A nurse is caring for a patient diagnosed with diabetic ketoacidosis.
Which of the following symptoms should the nurse expect?
Cheyne-Stokes breathing.
Acetone odor to breath.
Blood glucose level below 40 mg/dL.
Malignant hypertension.
The Correct Answer is B
Choice A rationale
Cheyne-Stokes breathing, characterized by a cycle of increasing and decreasing respiratory rate and depth, is not a typical symptom of diabetic ketoacidosis (DKA). DKA is more commonly associated with Kussmaul breathing, which is rapid, deep, and labored.
Choice B rationale
An acetone odor to the breath is a classic symptom of DKA. This is due to the body breaking down fat for energy, which produces ketones. These ketones can cause the breath to smell fruity or like nail polish remover.
Choice C rationale
A blood glucose level below 40 mg/dL is not a symptom of DKA. In fact, DKA is characterized by high blood glucose levels, typically above 250 mg/dL111213.
Choice D rationale
Malignant hypertension is not a typical symptom of DKA. While DKA can cause dehydration and electrolyte imbalances that may affect blood pressure, it does not typically cause malignant hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A recent history of stressful, positive life events is not a primary risk factor for depression. While any significant life change can trigger stress and potentially contribute to depression, it is typically negative or traumatic events that are most strongly associated with an increased risk of depression.
Choice B rationale
Being male and over the age of 80 is a primary risk factor for depression. Older adults, particularly those with chronic medical conditions, are at an increased risk of depression. Additionally, while women are more likely than men to experience depression at younger ages, the gender gap narrows with age.
Choice C rationale
Being an only child is not a primary risk factor for depression. While family history can play a role in depression risk, it is typically a history of depression in first-degree relatives that is most strongly associated with an increased risk.
Choice D rationale
Having elevated levels of serotonin is not a primary risk factor for depression. In fact, it is typically low levels of serotonin that are associated with an increased risk of depression. Informed consent Explore
Correct Answer is A
Explanation
Choice A rationale
A client diagnosed with preeclampsia reporting epigastric pain and unresolved headache is a serious concern. Epigastric pain could indicate severe liver involvement, and a persistent headache could be a sign of progressing neurological involvement, both of which are severe features of preeclampsia. These symptoms suggest the condition may be worsening to eclampsia, a life-threatening complication characterized by the onset of seizure activity or coma in a woman with preeclampsia. Immediate medical attention is necessary to prevent further complications.
Choice B rationale
A tearful client at 32 weeks of gestation experiencing irregular, frequent contractions could be experiencing preterm labor. However, emotional distress and contractions do not necessarily indicate a medical emergency. It’s important to monitor the situation, but it does not need to be immediately reported to the provider.
Choice C rationale
A client diagnosed with preeclampsia having 2+ proteinuria and 2+ patellar reflexes are expected findings. Proteinuria is a common sign of preeclampsia, and hyperreflexia can occur due to increased neuromuscular irritability. While these should be monitored, they do not need to be immediately reported to the provider.
Choice D rationale
A client at 28 weeks of gestation receiving terbutaline reporting fine tremors is an expected side effect of the medication. Terbutaline, a beta-adrenergic agonist, can cause tremors by stimulating the nervous system. While it may be uncomfortable for the client, it is not a medical emergency.
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