A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?

Desmopressin acetate

Spironolactone

Furosemide

Dopamine

Answer and Explanation

The Correct Answer is A

A. Desmopressin acetate: This synthetic form of antidiuretic hormone (ADH) reduces excessive urine output by increasing water reabsorption in the kidneys. It helps restore fluid balance and prevent dehydration in diabetes insipidus. Without treatment, continued polyuria can lead to severe dehydration and electrolyte imbalances.

B. Spironolactone: This potassium-sparing diuretic promotes sodium and water excretion by blocking aldosterone receptors. It is used to treat conditions like heart failure and hyperaldosteronism but would worsen polyuria and dehydration in diabetes insipidus.

C. Furosemide: This loop diuretic inhibits sodium and chloride reabsorption in the kidneys, leading to increased urine output. Administering it to a client with diabetes insipidus would further aggravate excessive fluid loss and the risk of dehydration.

D. Dopamine: This vasopressor is used to improve cardiac output and blood pressure in conditions like shock. It does not affect ADH levels or urine concentration and would not help manage the excessive diuresis seen in diabetes insipidus.

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Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"C"}}

Explanation

Indication of potential improvement:
• Shortness of breath with exertion
• Lung sounds clear

Indication of potential worsening condition:
• WBC count 11,800/mm³
• Temperature 38.5°C (101.3°F)
• Weight 113 kg (249 lb)
• Creatinine 1.8 mg/dL

Rationale:

• Shortness of breath with exertion: Previously, the client had dyspnea at rest. Improvement to exertional dyspnea suggests better fluid balance and cardiac function.

• Lung sounds clear: The initial presence of crackles indicated pulmonary congestion. Clear lung sounds suggest reduced fluid overload, reflecting improved cardiac function.

• WBC count 11,800/mm³: An increasing WBC count suggests a possible infection, which can worsen heart failure by increasing metabolic demands and fluid retention.

• Temperature 38.5°C (101.3°F): Fever indicates a possible infection, such as a UTI, which the client has a history of. Infections can exacerbate heart failure by triggering systemic inflammation and fluid shifts.

• Weight 113 kg (249 lb): Weight gain in heart failure is often due to fluid retention, indicating worsening congestion.

• Creatinine 1.8 mg/dL: A rising creatinine level suggests worsening kidney function, which may result from reduced perfusion due to heart failure or excessive diuresis from furosemide.

A. Blood pressure 108/62 mm Hg B. Potassium 3.5 mEq/L (3.5 to 5 mEq/L) C. Frequent, nonproductive cough D. Frequent, painless urination

Correct Answer is C

Explanation

A. Blood pressure 108/62 mm Hg: Lisinopril is an antihypertensive, and a systolic BP above 90 mm Hg is typically not considered an adverse effect. Hypotension can occur but is more concerning if it results in symptoms such as dizziness or syncope.

B. Potassium 3.5 mEq/L (3.5 to 5 mEq/L): Lisinopril can cause hyperkalemia, but a potassium level of 3.5 mEq/L is within the normal range. Monitoring potassium levels is essential, but this finding does not indicate an adverse effect.

C. Frequent, nonproductive cough: A dry, persistent cough is a common adverse effect of lisinopril due to the accumulation of bradykinin. It often does not resolve until the medication is discontinued or switched to an alternative, such as an angiotensin receptor blocker (ARB).

D. Frequent, painless urination: Lisinopril does not typically cause increased urination. While it affects renal function, it is more likely to lead to hyperkalemia or reduced glomerular filtration rate in susceptible individuals.

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A nurse is caring for a client who has diabetes insipidus and has had a urinary output of 3,000 mL in the past 12 hr. Which of the following medications should the nurse expect to administer to the client?

Nursing Test Bank

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A nurse is caring for a client who is experiencing an exacerbation of heart failure. Findings upon admission: The nurse is assessing the client 24 hr later. How should the nurse interpret the findings related to the diagnosis of heart failure?

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"C"}}

Explanation

A nurse is assessing a client who is taking lisinopril. Which of the following findings should the nurse document in the client's medical record as an adverse effect?

Correct Answer is C

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