What manifestation is expected with syndrome of inappropriate antidiuretic hormone (SIADH)?
Hyponatremia.
Polyuria.
Hypotension.
Polydipsia.
The Correct Answer is A
Choice A rationale
SIADH involves the excessive release of antidiuretic hormone, which causes the kidneys to reabsorb too much water back into the bloodstream. This leads to an increase in total body water, which dilutes the concentration of sodium in the blood. Consequently, serum sodium levels drop below the normal range of 135 to 145 mEq/L, resulting in dilutional hyponatremia. This shift can cause cellular swelling, particularly in the brain, leading to neurologic symptoms.
Choice B rationale
Polyuria, or the production of large volumes of dilute urine, is the hallmark of diabetes insipidus, which is the opposite of SIADH. In SIADH, the body retains water, leading to very low urine output. The urine that is produced is highly concentrated because the kidneys are reclaiming as much water as possible. Therefore, a patient with SIADH will experience oliguria, not polyuria, with a high urine specific gravity typically exceeding the 1.030 mark.
Choice C rationale
SIADH causes fluid retention and an expansion of the extracellular fluid volume. This increase in intravascular volume typically leads to normovolemic or hypervolemic states, which usually results in normal blood pressure or hypertension. Hypotension is more commonly associated with conditions of fluid loss or dehydration, such as diabetes insipidus or adrenal insufficiency. In SIADH, the volume expansion prevents the blood pressure from dropping unless there are other unrelated co-morbidities present.
Choice D rationale
Polydipsia, or excessive thirst, is a common symptom of diabetes mellitus or diabetes insipidus, where the body is losing large amounts of fluid. In SIADH, the body is already overloaded with water due to excessive reabsorption. While some patients may still feel thirsty, it is not a primary manifestation of the hormone's action. Clinical management of SIADH actually requires strict fluid restriction to prevent further dilution of serum sodium levels and worsening of the hyponatremia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Choosing this option confirms that the individual has complied with the required identity verification protocol using a valid photo ID. In a professional or educational setting, verification ensures the integrity of the assessment process and confirms the identity of the participant. This action is a standard procedural requirement for high-stakes testing to maintain security and prevent academic or professional dishonesty, satisfying the specific instructions provided by the proctoring or assessment system.
Choice B rationale
Acknowledging a choice not to follow assessment instructions suggests a knowing violation of the established code of conduct. Such an action usually results in disciplinary measures, a failing grade, or the invalidation of the exam results. In a clinical or professional environment, following standardized protocols is essential for accountability. This choice would be counterproductive to the goal of completing the assessment and would trigger administrative review due to the non-compliance.
Choice C rationale
Stating that verification will be completed at the end of the examination period is generally not an acceptable alternative to immediate verification. Most secure testing platforms require identity confirmation before the exam begins to ensure the person taking the test is the authorized individual. Procrastinating this step can lead to technical lockouts or the suspicion of misconduct, as the identity must be established before the substantive work of the assessment is performed.
Choice D rationale
Reporting the lack of a valid photo identification card indicates an inability to meet the baseline requirements for taking a proctored examination. Without proper identification, the system cannot verify the participant's identity, which usually prevents the individual from proceeding with the test. This choice serves as a notification of a barrier to compliance but does not satisfy the security requirements necessary to maintain the validity and reliability of the assessment environment.
Correct Answer is C
Explanation
Choice A rationale
Bullae development refers to the formation of large air-filled spaces within the lung parenchyma. While these can occur in advanced chronic obstructive pulmonary disease, specifically emphysema, they are not the defining structural change of chronic bronchitis. Chronic bronchitis is primarily a disease of the conducting airways rather than the distal air spaces. Bullae result from the breakdown of alveolar walls, which is a separate pathologic process from the airway inflammation seen in bronchitis.
Choice B rationale
The destruction of alveolar walls is the primary structural change seen in emphysema, not chronic bronchitis. In emphysema, the loss of elastic recoil and surface area for gas exchange leads to permanent enlargement of the air spaces. In contrast, chronic bronchitis involves the larger and smaller bronchi. While both conditions often coexist in patients with COPD, the specific pathology of chronic bronchitis is centered on the hypersecretion of mucus and airway narrowing.
Choice C rationale
Hypertrophy of the mucous glands and an increase in the number of goblet cells are the classic structural changes of chronic bronchitis. Chronic exposure to irritants, such as cigarette smoke, triggers a chronic inflammatory response that leads to the enlargement of these glands in the submucosa of the large airways. This results in the hallmark symptom of a persistent, productive cough lasting for at least three months in two consecutive years due to excessive mucus.
Choice D rationale
Increased surfactant production does not occur in chronic bronchitis. Surfactant is produced by type II alveolar cells to reduce surface tension and prevent alveolar collapse. In chronic inflammatory lung diseases, surfactant function may actually be impaired or diluted by the presence of inflammatory exudates and excessive mucus. There is no physiologic mechanism in chronic bronchitis that leads to an increase in surfactant; rather, the focus is on the overproduction of thick, tenacious mucus.
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