A nurse is providing care for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client most likely to be diagnosed with diabetic ketoacidosis (DKA)?
Serum sodium 140 mg/dL
Blood urea nitrogen (BUN) 18 mg/dL
Serum bicarbonate less than 15
Arterial blood pH 7.46
The Correct Answer is C
A. Serum sodium 140 mg/dL: This is a normal sodium level and does not provide diagnostic information specific to DKA. Sodium may fluctuate in DKA but is not a defining lab value for the condition.
B. Blood urea nitrogen (BUN) 18 mg/dL: This BUN level is within normal limits. Although BUN can be elevated in DKA due to dehydration, a normal value does not support the diagnosis of DKA on its own.
C. Serum bicarbonate less than 15: A low bicarbonate level indicates metabolic acidosis, which is a key diagnostic feature of DKA. It reflects the buffering of excess ketone acids in the blood, making this a highly specific indicator.
D. Arterial blood pH 7.46: This value is slightly alkalotic and inconsistent with DKA, which is characterized by metabolic acidosis and a pH usually below 7.3. Elevated pH would suggest another acid-base disorder.
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Related Questions
Correct Answer is D
Explanation
A. Weight gain of 5 lb: While weight changes can reflect improved nutritional intake or fluid balance, a 5-pound weight gain is not a reliable indicator of improved beta-cell function. Weight gain may also increase insulin resistance, which could worsen glycemic control.
B. Fasting blood glucose of 140 mg/dL: A fasting glucose of 140 mg/dL is above the diagnostic threshold for diabetes and suggests poor glycemic control. This level does not support the idea of improved beta-cell function or recovery.
C. Client reports smoking cessation: Smoking cessation is a positive lifestyle change that benefits cardiovascular and overall health, but it is not a direct indicator of beta-cell recovery or improved glucose metabolism.
D. HbA1c = 5.6%: An HbA1c of 5.6% is within the normal, non-diabetic range, suggesting that the client’s average blood glucose levels have been well controlled over the past 2 to 3 months. This implies that the pancreas is producing insulin effectively, which may reflect restored beta-cell function.
Correct Answer is B
Explanation
A. "Metastasis means a group of abnormal kidney cells is localized to a single location.": This describes a localized or primary tumor, not metastasis. Metastasis refers specifically to the spread of cancer cells beyond the original site.
B. "Metastasis occurs when cancerous growths are located in the kidneys and also another part of the body.": Metastasis is the process by which cancer cells break away from the original tumor and spread through the blood or lymphatic system to distant organs. It indicates the presence of secondary tumors outside the kidney.
C. "Metastasis occurs when cancer cells grow until they run out of space and stop growing.": Cancer cells do not stop growing when space runs out; they continue to grow uncontrollably. This statement does not accurately reflect the meaning or mechanism of metastasis.
D. "Metastasis is when a group of kidney cells have changed to more closely resemble intestinal cells.": This describes metaplasia, not metastasis. Metaplasia is a change in cell type due to chronic irritation, not the spread of cancer.
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