A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L), phosphorus of 1.7 mg/dl (55 mmol/L), serum creatinine of 2.2 mg/dl (194 mmol/L). and high urine calcium. While the patient awaits surgery, the nurse should:

institute seizure precautions such as padded side rails.

assist the patient to perform range-of-motion exercises QID.

encourage the patient to drink 4000 ml of ﬂuid daily.

monitor the patient for positive Chvostek’s or Trousseaus sign.

Answer and Explanation

The Correct Answer is C

The patient with primary hyperparathyroidism has high levels of calcium in the blood (hypercalcemia) which can lead to symptoms such as kidney stones, bone pain, and weakness. High urine calcium levels may also be present due to the increased calcium in the blood.

One important intervention for managing hypercalcemia is to encourage ﬂuid intake to promote increased urine output and prevent the formation of kidney stones. Therefore, the nurse should encourage the patient to drink at least 4000 ml of ﬂuids per day.

Seizure precautions (a), range-of-motion exercises (b), and monitoring for positive Chvostek’s or Trousseaus sign (d) are not directly related to managing hypercalcemia and are not necessary in this case.

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Correct Answer is C

Explanation

Clostridium difficile is a highly contagious bacteria that can spread easily from person to person. The patient should be placed in a private room to prevent the spread of the infection to other patients. Contact isolation precautions should also be implemented, which involves wearing gloves and a gown when entering the patient's room, as well as washing hands thoroughly after leaving the room.

Options a and b are not directly related to the care of a patient with Clostridium difficile. Option d is also not directly related, although proper food handling and storage can help prevent the spread of other types of infections.

A. Excess ﬂuid volume related to intake greater than output. B. Risk for impaired skin integrity related to generalized edema. C. Activity intolerance related to muscle cramps and weakness. D. Insomnia related to waking at night to void.

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.

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A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L), phosphorus of 1.7 mg/dl (55 mmol/L), serum creatinine of 2.2 mg/dl (194 mmol/L). and high urine calcium. While the patient awaits surgery, the nurse should:

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Naxlex Comprehensive Predictor Exams

A patient who is hospitalized with abdominal pain and watery, incontinent diarrhea is diagnosed with Clostridium difficile. In planning care for the patient, the nurse will:

Correct Answer is C

Explanation

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

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A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L), phosphorus of 1.7 mg/dl (55 mmol/L), serum creatinine of 2.2 mg/dl (194 mmol/L). and high urine calcium. While the patient awaits surgery, the nurse should:

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