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 D
Explanation
Choice A rationale
Infection is not directly related to weight loss, ill-fitting dentures, or limited fiber intake. The primary risks are more connected to gastrointestinal function rather than infections. While malnutrition can affect immune response, infection risk isn’t the primary concern here.
Choice B rationale
Deficient fluid volume is not a direct consequence of weight loss or dietary habits related to ill-fitting dentures. While fluid intake should be monitored, it is not the most immediate risk associated with these symptoms.
Choice C rationale
Excessive intake of convenience foods might contribute to poor nutritional status and unintended weight loss, but it is not the primary risk. The client's condition more directly influences gastrointestinal health rather than dietary habits.
Choice D rationale
Constipation is a significant risk due to limited intake of high-fiber foods. Fiber is crucial for promoting bowel movements and preventing constipation. Weight loss and ill-fitting dentures may further reduce the client's dietary fiber intake, increasing the likelihood of constipation
Correct Answer is B
Explanation
Choice A rationale
Scoliosis refers to a lateral curvature of the spine, not an exaggeration of the lumbar spine curve, which is characterized by lordosis.
Choice B rationale
Lordosis is an exaggerated inward curve of the lumbar spine, often referred to as swayback. This condition is identified by the nurse as the client presents with an exaggerated lumbar curve.
Choice C rationale
Kyphosis describes an excessive outward curvature of the thoracic spine, resulting in a hunched back, not the lumbar spine.
Choice D rationale
Dowager's hump is a term commonly associated with kyphosis, characterized by a pronounced curvature of the upper back, not the lumbar region.
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