in renal artery stenosis but doesn’t cause SIADH, which is linked to cancers. Lung cancer with vincristine is riskier, making this incorrect, as it’s not associated with the syndrome in the nurse’s risk assessment of clients.

Choice C reason: Lung cancer, especially small cell, and vincristine are strongly associated with SIADH due to ectopic ADH production. This aligns with oncology risk factors, making it the correct client most at risk for SIADH in the nurse’s outpatient clinic care.

Choice D reason: Hyperthyroidism and methimazole don’t typically cause SIADH, unlike lung cancer’s strong link. Vincristine-treated cancer is the highest risk, making this incorrect, as it’s not a primary cause of SIADH in the nurse’s evaluation of the outpatient clients.

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Correct Answer is D

Explanation

Choice A reason: Nebulizer and pulse oximeter monitor breathing but are less critical than preparing for respiratory failure, a Guillain-Barré complication. Intubation equipment is essential, making this incorrect, as it’s secondary to the nurse’s priority of addressing potential airway compromise in the client.

Choice B reason: Blood pressure cuff and flashlight are useful but don’t address the risk of respiratory paralysis in Guillain-Barré. Intubation tray is critical, making this incorrect, as it’s less urgent than the nurse’s need to prepare for life-threatening respiratory complications in the client.

Choice C reason: Nasal cannula and spirometer support breathing but are inadequate for acute respiratory failure in Guillain-Barré. Electrocardiographic and intubation equipment are vital, making this incorrect, as it doesn’t prioritize the nurse’s preparation for the client’s potential rapid respiratory deterioration.

Choice D reason: Electrocardiographic electrodes and intubation tray are essential for Guillain-Barré, as ascending paralysis risks respiratory failure and autonomic dysfunction. This aligns with neurological emergency protocols, making it the correct choice for the nurse to bring to manage life-threatening complications effectively.

A. “Until your incision is healed, do not submerge your pacemaker. Only take showers.” B. “Report any pulse rates lower than your pacemaker settings.” C. “If you feel weak, apply pressure over your generator.” D. “Have your pacemaker turned off before having magnetic resonance imaging (MRI).” E. “Do not lift your left arm above the level of your shoulder for 8 weeks.”

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Avoiding submersion until the incision heals prevents infection in a new pacemaker site. This aligns with post-implant care, making it a correct instruction the nurse would include to ensure proper healing and device safety for the client.

Choice B reason: Reporting pulse rates below pacemaker settings indicates potential device failure, requiring prompt evaluation. This aligns with pacemaker monitoring, making it a correct instruction the nurse would teach the client to ensure device function and cardiac stability.

Choice C reason: Applying pressure over the generator doesn’t address weakness and may harm the device. Reporting low pulse rates is correct, making this incorrect, as it’s not a valid instruction for the nurse to include in pacemaker teaching.

Choice D reason: Pacemakers aren’t turned off for MRI; MRI-compatible devices or alternatives are used. Arm movement restriction is correct, making this incorrect, as it’s inaccurate compared to the nurse’s proper instructions for pacemaker care and MRI safety.

Choice E reason: Avoiding arm lifting above the shoulder for 8 weeks prevents lead dislodgement in a new pacemaker. This aligns with post-implant restrictions, making it a correct instruction the nurse would include to protect the device’s integrity.

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The nurse cares for clients in the outpatient clinic. Which client is MOST at risk for the syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse teaches a client with a new permanent pacemaker. Which instructions would the nurse include in this client’s teaching? (Select all that apply)

Correct Answer is ["A","B","E"]

Explanation

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The nurse cares for clients in the outpatient clinic. Which client is MOST at risk for the syndrome of inappropriate antidiuretic hormone secretion (SIADH)?