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
None
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Prodrome is incorrect. The prodrome phase occurs before the onset of the headache and can last for hours to days. During this phase, individuals may experience subtle changes that serve as warning signs of an impending migraine attack. Common prodromal symptoms include fatigue, mood changes, food cravings, increased thirst, and heightened sensitivity to light or sound. Tingling of the face and blind spots in the eyes are not typically associated with the prodrome phase.
Choice B Reason:
Aura is correct. The aura phase of a migraine typically occurs before or during the headache phase and involves neurological symptoms. Aura symptoms can include visual disturbances such as blind spots, zigzag lines, or flashing lights, as well as sensory symptoms like tingling or numbness, often starting in one part of the body and spreading gradually. The tingling of the face and blind spots in the eyes described by the client are consistent with the aura phase of a migraine.
Choice C Reason:
Postdrome is incorrect. The postdrome phase occurs after the headache phase and can last for hours to days. During this phase, individuals may experience lingering symptoms such as fatigue, difficulty concentrating, mood changes, and muscle aches. While some individuals may experience visual disturbances during the postdrome phase, the tingling of the face and blind spots in the eyes described by the client are more characteristic of the aura phase.
Choice D Reason:
Headache is incorrect. The headache phase of a migraine is characterized by moderate to severe throbbing head pain, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light or sound. While visual disturbances can occur during the headache phase, the tingling of the face and blind spots in the eyes described by the client precede the onset of headache, suggesting the aura phase rather than the headache phase.
Correct Answer is A
Explanation
Choice A Reason:
Typical pneumonia is correct. Streptococcus pneumoniae is a common bacterial pathogen that causes typical pneumonia, also known as community-acquired pneumonia (CAP). Typical pneumonia is characterized by an acute onset of symptoms such as fever, productive cough with purulent sputum, chest pain, and difficulty breathing. Streptococcus pneumoniae is one of the most common causes of typical pneumonia, especially in community settings.
Choice B Reason:
Chemical pneumonitis is incorrect. chemical pneumonitis, refers to inflammation of the lung tissue caused by inhalation or aspiration of toxic chemicals, gases, or gastric contents. It is not caused by Streptococcus pneumoniae.
Choice C Reason:
Atypical pneumonia is incorrect. Atypical pneumonia, refers to pneumonia caused by atypical pathogens such as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Atypical pneumonia typically presents with milder symptoms compared to typical pneumonia and may not respond to traditional antibiotics used for typical bacterial pneumonia.
Choice D Reason:
Aspiration pneumonia. Aspiration pneumonia, occurs when foreign material, such as food, saliva, or gastric contents, is aspirated into the lungs, leading to inflammation and infection. While Streptococcus pneumoniae can cause pneumonia in the context of aspiration, it is more commonly associated with typical pneumonia acquired through inhalation of respiratory droplets containing the bacteria.
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