A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Blood glucose level below 40 mg/dL

Malignant hypertension

Cheyne-Stokes breathing

Acetone odor to breath

Answer and Explanation

The Correct Answer is D

A. Blood glucose level below 40 mg/dL: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, typically with blood glucose levels significantly elevated above normal, often exceeding 250 mg/dL. A glucose level below 40 mg/dL would indicate hypoglycemia, which is not a feature of DKA.

B. Malignant hypertension: Malignant hypertension is a condition characterized by extremely high blood pressure and is not directly associated with DKA. DKA primarily involves issues with glucose and acid-base balance rather than hypertension.

C. Cheyne-Stokes breathing: Cheyne-Stokes breathing is a specific pattern of periodic breathing typically seen in severe neurologic conditions or heart failure, not in DKA. DKA is associated with Kussmaul breathing, which is deep and rapid breathing as the body attempts to compensate for metabolic acidosis.

D. Acetone odor to breath: An acetone (fruity) odor to the breath is a classic sign of DKA due to the presence of ketones in the blood and urine. This occurs because the body is breaking down fatty acids for energy, leading to the production of ketones, which are then excreted through the breath and urine.

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Correct Answer is A

Explanation

A. Hepatomegaly: Hepatomegaly, or enlargement of the liver, is a common finding in right-sided heart failure due to congestion of the liver from impaired venous return. It indicates systemic venous congestion.

B. Crackles in the lungs: Crackles in the lungs are more commonly associated with left-sided heart failure, which leads to pulmonary congestion. Right-sided heart failure primarily causes systemic venous congestion rather than pulmonary issues.

C. Dry, hacking cough: A dry, hacking cough is not typically associated with right-sided heart failure. It is more related to left-sided heart failure or other pulmonary conditions.

D. Dizziness: Dizziness can occur in various conditions, including heart failure, but it is not a specific finding for right-sided heart failure. It is often due to decreased cardiac output or orthostatic hypotension.

A. Dry skin B. Heat intolerance C. Drowsiness D. Bradycardia

Correct Answer is B

Explanation

A. Dry skin: Dry skin is typically a symptom of hypothyroidism, where there is insufficient thyroid hormone. In thyrotoxicosis, skin changes would more likely include warm, moist skin due to increased metabolism.

B. Heat intolerance: Heat intolerance is a common symptom of thyrotoxicosis because the increased metabolic rate leads to higher body temperatures and intolerance to heat.

C. Drowsiness: Drowsiness is usually associated with hypothyroidism, where low thyroid levels slow down metabolism, leading to fatigue and lethargy. Thyrotoxicosis typically causes hyperactivity and insomnia rather than drowsiness.

D. Bradycardia: Bradycardia, or slow heart rate, is associated with hypothyroidism. In thyrotoxicosis, increased thyroid hormone levels lead to an elevated heart rate (tachycardia), not a decreased one.

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A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

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