A patient is admitted to the hospital in Addisonian Crisis a month after a diagnosis of Addison’s disease. The nurse identifies the nursing diagnosis of ineﬀective therapeutic regimen management related to lack of knowledge of management of the condition when the patient says:

“I double my dose of hydrocortisone on the days that I go for a run.”

“I had the stomach ﬂu earlier this week and couldn't take the hydrocortisone.”

“I frequently eat at restaurants, and so my food has a lot of added salt."

“I do yoga exercises almost every day to help me reduce stress and relax.”

Answer and Explanation

The Correct Answer is B

The statement "I had the stomach ﬂu earlier this week and couldn't take the hydrocortisone" indicates that the patient may not be adhering to their prescribed medication regimen, which can lead to an Addisonian crisis. Therefore, the nursing diagnosis of ineﬀective therapeutic regimen management related to lack of knowledge of management of the condition is appropriate.

Addison’s disease is a condition in which the adrenal glands do not produce enough cortisol and aldosterone. Hydrocortisone is a glucocorticoid medication that is often used to replace the cortisol that the adrenal glands are not producing. In the Addisonian crisis, the body is unable to produce the necessary levels of cortisol and aldosterone, which can lead to potentially life-threatening complications such as hypotension, dehydration, and electrolyte imbalances.

The other statements may indicate areas where patient education is needed, but they do not directly relate to the immediate risk of an Addisonian crisis.

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Correct Answer is A

Explanation

Excess ﬂuid volume related to intake greater than output would be the most appropriate nursing diagnosis for a patient with symptoms of DI (diabetes insipidus). This condition results in excessive urine output and, as a consequence, can lead to dehydration and electrolyte imbalances. Therefore, monitoring and managing ﬂuid volume is a priority for patients with DI.

Risk for impaired skin integrity related to generalized edema is more commonly associated with conditions that cause ﬂuid retention such as heart failure, liver failure, or kidney disease, rather than DI.

Activity intolerance related to muscle cramps and weakness is a possible nursing diagnosis for patients with conditions that aﬀect muscle function, such as muscular dystrophy or multiple sclerosis, but not specifically for DI.

Insomnia related to waking at night to void is more commonly associated with urinary frequency or nocturia due to conditions such as urinary tract infections or benign prostatic hyperplasia, but not specifically for DI.

A. These injections will increase the hydrochloric acid in my stomach: B. The cobalamin injections need to be taken until my inﬂamed stomach heals. C. The cobalamin injections will prevent me from becoming anemic. D. These injections will decrease my risk for developing Stomach cancer.

Correct Answer is C

Explanation

The correct answer is choicec. The cobalamin injections will prevent me from becoming anemic.

Choice A rationale:

Cobalamin (B12) injections do not increase hydrochloric acid production in the stomach.Chronic atrophic gastritis often leads to decreased production of hydrochloric acid due to the loss of parietal cells, but B12 injections do not reverse this condition.

Choice B rationale:

The need for cobalamin injections is typically lifelong in patients with chronic atrophic gastritis because the condition leads to a permanent loss of intrinsic factor, which is necessary for B12 absorption. The injections are not just until the stomach heals.

Choice C rationale:

Chronic atrophic gastritis can lead to vitamin B12 deficiency due to the loss of intrinsic factor, which is essential for B12 absorption.This deficiency can cause pernicious anemia, and B12 injections are necessary to prevent this condition.

Choice D rationale:

While chronic atrophic gastritis does increase the risk of stomach cancer, B12 injections are not specifically aimed at reducing this risk.The primary purpose of B12 injections is to prevent anemia.

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A patient is admitted to the hospital in Addisonian Crisis a month after a diagnosis of Addison’s disease. The nurse identifies the nursing diagnosis of ineﬀective therapeutic regimen management related to lack of knowledge of management of the condition when the patient says:

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Naxlex Comprehensive Predictor Exams

The nurse is creating the care plan for a patient with symptoms of DI who was admited to the hospital for evaluation and treatment of the condition. An appropriate nursing diagnosis for the patient is:

Correct Answer is A

Explanation

A patient with chronic atrophic gastritis was prescribed monthly Cobalamin (B12) injections The determines that teaching regarding the injections has been eﬀective when the patient States:

Correct Answer is C

Explanation

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