A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 100 mg/dl. Which of the following interventions should the nurse initiate first?

Potassium chloride 10 mEq/hr

Bicarbonate by IV infusion

Subcutaneous insulin injections

0.99% sodium chloride 15 mL/kg/hr

Answer and Explanation

The Correct Answer is D

A. Potassium chloride 10 mEq/hr:
While potassium replacement is crucial in DKA, initiating it before fluid resuscitation can lead to further complications. Insulin administration can drive potassium back into cells, potentially causing hypokalemia. Fluid resuscitation helps address dehydration and electrolyte imbalances.
B. Bicarbonate by IV infusion:

Bicarbonate therapy is generally reserved for severe cases of acidosis, and its use in DKA is controversial. In this scenario, the blood glucose level is not significantly elevated, and the focus should be on fluid resuscitation and insulin administration.
C. Subcutaneous insulin injections:
While insulin is a critical component of DKA management, it should be administered intravenously for faster and more precise control of blood glucose levels. Subcutaneous insulin injections are not the initial route of administration in DKA.
D. 0.9% sodium chloride 15 mL/kg/hr:
This is the correct answer. The first step in DKA management is fluid resuscitation with isotonic saline (0.9% sodium chloride). The goal is to address dehydration, restore intravascular volume, and improve perfusion. Insulin therapy and other interventions follow fluid resuscitation.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

A. Oxygen saturation 96%:
Oxygen saturation at 96% is within the normal range and may not be directly influenced by the infusion of albumin. Albumin administration is more related to improving intravascular volume and blood pressure.
B. PaCO2 30 mm Hg:
The partial pressure of carbon dioxide (PaCO2) is a measure of respiratory status. Albumin infusion is not directly associated with changes in PaCO2.
C. Decrease in protein:
Albumin is a protein, and its infusion would not lead to a decrease in protein levels. In fact, albumin administration increases the oncotic pressure in the intravascular space, helping to retain fluid and improve blood volume.
D. Increase in BP:
This is the correct answer. Albumin is a colloid solution that increases oncotic pressure in the bloodstream. By increasing oncotic pressure, albumin helps to draw fluid from the interstitial space into the vascular space, thereby increasing blood volume. This can contribute to an increase in blood pressure, which is a desired effect in the management of shock.

A. "Limit your sodium intake. B. Avoid caffeinated beverages C. Take the medication with meals. D. Restrict milk products

Correct Answer is B

Explanation

A. Limit your sodium intake: While excessive sodium intake may be a concern for individuals with certain health conditions, there is no specific restriction on sodium intake associated with theophylline use. This instruction is not directly relevant to theophylline therapy.
B. Avoid caffeinated beverages (Correct Answer): Caffeine can increase the risk of theophylline toxicity by enhancing its effects. Theophylline is metabolized in the liver, and caffeine can interfere with this process. Therefore, it is advisable for individuals taking theophylline to avoid excessive consumption of caffeinated beverages.
C. Take the medication with meals: Theophylline is often prescribed on an empty stomach because food can decrease its absorption. However, the specific recommendation may vary based on the formulation of the medication. It is important to follow the healthcare provider's instructions regarding when to take theophylline in relation to meals.
D. Restrict milk products: There is no general restriction on milk products associated with theophylline use. However, it's important to note that high-fat meals may affect the absorption of theophylline, so individualized instructions from the healthcare provider should be followed.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 100 mg/dl. Which of the following interventions should the nurse initiate first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect

Correct Answer is D

Explanation

A nurse is providing discharge dietary teaching to a client who has a new prescription for theophylline. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving 0.9% sodium chloride solution to treat dehydration. Which of the following findings should the nurse identify as an adverse effect of the solution?

A nurse is caring for a client who has pancreatic cancer and reports severe pain. Which of the following medications should the nurse expect in administer?

A nurse is caring for a client who is receiving ceftriaxone intravenously. Which of the following manifestations should the nurse identify as an allergic reaction?

A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider?

A nurse is reviewing the medication list of a client who has erectile dysfunction and is requesting a prescription for sildenafil. The nurse should identify that which of the following medications is a contraindication for receiving this medication?

A nurse on a medical-surgical unit is preparing to administer an influenza vaccine to a client. The client tells the nurse. "I no longer want to receive this vaccine." Which of the following responses should the nurse make?

A nurse is providing discharge teaching to a client who has a new prescription for furosemide. Which of the following instructions should the nurse include in the teaching?

A nurse is teaching a class about administering IV fluids to treat dehydration. The nurse should include in the teaching that which of the following laboratory values indicates effective treatment of dehydration?