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
Encouraging adequate water intake by the client is a general recommendation for maintaining hydration but does not address the client's fear of the EEG procedure, nor does it dispel misconceptions about electrical shock.
Choice B rationale
Distracting the client's attention from the test may provide temporary relief from anxiety but does not address or correct the client's specific fear related to being electrocuted during the EEG procedure.
Choice C rationale
Informing the client that they will not experience any electrical shock is crucial in dispelling the client's fear. An EEG measures electrical activity in the brain using sensors on the scalp; it does not involve delivering electrical shocks to the client.
Choice D rationale
Informing the client that they will experience only mild electrical shock is incorrect and could increase the client's fear. An EEG does not administer any form of electrical shock to the client; it is a non-invasive and painless procedure.
Correct Answer is A
Explanation
Choice A rationale
Autolytic debridement is the natural process by which the body breaks down and removes dead tissue. Moisture-retentive dressings create an optimal environment for this process, facilitating wound healing.
Choice B rationale
Decreasing epidermal resurfacing is not a recognized benefit of moisture-retentive dressings. These dressings aim to promote healing, not inhibit epidermal growth.
Choice C rationale
While moisture-retentive dressings can help with the absorption of topical medications, this is not their main advantage. The primary benefit is creating a conducive environment for autolytic debridement.
Choice D rationale
Promoting the formation of a protective scab that traps excess exudate is not the main advantage of moisture-retentive dressings. In fact, these dressings help manage exudate and reduce the risk of infection without forming a scab.
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