A nurse is assessing a client with suspected diabetic ketoacidosis (DKA). Which laboratory finding is most indicative of this condition?
Blood pH of 7.45
Serum bicarbonate of 12 mEq/L
Blood glucose of 200 mg/dL
Serum potassium of 5.5 mEq/L
The Correct Answer is B
Choice A reason: A blood pH of 7.45 is normal or slightly alkalotic, not indicative of DKA, which causes metabolic acidosis due to ketone accumulation. DKA typically presents with a pH below 7.35, reflecting acid-base imbalance from ketoacid production, making this finding inconsistent with DKA.
Choice B reason: A serum bicarbonate of 12 mEq/L indicates metabolic acidosis, a hallmark of DKA. Ketoacids produced from fat metabolism in uncontrolled hyperglycemia consume bicarbonate, lowering its levels, confirming DKA’s acid-base disturbance and making this the most indicative laboratory finding.
Choice C reason: A blood glucose of 200 mg/dL is elevated but not specific to DKA, which typically involves glucose levels above 250 mg/dL, often much higher. This level could indicate hyperglycemia but does not confirm the severe metabolic acidosis characteristic of DKA.
Choice D reason: Serum potassium of 5.5 mEq/L suggests hyperkalemia, common in DKA due to acidosis shifting potassium extracellularly. However, it is less specific than low bicarbonate, as hyperkalemia can occur in other conditions, and bicarbonate directly reflects DKA’s acidotic state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Oral analgesics are less effective in acute pancreatitis due to severe pain and potential gastric dysmotility from inflammation. IV opioids provide faster, more reliable pain relief, as oral absorption may be impaired, making this a less appropriate choice for acute pain management.
Choice B reason: A high-fiber diet is contraindicated in acute pancreatitis, as it stimulates digestion, increasing pancreatic enzyme secretion and worsening inflammation and pain. Patients are typically kept NPO (nothing by mouth) to rest the pancreas, making this an inappropriate intervention for pain control.
Choice C reason: IV opioid analgesics, such as morphine or fentanyl, are the preferred treatment for severe pain in acute pancreatitis. They provide rapid, effective analgesia by acting on central pain receptors, reducing discomfort without stimulating pancreatic activity, making this the priority intervention for pain management.
Choice D reason: Applying a warm compress to the abdomen is contraindicated, as heat may increase inflammation and blood flow to the pancreas, worsening pain and tissue damage. Pain management in pancreatitis relies on pharmacological interventions, making this an incorrect and potentially harmful action.
Correct Answer is C
Explanation
Choice A reason: Gestational diabetes involves insulin resistance due to placental hormones, not primarily beta cell failure to respond to insulin. It occurs during pregnancy and usually resolves post-delivery, making it distinct from type 2 diabetes, where insulin resistance and beta cell dysfunction are chronic.
Choice B reason: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency, not beta cells failing to respond to insulin. The lack of insulin production distinguishes it from type 2, where insulin resistance is the primary issue.
Choice C reason: Type 2 diabetes is characterized by insulin resistance, where peripheral tissues and beta cells fail to respond effectively to insulin, combined with progressive beta cell dysfunction. This leads to relative insulin deficiency, making this the correct diagnosis for the described pathophysiology.
Choice D reason: Impaired glucose tolerance is a prediabetic state with elevated glucose levels but not yet meeting diabetes criteria. It involves mild insulin resistance but not significant beta cell failure to respond to insulin, distinguishing it from established type 2 diabetes with more pronounced dysfunction.
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