A nurse is providing care for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following is a clinical manifestation of HHS?

Insulin resistance

Metabolic acidosis

Hypervolemia

Ketosis

Answer and Explanation

The Correct Answer is A

A. Insulin resistance: HHS typically occurs in clients with type 2 diabetes who have some circulating insulin, but not enough to prevent severe hyperglycemia. Insulin resistance is a key feature, as it allows glucose levels to rise without triggering significant fat breakdown or ketone production.
B. Metabolic acidosis: Metabolic acidosis is more commonly seen in diabetic ketoacidosis (DKA) due to the accumulation of ketones. In HHS, acidosis is usually absent or only mild because fat breakdown is minimal.
C. Hypervolemia: HHS leads to profound dehydration due to osmotic diuresis caused by severe hyperglycemia. Clients are more likely to be hypovolemic rather than hypervolemic due to fluid losses.
D. Ketosis: Unlike DKA, HHS generally does not present with significant ketosis because the body retains enough insulin to prevent fat breakdown. The absence of ketosis is one of the key diagnostic differences between the two conditions.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

A. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys:
Reduced renal perfusion causes prerenal acute kidney injury, not acute tubular necrosis (ATN). In ATN, the injury is intrarenal, specifically within the tubules, rather than being due to reduced blood flow to the kidneys.
B. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down: This describes postrenal acute kidney injury, typically due to obstruction in the urinary tract, such as stones or enlarged prostate. It is not the underlying mechanism in acute tubular necrosis, which is a type of intrarenal injury.
C. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys: While inflammation may be present in certain renal conditions, acute tubular necrosis primarily involves ischemic or toxic injury to tubular epithelial cells, not immune cell invasion. Inflammatory cell infiltration is more characteristic of interstitial nephritis.
D. The glomerular filtration rate decreases because there is injury to the renal tubular cells:
In acute tubular necrosis, the primary damage is to the tubular epithelial cells, leading to cellular death and sloughing. This impairs the kidney’s ability to reabsorb and filter properly, resulting in a drop in glomerular filtration rate due to tubular dysfunction and obstruction.

A. Administer acetaminophen by mouth for pain control B. Insert an indwelling urinary catheter to monitor urine output C. Prepare for a STAT non-contrast CT scan D. Perform a thorough health history

Correct Answer is C

Explanation

A. Administer acetaminophen by mouth for pain control: While pain management is important, it is not the first priority. The primary concern after a traumatic fall is to rule out any life-threatening conditions, such as intracranial bleeding or fractures, which require diagnostic imaging before administering pain relief.
B. Insert an indwelling urinary catheter to monitor urine output: Inserting a catheter may be necessary later, but the first step should be assessing for any immediate life-threatening injuries or complications resulting from the fall, which can be done through imaging studies.
C. Prepare for a STAT non-contrast CT scan: The first priority after a traumatic fall, especially if there is a concern about head injury or internal bleeding, is to assess for any potential life-threatening conditions through a non-contrast CT scan. This helps identify fractures, bleeding, or brain injuries that need immediate attention.
D. Perform a thorough health history: While gathering a health history is important, it should come after ensuring that any potential life-threatening injuries have been ruled out. Diagnostic imaging should be the first intervention to address any immediate risks.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is providing care for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following is a clinical manifestation of HHS?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is caring for a client who has had a traumatic fall. Which of the following interventions should the nurse implement first?

Correct Answer is C

Explanation

A nurse is providing teaching to newly licensed nurses about cardiac tamponade. Which of the following should the nurse include when teaching about Phase II cardiac tamponade?

A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is being treated with conivaptan. Which of the following findings should the nurse report to the provider immediately?

A nurse is caring for a client who has deep vein thrombosis (DVT) of their right lower leg. Which of the following manifestations should the nurse expect? (Select All that Apply.)

The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?

A client presents with a pH of 7.25, PC02 of 40 mmHg, HCO3- of 16 mEq/L. Which of the following best describes the client's acid-base imbalance?

A nurse is reinforcing teaching to a group of high school students about how penetrating traumatic brain injuries cause damage to the brain. Which of the following statements should the nurse include in the teaching?

A nurse is providing postoperative care to a client who lost 800 mL of blood during surgery. The client's blood pressure has been steadily decreasing over the past 2 hr. Which of the following categories of shock should the nurse recognize is occurring?