A client who has small cell carcinoma of the lung is admitted with symptoms of syndrome of inappropriate antidiuretic hormone (SIADH). As the client responds to treatment, the client's serum sodium level increases from 120 mEq/L (120 mmol/L) to 125 mEq/L (125 mmol/L). Based on this finding, which intervention should the nurse implement?Reference Range:

Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Assess for increasing fluid volume overload.

Withhold next scheduled dose of treatment.

Increase neurologic checks to every 2 hours.

Maintain the prescribed fluid restriction.

Answer and Explanation

The Correct Answer is D

A. Assessing for increasing fluid volume overload is not indicated with a rising serum sodium level; instead, it suggests correction of hyponatremia, a common complication of SIADH.

B. Withholding the next scheduled dose of treatment is not appropriate based solely on a rise in serum sodium level within the normal range.

C. Increasing neurologic checks may be necessary in severe cases of hyponatremia but is not directly indicated by a rise in serum sodium within the normal range.

D. Maintaining the prescribed fluid restriction is essential to prevent further dilutional hyponatremia and to help normalize the serum sodium level gradually.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Crohn's disease with colectomy. Peritoneal dialysis involves instilling dialysis fluid into the peritoneal cavity, and conditions that affect the integrity or function of the peritoneum, such as Crohn's disease with colectomy, can be contraindications due to the risk of infection or inadequate dialysis.

B. Latent hepatitis C is not a contraindication for peritoneal dialysis, although active hepatitis C infection may be a concern due to increased risk of peritonitis.

C. Type 2 diabetes mellitus is not a contraindication for peritoneal dialysis; in fact, it is a common cause of end-stage renal disease and may necessitate dialysis.

D. Nephrotic syndrome history is not a contraindication for peritoneal dialysis; in fact, peritoneal dialysis may be indicated in some cases of renal failure associated with nephrotic syndrome.

A. Protect the skin of the radiation portal site from sunlight exposure. B. Avoid washing the skin inside the radiation portal site. C. Remove the ink marks of the portal after each radiation treatment. D. Apply moisture lotions daily to the radiation portal site.

Correct Answer is A

Explanation

A. Protecting the skin of the radiation portal site from sunlight exposure is crucial to prevent further damage to the irradiated area, as the skin becomes more sensitive during radiation therapy.

B. Washing the skin inside the radiation portal site should be done gently with mild soap and water, as directed by the healthcare provider, to maintain cleanliness and prevent infection. However, excessive rubbing or scrubbing should be avoided to minimize irritation.

C. The ink marks of the portal are used as reference points for accurate delivery of radiation and should not be removed until instructed by the healthcare provider or radiation therapist.

D. Moisturizing the radiation portal site can help alleviate dryness and discomfort associated with radiation therapy, but it should be done sparingly and with products recommended by the healthcare provider to avoid potential interactions or interference with the treatment.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?

Correct Answer is A

Explanation

The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which instruction regarding skin care of the portal site should the nurse provide?

Correct Answer is A

Explanation

Which dietary instruction is most important for the nurse to explain to a client who has had gastric bypass surgery?

The nurse is caring for a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain?

The nurse assists a client with Parkinson's disease to ambulate in the hallway. The client appears to "freeze" and then carefully lifts one leg and steps forward. The client tells the nurse of pretending to step over a crack on the floor. How should the nurse respond?

The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?

The nurse assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory result should the nurse review?

The nurse is teaching a client with glomerulonephritis about self care. Which dietary recommendation should the nurse encourage the client to follow?