A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

Decreasing serum sodium

Decreasing blood glucose

Decreasing serum potassium

Increasing urinary output

Answer and Explanation

The Correct Answer is D

One of the hallmarks of adrenal insufficiency is dehydration and decreased urinary output, which can lead to electrolyte imbalances such as hyperkalemia and hyponatremia. As treatment begins to take eﬀect, the patient's ﬂuid and electrolyte balance should improve, leading to an increase in urinary output. Acute adrenal insufficiency, also known as the Addisonian crisis, is a life-threatening condition caused by a sudden decrease in cortisol and aldosterone hormones. Treatment usually involves the administration of intravenous glucocorticoids and mineralocorticoids to replace the deficient hormones.
Decreasing serum sodium (a) and decreasing blood glucose (b) are not signs of improvement but rather indicative of continued adrenal insufficiency. Decreasing serum potassium (c) is also not a sign of improvement as it could indicate that the patient is developing hyperkalemia, which is a potential complication of adrenal crisis.

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Correct Answer is A

Explanation

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia are the main reasons for initiating cardiac monitoring in patients with diabetic ketoacidosis. In diabetic ketoacidosis, insulin deficiency causes the body to break down fat for energy, leading to the production of ketones and resulting in metabolic acidosis. In addition, glucose and potassium are lost in the urine due to osmotic diuresis. Hypokalemia can cause ECG changes and dysrhythmias, which can be life-threatening.

Hypokalemia is a common complication of DKA and can lead to ECG changes such as ST-segment depression, T-wave inversion, and U waves².

Hypovolemic shock related to osmotic diuresis is an important consideration in the management of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia is not a common complication of diabetic ketoacidosis, and it is not the primary reason for initiating cardiac monitoring.

Fluid overload resulting from aggressive ﬂuid replacement is a potential complication of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

A. Provide three large meals a day. B. Observe stool characteristics. C. Evaluate intake and output. D. Monitor laboratory reports of electrolytes.

Correct Answer is A

Explanation

Clients with acute gastritis are recommended to eat smaller, frequent meals instead of three large meals. This helps to reduce the workload on the digestive system and allows the stomach to heal. Therefore, option A is not a suitable nursing intervention for a client with acute gastritis.

Options b, c, and d are all appropriate nursing interventions for a client with acute gastritis. Observing stool characteristics can help to identify any bleeding or inﬂammation in the gastrointestinal tract, evaluating intake and output can help to identify any ﬂuid imbalances, and monitoring laboratory reports of electrolytes can help to identify any imbalances that may occur because of vomiting or diarrhea.

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A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

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Naxlex Comprehensive Predictor Exams

Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

Correct Answer is A

Explanation

A nurse is planning care for a client who has acute gastritis. Which of the following nursing interventions should NOT be included in the plan of care?

Correct Answer is A

Explanation

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