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 A
Explanation
Choice A Reason:
"You must experiment with your body to find out what stimulation is enjoyable after your injury." This statement encourages the client to explore their body and discover what types of sexual stimulation are enjoyable and pleasurable for them post-injury. It promotes self-discovery and empowerment in sexual expression, which can be important for sexual satisfaction and intimacy.
Choice B Reason:
"You will not be able to have an intimate relationship with anyone after a spinal cord injury." This statement is incorrect and defeatist. It can create unnecessary feelings of hopelessness and despair in the client. Individuals with spinal cord injuries can still have intimate relationships and engage in sexual activity with partners, albeit with potential adjustments or accommodations.
Choice C Reason:
"You should not feel undesirable after your injury. You are still nice-looking. “While it's important to address body image concerns and reassure the client about their physical appearance, this statement may not directly address sexual stimulation or intimacy. However, it can help promote self-confidence and positive self-esteem, which are important aspects of sexuality and relationships.
Choice D Reason:
"Clients who have a spinal cord injury are not aroused by touch around the groin area." This statement is inaccurate and dismissive of the individual's potential for sexual arousal and pleasure. Sensation and arousal can vary among individuals with spinal cord injuries, and touch around the groin area may still be arousing for some individuals, depending on the level and extent of injury.
Correct Answer is ["A","D","E"]
Explanation
Choice A Reason:
The client admitted with diabetic ketoacidosis (DKA) is correct. Diabetes is a common cause of peripheral neuropathy, particularly if poorly controlled. Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by high blood sugar levels and ketone accumulation. Prolonged uncontrolled diabetes can lead to nerve damage and peripheral neuropathy.
Choice B Reason:
The client admitted with sleep apnea is incorrect. Sleep apnea is a sleep disorder characterized by pauses in breathing or shallow breathing during sleep. While sleep apnea itself is not typically associated with peripheral neuropathy, underlying conditions such as obesity or diabetes, which are risk factors for sleep apnea, can also increase the risk of peripheral neuropathy.
Choice C Reason:
The client admitted with a hypertensive crisis is incorrect. Hypertension (high blood pressure) is not directly associated with peripheral neuropathy. However, poorly controlled hypertension can lead to vascular complications and contribute to conditions such as atherosclerosis, which may indirectly increase the risk of peripheral neuropathy.
Choice D Reason:
The client admitted for an exacerbation of Systemic Lupus Erythematosus (SLE) is correct. Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect various organs and tissues, including the peripheral nerves. Peripheral neuropathy can occur as a complication of SLE, particularly in cases of active disease or as a result of certain medications used to treat SLE.
Choice E Reason:
The client admitted with untreated tuberculosis is incorrect. Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis. While TB itself is not typically associated with peripheral neuropathy, certain medications used to treat TB, such as isoniazid, can cause peripheral neuropathy as a side effect.
Choice F Reason:
The client admitted with cirrhosis secondary to chronic alcohol use is correct. Chronic alcohol use and cirrhosis can lead to various neurological complications, including peripheral neuropathy. Alcohol-related peripheral neuropathy often presents with sensory symptoms such as tingling, numbness, and pain in the extremities.
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