CCRN Endocrine and Metabolic Crises 4

Question 1

A nurse correcting hyponatremia is careful to raise serum sodium slowly to avoid which serious complication?

Accepted Answer

Osmotic demyelination syndrome (central pontine myelinolysis)

Answer

Overly rapid correction of chronic hyponatremia causes osmotic demyelination, leading to irreversible neurologic injury.

Question 2

Central diabetes insipidus is most appropriately treated with which medication?

Accepted Answer

Desmopressin (DDAVP)

Answer

Central DI results from ADH deficiency, so synthetic ADH (desmopressin) replaces the missing hormone.

Question 3

A postoperative neurosurgical patient develops urine output of 800 mL/hr with rising serum sodium. What condition should the nurse suspect?

Accepted Answer

Diabetes insipidus

Answer

High-volume dilute urine with hypernatremia after pituitary/brain surgery strongly suggests central diabetes insipidus.

Question 4

Which finding indicates effective treatment of DKA?

Accepted Answer

Closure of the anion gap and resolution of ketosis

Answer

Resolution of DKA is defined by closure of the anion gap and clearing of ketones, not glucose alone.

Question 5

A patient in adrenal crisis is most likely to display which electrolyte pattern?

Accepted Answer

Hyponatremia and hyperkalemia

Answer

Aldosterone deficiency in adrenal crisis causes sodium loss and potassium retention, producing hyponatremia and hyperkalemia.

CCRN Review Practice Test