Practice Quiz

NCLEX-RN

Category - Physiological

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Marcus, a 39-year-old lawyer, was rushed to the emergency department because of a stroke. The patient was assigned to a newly hired nurse. The client was unconscious. An indwelling catheter was inserted and the client was hooked to a cardiac monitor. Before the end of shift report, the nurse notes a urine output of 400 ml in four hours. Which of the following documentation would show appropriate management of this client?
  1. Urine output 400 ml in four hours; checked for hyperglycemia.
  2. Decreased IV fluid rate.
  3. Monitored for decreased urine specific gravity.
  4. Monitored for lightheadedness and weakness.
Explanation
Answer: C - Clients with diabetes insipidus, manifested by excessive urination, should be monitored for decreased urine specific gravity. Excessive urination of up to 400ml in four hours is rare in hyperglycemia. Since there is increased urination, the client is at risk for fluid volume deficit; IV fluid should be regulated appropriately. Lightheadedness and weakness are key findings in diabetes insipidus; the nurse should ensure the client’s safety at all times.
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