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A nurse is caring for a client who has type 2 diabetes mellitus and notes the client is declining. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?

Hypertension

Fruity breath

Ketosis

Glucose level of 650 mg/dL

Answer and Explanation

The Correct Answer is D

A. Hypertension can be a symptom of many conditions and is not specific to HHS.

B. Fruity breath is typically associated with diabetic ketoacidosis (DKA) due to the presence of acetone, not HHS.

C. Ketosis is a key feature of DKA, not HHS. In HHS, ketosis is usually absent or minimal.

D. A glucose level of 650 mg/dL is indicative of HHS, which is characterized by extremely high blood glucose levels without significant ketosis. HHS often occurs in type

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Correct Answer is ["A","B","C","E"]

Explanation

A. A decreased level of consciousness is a common symptom of ARF due to hypoxemia, which reduces oxygen delivery to the brain, leading to confusion, agitation, or lethargy.

B. Hypercarbia, or elevated levels of carbon dioxide (CO2) in the blood, occurs due to impaired gas exchange in ARF, which leads to respiratory acidosis.

C. Severe dyspnea, or difficulty breathing, is a hallmark symptom of ARF as the lungs fail to maintain adequate oxygenation or ventilation.

D. Nausea is not a typical manifestation of ARF; while it may occur due to other factors, it is not directly associated with respiratory failure.

E. Tachycardia, or an increased heart rate, is often seen in ARF as the body attempts to compensate for hypoxemia by increasing cardiac output to deliver more oxygen to tissues.

A. Auscultate the site for a bruit. B. Measure the client's blood pressure to ensure it is higher in the left arm than the right. C. Auscultate the antecubital fossa using a Doppler. D. Check the brachial and radial pulses of the left arm simultaneously.

Correct Answer is A

Explanation

A. Auscultating for a bruit at the site of an AV graft is the most appropriate method to assess its patency. A bruit is a sound made by turbulent blood flow, indicating that the graft is functioning.

B. Measuring blood pressure in both arms does not specifically assess the patency of the graft and could potentially harm the graft if measured in the affected arm.

C. Auscultating the antecubital fossa using a Doppler is not a standard practice for assessing AV graft patency; instead, a stethoscope is used directly over the graft site.

D. Checking the brachial and radial pulses does not assess the graft directly. Although pulse presence is important, it does not provide information about the graft’s patency.

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A nurse is caring for a client who has type 2 diabetes mellitus and notes the client is declining. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","E"]

Explanation

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