A nurse is caring for a group of clients in a medical unit. Which of the following clients is at the highest risk for developing osmotic cerebral edema?

A client with a decreased potassium level

A client with a decreased serum glucose

A client with an increased hemoglobin A1C

A client with an increased creatinine level

None

Answer and Explanation

The Correct Answer is B

Choice A Reason:

A client with a decreased potassium level is incorrect. Hypokalemia (decreased potassium level) can cause various neurological symptoms, but it doesn't directly lead to osmotic cerebral edema.

Choice B Reason:

When plasma glucose levels are rapidly lowered, an osmotic gradient develops between the brain and plasma, which can lead to cerebral edema. Brain cells pull water from the plasma, resulting in widespread edema.

Choice C Reason:

While HbA1c is an important marker of diabetes control and may indicate poor long-term management, it does not directly relate to the acute metabolic derangements (e.g., rapid osmotic shifts, severity of acidosis) that predispose to cerebral edema in DKA.

Choice D Reason:

A client with an increased creatinine level is incorrect. Elevated creatinine levels typically indicate kidney dysfunction or dehydration, but they don't directly cause osmotic cerebral edema.

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

Explanation

Choice A Reason:

Pleural cavity decompression via needle aspiration is inappropriate. Pleural cavity decompression via needle aspiration may be indicated in cases of tension pneumothorax, a potentially life-threatening condition in which air accumulates in the pleural space and compresses the lung. While it is an intervention rather than a diagnostic tool, it may be performed emergently if tension pneumothorax is suspected based on clinical findings.

Choice B Reason:

Focused assessment with sonography in trauma (FAST) is appropriate. FAST is a bedside ultrasound examination commonly used in trauma settings to rapidly assess for the presence of free fluid in the pericardial, pleural, and peritoneal spaces. It can help identify hemopericardium, hemothorax, or intra-abdominal hemorrhage, which may be indicative of thoracic injury.

Choice C Reason:

Chest x-ray is appropriate. Chest x-ray is a commonly used imaging modality for evaluating thoracic injuries. It can help visualize abnormalities such as rib fractures, pneumothorax, hemothorax, pulmonary contusions, or other traumatic injuries to the chest.

Choice D Reason:

Thoracentesis is appropriate. Thoracentesis is a procedure used to sample fluid from the pleural space for diagnostic or therapeutic purposes. It may be indicated if there is a suspicion of pleural effusion or if fluid accumulation is seen on imaging studies such as chest x-ray or ultrasound.

Choice E Reason:

Ultrasound is appropriate. Ultrasound can be used to evaluate various aspects of thoracic injuries, including the presence of pneumothorax, hemothorax, or pleural effusion. It is often used as part of the FAST examination but can also be performed separately for more detailed assessment.

A. Loss of teeth B. Stroke C. Sleepiness D. Fatty deposits E. Muscle dysfunction

Correct Answer is ["B","D","E"]

Explanation

Choice A Reason:

Loss of teeth is not typically considered a direct factor contributing to obstructive sleep apnea. While the presence of teeth may play a role in maintaining the structure of the oral cavity, it is not a primary risk factor for OSA.

Choice B Reason:

Stroke is correct. Individuals who have had a stroke are at increased risk of developing obstructive sleep apnea. Stroke can cause damage to areas of the brain involved in controlling breathing and upper airway function, leading to disruptions in respiratory control during sleep.

Choice C Reason:

Sleepiness is a symptom commonly associated with obstructive sleep apnea rather than a direct contributing factor. Excessive daytime sleepiness is a consequence of disrupted sleep patterns and recurrent episodes of breathing cessation during the night, which are characteristic features of obstructive sleep apnea.

Choice D Reason:

Fatty deposits is correct. Excessive fatty deposits, particularly around the neck and throat, can contribute to the narrowing and collapse of the upper airway during sleep, increasing the risk of obstructive sleep apnea. Obesity is a significant risk factor for OSA due to the accumulation of fat deposits in the upper airway tissues.

Choice E Reason:

Muscle dysfunction is correct. Muscle dysfunction, particularly of the muscles surrounding the upper airway, can impair the ability of these muscles to keep the airway open during sleep. Weakness or dysfunction of these muscles can lead to increased collapsibility of the upper airway, contributing to obstructive sleep apnea.

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A nurse is caring for a group of clients in a medical unit. Which of the following clients is at the highest risk for developing osmotic cerebral edema?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Explanation

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Correct Answer is ["B","D","E"]

Explanation

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