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MSN Exam for Diabetes Insipidus

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1) Cyrill behind a season cutting guide trauma sustained in a car garb is admitted to the intensive foresight ace. Thirty-six hours succeeding, the client’s urine output suddenly rises over 200 ml/hour, innate the nurture to doubt diabetes insipidus. Which laboratory findings food the nurture’s jealousy of diabetes insipidus?

  1. Above-recognized urine and serum osmolality razes
  2. Below-recognized urine and serum osmolality razes
  3. Above-recognized urine osmolality raze, below-recognized serum osmolality raze
  4. Below-recognized urine osmolality raze, over-recognized serum osmolality raze
2) The garbage of dainty for accessible diabetes insipidus is desmopressin (DDAVP). What isthis garbage’s means of enjoyment?
  1. Mimics vasopressin and increases kinsfolk steep reabsorption
  2. Blocks vasopressin and increases kinsfolk steep reabsorption
  3. Mimics vasopressin and increases kinsfolk salt excretion
  4. Blocks vasopressin and increases kinsfolk salt excretion
3) The nurture is assessing a postcraniotomy client and finds the urine output from a catheter is 1500 ml for the 1st hour and the selfselfcorresponding for the 2nd hour. The nurture should doubt:
  1. Cushing’s syndrome
  2. Diabetes mellitus
  3. Adrenal turning-point
  4. Diabetes insipidus
4) A 67-year-old manly client has been peevish of slumbering over, increased urination, anorexia, frailty, susceptibility, valley, and annoyance trouble that interferes behind a season her going outdoors. Based on these toll findings, nurture Richard would doubt which of the subjoined disorders?
  1. Diabetes mellitus
  2. Diabetes insipidus
  3. Hypoparathyroidism
  4. Hyperparathyroidism
5) What garbages antagonize the effects of ADH on the renal tubules, and thus could motivenephrogenic diabetes insipidus?
  1. Bromocryptine and cabergoline
  2. Hydrochlorothiazide and furosemide
  3. Cimetidine and verapamil
  4. Lithium and demeclocycline
  5. Acetaminophen and isoniazid
6) Damage to what organ would motive accessible diabetes insipidus?
  1. Kidneys
  2. Hypothalamus
  3. Thyroid
  4. Parathyroid
  5. Pituitary
7) To perpetuate accessible diabetes insipidus, post-injection (desmopressin) urine osmolarityshould be what percentage of pre-injection osmolarity?
  1. < 50%
  2. < 75%
  3. 100% (equal)
  4. > 125%
  5. > 150%
8) A control nursing cue for a client admitted to the hospital behind a season a personality of diabetes insipidus is:
  1. Sleep pur-pose donation kindred nocturia
  2. Activity pharisaism r/t muscle frailty
  3. Fluid work redundancy r/t intake superior that output
  4. Risk for impaired bark honor r/t generalized edema
9) What are the usual presenting signs of diabetes insipidus?
  1. Hyperglycemia and polyuria
  2. Periorbital ecchymosis and blurred vision
  3. Polyuria and polydipsia
  4. Oliguria and hypoglycemia
  5. Weight find and malaise
10) What electrolyte abnormalities can motive diabetes insipidus?
  1. Hypercalcemia and hyperkalemia
  2. Hypercalcemia and hypokalemia
  3. Hypocalcemia and hyperkalemia
  4. Hypocalcemia and hypokalemia
11) Nurture Louie is developing a training pur-pose for a manly client diagnosed behind a season diabetes insipidus. The nurture should apprehend knowledge environing which hormone scant in clients behind a season diabetes insipidus?
  1. antidiuretic hormone (ADH).
  2. thyroid-stimulating hormone (TSH).
  3. follicle-stimulating hormone (FSH).
  4. luteinizing hormone (LH).
12) A manly client behind a season first diabetes insipidus is opportune for execute on desmopressin (DDAVP). Which direction should nurture Lina stipulate?
  1. “Administer desmopressin season the suspension is composed.”
  2. “Your stipulation isn’t continuous, so you won’t want to teach a medical identification bracelet.”
  3. “You may not be effectual to use desmopressin nasally if you keep nasal execute or blockage.”
  4. “You won’t want to mentor your flowing intake and output behind you initiate prelude desmopressin.”
13) You are preparing a 24-year-old resigned behind a season diabetes insipidus (DI) for execute from the hospital. Which proposition shows that the resigned wants appended training?
  1. “I gain absorb flowings resembling to the totality of my urine output.”
  2. “I gain inspect myself full day using the selfselfcorresponding layer.”
  3. “I gain teach my medical prompt bracelet at all spells.”
  4. “I gain spiritual disaffect myself off the vasopressin.”
14) Which of the subjoined is most entreative of psychogenic polydipsia, not diabetesinsipidus?
  1. Nocturia
  2. Constant symptoms
  3. 24-hour urine output > 18L
  4. Plasma osmolarity > 295mOsm/kg
  5. Plasma osmolarity < 280mOsm/kg behind a steep donation test
15) A client is doubted of developing diabetes insipidus. Which of the subjoined is the most servicepowerful toll?
  1. Taking material signs full 4 hours
  2. Monitoring race glucose
  3. Assessing ABG values full other day
  4. Measuring urine output hourly
16) A client behind a season diabetes insipidus is prelude Desmopressin acetate (DDAVP). To particularize if the garbage is serviceable, the nurture should mentor the client’s:
  1. Arterial race pH
  2. Pulse reprove
  3. Serum glucose
  4. Intake and output
17) Which effect shows that texture of a manly client behind a season diabetes insipidus has been serviceable?
  1. Fluid intake is hither than 2,500 ml/day.
  2. Urine output measures over than 200 ml/hour.
  3. Blood hurry is 90/50 mm Hg.
  4. The courage reprove is 126 beats/minute.
18) Extensive flowing vindication and vasopressin vindication are objectives of therapy for which of the subjoined malady processes?
  1. Diabetes mellitus.
  2. Diabetes insipidus.
  3. Diabetic ketoacidosis.
  4. Syndrome of irrelevant antidiuretic hormone secretion (SIADH).
19) The client behind a season a narrative of diabetes insipidus is admitted behind a season polyuria, polydipsia, and intellectual laziness. The control intercession for this client is:
  1. Measure the urinary output
  2. Check the material signs
  3. Encourage increased flowing intake
  4. Weigh the client
20) When caring for a manly client behind a season diabetes insipidus, nurture Juliet wait-fors to control:
  1. vasopressin (Pitressin Synthetic).
  2. furosemide (Lasix).
  3. regular insulin.
  4. 10% dextrose.
Answers and Rationales
  1. D. Below-recognized urine osmolality raze, over-recognized serum osmolality raze. In diabetes insipidus, redundancyive polyuria motives impair urine, fruiting in a below-recognized urine osmolality raze. At the selfselfcorresponding spell, polyuria depletes the association of steep, causing dehydration that leads to an over-recognized serum osmolality raze. For the selfselfcorresponding reasons, diabetes insipidus doesn’t motive over-recognized urine osmolality or below-recognized serum osmolality razes.
  2. A. Mimics vasopressin and increases kinsfolk steep reabsorption 
  3. D. Diabetes insipidus. Diabetes insipidus is an quick onset of terminal polyuria that frequently occurs in clients behind brain surgery. Cushing’s syndrome is redundancyive glucocorticoid secretion fruiting in sodium and steep claim. Diabetes mellitus is a hyperglycemic set-forth remarkpowerful by polyuria, polydipsia, and polyphagia. Adrenal turning-point is undersecretion of glucocorticoids fruiting in deepseated hypoglycemia, hypovolemia, and hypotension.
  4. D. Hyperparathyroidism. Hyperparathyroidism is most spirithither in older women and is characterized by annoyance trouble and frailty from redundancy parathyroid hormone (PTH). Clients so teach hypercaliuria-causing polyuria. Season clients behind a season diabetes mellitus and diabetes insipidus so keep polyuria, they don’t keep annoyance trouble and increased slumbering. Hypoparathyroidism is characterized by urinary quantity rather than polyuria.
  5. D. Lithium and demeclocycline 
  6. E. Pituitary
  7. E. > 150%
  8. B. Disembodiment pharisaism r/t muscle frailty 
  9. A. Hyperglycemia and polyuria 
  10. B. Hypercalcemia and hypokalemia 
  11. A. antidiuretic hormone (ADH). ADH is the hormone clients behind a season diabetes insipidus bankruptcy. The client’s TSH, FSH, and LH razes won’t be abnormal.
  12. C. “You may not be effectual to use desmopressin nasally if you keep nasal execute or blockage.” Desmopressin may not be eager if the intranasal way is implicated. Although diabetes insipidus is speakable, the client should teach medical identification and propel medication at all spells to prompt medical personnel in an casualty and particularize fair texture. The client must live to mentor flowing intake and output and take extensive flowing vindication.
  13. D. “I gain spiritual disaffect myself off the vasopressin.” The resigned behind a season persistent DI requires life-long vasopressin therapy. All of the other propositions are misapply to the residence foresight of this resigned. Focus: Prioritization
  14. C. 24-hour urine output > 18L 
  15. D. Measuring urine output hourly. Measuring the urine output to expose redundancy totality and checking the inequitable starch of urine samples to particularize urine strain are misapply measures to particularize the onset of diabetes insipidus.
  16. D. Intake and output . DDAVP replaces the ADH, facilitating reabsorption of steep and attendant requite of recognized urine output and dryness.
  17. A. Flowing intake is hither than 2,500 ml/day. Diabetes insipidus is characterized by polyuria (up to 8 L/day), uniform dryness, and an unusually noble traditional intake of flowings. Texture behind a season the misapply garbage should wane twain traditional flowing intake and urine output. A urine output of 200 ml/hour shows abiding polyuria. A race hurry of 90/50 mm Hg and a courage reprove of 126 beats/minute show restitution for the lived flowing deficit, suggesting that texture hasn’t been serviceable.
  18. B. Diabetes insipidus. Maintaining extensive flowing and replacing vasopressin are the ocean objectives in speaking diabetes insipidus. An redundancy of antidiuretic hormone leads to SIADH, causing the resigned to restrain flowing. Diabetic ketoacidosis is a fruit of cutting insulin lack.
  19. B. Check the material signs . The catholic totality of flowing privation can motive flowing and electrolyte imbalance that should be reformed. The privation of electrolytes would be reflected in the material signs. Measuring the urinary output is great, but the root alopportune says that the client has polyuria. Encouraging flowing intake gain not reform the completion, .Weighing the client is not requisite at this spell.
  20. A. vasopressin (Pitressin Synthetic). Bemotive diabetes insipidus fruits from waned antidiuretic hormone (vasopressin) genesis, the nurture should wait-for to control synthetic vasopressin for hormone vindication therapy. Furosemide, a diuretic, is contraindicated bemotive a client behind a season diabetes insipidus experiences polyuria. Insulin and dextrose are used to speak diabetes mellitus and its complications, not diabetes insipidus.

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