Which outcome indicates that treatment of a client with diabetes insipidus has been effective?

Fluid intake is less than 2,500 ml/day

Heart rate is 126 beats/minute

Blood pressure is 90/50 mm Hg

Urine output measures more than 200 ml/hour

Answer and Explanation

The Correct Answer is A

Reasoning:

Choice A reason: Effective treatment of diabetes insipidus, typically with desmopressin, restores ADH function, reducing excessive urine output and thirst. Fluid intake below 2,500 ml/day indicates improved water reabsorption in the kidneys, normalizing fluid balance and reducing polyuria, which is a key sign of successful management of this condition.

Choice B reason: A heart rate of 126 beats/minute indicates tachycardia, often a sign of dehydration or hypovolemia in untreated diabetes insipidus. Effective treatment should normalize heart rate by correcting fluid balance, so persistent tachycardia suggests ongoing fluid loss and ineffective treatment, not a successful therapeutic outcome.

Choice C reason: Blood pressure of 90/50 mm Hg indicates hypotension, which can result from severe dehydration in untreated diabetes insipidus. Effective treatment should stabilize blood pressure by restoring fluid volume through improved water reabsorption, making low blood pressure an indicator of poor treatment response rather than success.

Choice D reason: Urine output exceeding 200 ml/hour reflects polyuria, a primary symptom of untreated diabetes insipidus due to ADH deficiency. Effective treatment reduces urine output by enhancing renal water reabsorption, so high urine output indicates persistent disease activity, not a successful response to therapy.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: An occluded urinary catheter is the most likely trigger for autonomic dysreflexia in spinal cord injury above T6. Bladder distension stimulates sympathetic overactivity, causing hypertension and bradycardia. This noxious stimulus below the injury level disrupts autonomic regulation, making catheter occlusion a common precipitant of this condition.

Choice B reason: A changed analgesia regimen is unlikely to cause autonomic dysreflexia. Pain may contribute to discomfort, but dysreflexia typically results from visceral stimuli like bladder or bowel distension. Analgesia changes do not directly trigger the sympathetic overresponse characteristic of this life-threatening condition.

Choice C reason: Failure to reposition may cause pressure injuries but is less likely to precipitate autonomic dysreflexia. While discomfort from immobility can contribute, visceral stimuli like catheter occlusion are more direct triggers, as they strongly activate the sympathetic nervous system below the spinal injury level.

Choice D reason: A blood transfusion is not a common cause of autonomic dysreflexia. Transfusions may cause reactions like fever, but dysreflexia results from stimuli like bladder distension. Transfusion-related complications do not typically trigger the autonomic overresponse seen in spinal cord injury patients with dysreflexia.

A. Pale thick skin B. Moon face C. Weight loss D. Hypotension

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Pale thick skin is not a typical effect of long-term corticosteroid use. Corticosteroids cause skin thinning due to reduced collagen production, leading to fragile, atrophic skin prone to bruising. Thick skin is more associated with conditions like scleroderma, not the catabolic effects of corticosteroids on skin tissue.

Choice B reason: Moon face is a classic sign of long-term corticosteroid use, resulting from fat redistribution to the face due to glucocorticoid-induced lipolysis and lipogenesis. Excess cortisol promotes fat deposition in the face and trunk, creating a rounded facial appearance, a hallmark of Cushing syndrome or iatrogenic corticosteroid effects.

Choice C reason: Weight loss is not expected with long-term corticosteroid use. Corticosteroids increase appetite and promote fat redistribution, leading to weight gain, particularly in the trunk and face. Weight loss may occur in conditions like Addison’s disease, where cortisol is deficient, not in hypercortisolism states.

Choice D reason: Hypotension is not a common effect of corticosteroids. They can cause fluid retention and increased blood volume due to mineralocorticoid activity, potentially leading to hypertension. Hypotension is more associated with adrenal insufficiency, where cortisol and aldosterone deficiencies reduce vascular tone and fluid balance.

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Which outcome indicates that treatment of a client with diabetes insipidus has been effective?

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Naxlex Comprehensive Predictor Exams

A client who suffered a spinal cord injury is experiencing an exaggerated autonomic response. What aspect of the client’s current health status is most likely to have precipitated this event?

Correct Answer is A

Explanation

A client receiving long-term treatment with high-dose corticosteroids is expected to exhibit which of the following?

Correct Answer is B

Explanation

A nurse is assisting a client who had a recent stroke with getting dressed for physical therapy. The client looks at each piece of clothing before putting it on the body. The client states, “This is how I know what item I am holding.” What impairment is this client likely experiencing?

The nurse providing care for a client with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk?

A nurse is caring for a client with Cushing’s syndrome. Which interventions would the nurse include in the client’s plan of care? (Select all that apply)

A client suffers a head injury. The nurse implements an assessment plan to monitor for potential subdural hematoma development. Which manifestation does the nurse anticipate seeing first?

Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance?

A client’s family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC?

A client is brought to the emergency department with symptoms of a cerebrovascular accident (CVA). The nurse would anticipate which diagnostic evaluation to be completed prior to initiation of treatment?

A nurse is caring for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which finding would indicate that the client has developed fluid overload?