What should the nurse suspect when hourly assessment of urine output on a client post-craniotomy exhibits a urine output from a catheter of 1,500 mL for two consecutive hours?
Cushing syndrome.
Adrenal crisis.
Arginine vasopressin deficiency (AVP-D).
Syndrome of inappropriate antidiuretic hormone (SIADH).
The Correct Answer is C
Choice A rationale
Cushing syndrome involves overproduction of cortisol and does not cause rapid urine output.
Choice B rationale
Adrenal crisis does not typically present with excessive urine output and would have other symptoms such as low blood pressure and electrolyte imbalances.
Choice C rationale
Arginine vasopressin deficiency (AVP-D), also known as diabetes insipidus, causes excessive urine output due to the lack of antidiuretic hormone (ADH).
Choice D rationale
Syndrome of inappropriate antidiuretic hormone (SIADH) causes water retention and low urine output, not excessive urine output. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Furuncles, also known as boils, are deep folliculitis caused by bacterial infection, not sebum blockage.
Choice B rationale
Carbuncles are clusters of furuncles connected under the skin and are also caused by bacterial infection, not sebum blockage.
Choice C rationale
Comedones are primary lesions of acne caused by the blockage of hair follicles by sebum and keratin. They can be open (blackheads) or closed (whiteheads).
Choice D rationale
Striae, also known as stretch marks, are caused by the tearing of the dermis due to rapid stretching of the skin and are not related to sebum blockage in hair follicles. .
Correct Answer is A
Explanation
Choice A rationale
The nurse should check the equipment first when an ICP reading of 0 mm Hg is noted, as this may indicate equipment malfunction. An accurate ICP reading is critical for assessing and managing intracranial pressure to ensure the client's safety.
Choice B rationale
Continuing the assessment without checking the equipment may lead to incorrect conclusions based on a potentially faulty reading. It’s crucial to ensure the accuracy of the equipment before proceeding.
Choice C rationale
Documenting the reading as an effective treatment outcome without verifying its accuracy can be dangerous. An ICP reading of 0 mm Hg is unusual and warrants equipment verification.
Choice D rationale
Contacting the health care provider to review the care plan is premature until the equipment has been checked to rule out a false reading, ensuring the nurse provides accurate information.
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