A nurse is caring for a client who has type 2 diabetes mellitus, and their glucose levels are rising. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?

Hypertension

Glucose level of 400 mg/dL

Serum osmolarity of 350 mOsm/L

Ketosis

Answer and Explanation

The Correct Answer is C

A. Hypertension is not a defining feature of HHS.
B. While glucose levels are elevated in HHS, a level of 400 mg/dL alone is not sufficient to diagnose HHS.
C. A serum osmolarity greater than 320 mOsm/L is characteristic of HHS, reflecting severe dehydration and hyperosmolarity.
D. Ketosis is typically absent or minimal in HHS, distinguishing it from diabetic ketoacidosis (DKA).

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Correct Answer is A

Explanation

A. Hypomagnesemia is common in chronic alcoholism and can cause increased blood pressure, hyperactive reflexes, abdominal issues, and mood changes.
B. Hypermagnesemia typically causes decreased reflexes and hypotension.
C. Hypocalcemia can cause neuromuscular irritability but is less directly associated with these symptoms in alcoholism.
D. Hypercalcemia generally causes decreased reflexes and lethargy.

A. Apply an antibiotic ointment on the surrounding skin with each dressing change B. Apply a clean occlusive dressing once daily and whenever soiled C. Abstain from wearing graduated compression stockings D. Provide a high-calorie, high-protein diet

Correct Answer is D

Explanation

A. Routine use of antibiotic ointment on surrounding skin is not standard unless infection is present.
B. Occlusive dressings help maintain a moist wound environment but must be managed carefully; frequency depends on wound status.
C. Graduated compression stockings are recommended to improve venous return and aid ulcer healing; abstaining from them is not advised.
D. A high-calorie, high-protein diet supports tissue repair and immune function, promoting healing and preventing infection in clients with venous ulcers.

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A nurse is caring for a client who has type 2 diabetes mellitus, and their glucose levels are rising. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?

Nursing Test Bank

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