A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of type 1 diabetes?
Hypernatremia
Decreased serum osmolality
Ketones in the urine
Hypoglycemia
The Correct Answer is C
Rationale:
A. Hypernatremia: While mild hypernatremia can occur in severe dehydration, it is not a defining or consistent feature of type 1 diabetes. Electrolyte imbalances may vary depending on hydration and glucose levels.
B. Decreased serum osmolality: In type 1 diabetes, serum osmolality is typically increased due to hyperglycemia and the osmotic effect of glucose in the bloodstream, which draws water out of cells and into the vascular space. A decrease would be inconsistent with the expected metabolic state.
C. Ketones in the urine: Ketones in the urine are a hallmark of type 1 diabetes, especially when insulin is deficient. Without insulin, the body breaks down fat for energy, producing ketones as a byproduct, which can be detected in the urine during diabetic ketoacidosis.
D. Hypoglycemia: Hypoglycemia is a complication of diabetes management, often resulting from too much insulin or missed meals. It is not a presenting manifestation of newly diagnosed type 1 diabetes, which typically presents with hyperglycemia and related symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Report of itching: Itching is a common early sign of an allergic transfusion reaction. These reactions occur due to sensitivity to plasma proteins in the donor blood and may also present with hives, flushing, or mild respiratory symptoms.
B. Distended jugular veins: Jugular vein distention is a sign of fluid overload or circulatory compromise, such as transfusion-associated circulatory overload (TACO), not an allergic reaction.
C. Report of low back pain: Low back pain is more indicative of an acute hemolytic reaction, which results from ABO incompatibility. This is a serious and life-threatening reaction distinct from allergic responses.
D. Temperature 37.8° C (100° F): A mild elevation in temperature may be seen with febrile non-hemolytic transfusion reactions, which are different from allergic reactions. Allergic reactions usually involve skin and respiratory symptoms.
Correct Answer is C
Explanation
Rationale:
A. Administer vasopressin to the client: Vasopressin is used to constrict splanchnic circulation and reduce portal pressure, helping control variceal bleeding. However, medication administration requires functional IV access, which must be verified or established before proceeding.
B. Request blood from the blood bank: Blood transfusion is necessary to treat hemorrhagic shock and restore circulating volume, but requesting blood is not the immediate priority before ensuring access for administration.
C. Verify that the client has adequate IV access: Establishing or verifying large-bore IV access is the first priority in any client experiencing hemorrhagic shock. This enables the rapid infusion of fluids, blood products, and medications necessary to stabilize the client.
D. Insert an indwelling urinary catheter: Monitoring urine output is important for assessing renal perfusion and fluid status, but it is not the most urgent intervention when the client is actively bleeding and hemodynamically unstable.
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