A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNK) is made. The nurse prepares for the administration of which initial therapy?

Administration of glucagon

Large amounts of IV saline solution

Long-acting IV insulin

Oxygen by nasal cannula

Answer and Explanation

The Correct Answer is B

B. Large amounts of IV saline solution: This is the correct initial therapy. HHNK is characterized by severe dehydration due to osmotic diuresis resulting from hyperglycemia. Therefore, the administration of large amounts of IV saline solution is essential to correct dehydration, restore intravascular volume, and improve tissue perfusion.
A. Glucagon is typically administered to treat severe hypoglycemia, not hyperglycemia.
C. Short-acting or regular insulin is administered initially to lower blood glucose levels rapidly. Long-acting insulin formulations may be used later to maintain glycemic control once the acute phase is managed.
D. Oxygen therapy may be indicated if the client is hypoxic, but it is not the initial therapy for HHNK. The priority in HHNK is to correct dehydration and hyperglycemia through fluid resuscitation and insulin therapy, respectively.

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Correct Answer is B

Explanation

B. Eating food relieves pain is typical of a duodenal ulcer. In the duodenum, food intake stimulates the release of pancreatic juices which comprises of bicarbonate. Bicarbonate neutralizes acid relieving pain.
A. Belching can help release gas from the stomach, which may provide temporary relief from pain caused by excess gastric acid irritating the ulcer.
C. Pain is aggravated by eating is typical of gastric ulcer. Food intake stimulates the secretion of gastric acid which irritates gastric ulcer aggravating pain.
D. Pain associated with duodenal ulcers typically occurs in the upper central or upper right quadrant of the abdomen.

A. Loops of large bowel become visibly outlined through the abdominal wall B. Intense thirst, parched tongue and dry mucous membranes C. Vomiting of bile-stained gastric contents D. High-pitched, frequent bowel sounds

Correct Answer is A

Explanation

A. Loops of large bowel become visibly outlined through the abdominal wall is a typical late clinical finding of a large bowel obstruction. In fact, visible loops of bowel through the abdominal wall may be observed in cases of a severe bowel obstruction, but it is not typically considered a late finding.

B. Intense thirst, parched tongue, and dry mucous membranes suggest dehydration, which can occur as a result of vomiting, decreased fluid intake, or fluid loss due to the obstruction. However, dehydration may occur earlier in the course of a bowel obstruction and may not be considered a late finding.
C. Vomiting in large bowel obstruction is commonly of fecal contents.
D. High-pitched, frequent bowel sounds is not a typical late clinical finding of a large bowel obstruction. Instead, bowel sounds are usually diminished or absent in cases of bowel obstruction due to decreased peristalsis beyond the site of obstruction.

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A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNK) is made. The nurse prepares for the administration of which initial therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is recording data obtained from a client's admission assessment. Which notation is most consistent with the presence of a duodenal ulcer? The client states that:

Correct Answer is B

Explanation

The nurse is assessing a client who has a large bowel obstruction. Which late clinical finding would the nurse expect?

Correct Answer is A

Explanation

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