A nurse is providing care for an older adult client who has hyperglycemia, polydipsia, and polyuria. Which of the following manifestations supports the clinical presentation of hyperosmolar hyperglycemic syndrome (HHS)? (Select All that Apply.)

Acetone breath.

Fever.

Serum glucose 800 mg/dL (74 to 106 mg/dL).

Serum bicarbonate 15 mEq/L (21 to 28 mEq/L).

Insidious onset.

Answer and Explanation

Correct Answer : B,C,E

Choice A rationale
Acetone breath is a characteristic symptom of diabetic ketoacidosis (DKA), not hyperosmolar hyperglycemic syndrome (HHS). In DKA, the body produces ketones, leading to a fruity or acetone-like breath odor. HHS, on the other hand, does not typically involve significant ketone production.
Choice B rationale
Fever can be a manifestation of HHS, often due to an underlying infection or illness that precipitates the hyperglycemic state. Infections are common triggers for HHS, leading to elevated body temperature.
Choice C rationale
Serum glucose levels of 800 mg/dL are indicative of HHS. HHS is characterized by extremely high blood glucose levels, often exceeding 600 mg/dL, without significant ketoacidosis.
Choice D rationale
Serum bicarbonate levels of 15 mEq/L are more indicative of DKA rather than HHS. In HHS, bicarbonate levels are usually within the normal range because there is no significant ketoacidosis.
Choice E rationale
Insidious onset is a hallmark of HHS. The condition develops gradually over days to weeks, unlike DKA, which has a more rapid onset.

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Correct Answer is B

Explanation

Choice A rationale
Using several different scales to obtain the weight is incorrect. Consistency is key when monitoring weight, especially for clients with chronic kidney disease. Using the same scale ensures that weight measurements are accurate and comparable over time. Different scales may have slight variations, leading to inconsistent and unreliable data.
Choice B rationale
Weighing at the same time each day is correct. It is important to weigh at the same time each day, preferably in the morning after voiding and before eating, to obtain consistent and accurate measurements. This helps in monitoring fluid retention and changes in body weight, which are critical for managing chronic kidney disease.
Choice C rationale
Calibrating weight scales every week is not necessary. While it is important to ensure that the scale is accurate, weekly calibration is excessive. Regular calibration according to the manufacturer’s instructions or as needed is sufficient to maintain accuracy. Over-calibration can be time-consuming and may not significantly improve measurement accuracy.
Choice D rationale
Measuring weight just prior to voiding is incorrect. Weighing after voiding provides a more accurate measurement of body weight without the influence of bladder contents. This is especially important for clients with chronic kidney disease, as fluid balance and retention are closely monitored.

A. Blood glucose levels. B. Gallbladder studies. C. Liver function tests. D. Thyroid function studies.

Correct Answer is C

Explanation

Choice A rationale
Monitoring blood glucose levels is not specifically required for clients taking pyrazinamide. This medication does not typically affect blood glucose levels.
Choice B rationale
Gallbladder studies are not required for clients taking pyrazinamide. This medication does not typically affect the gallbladder.
Choice C rationale
Liver function tests are required for clients taking pyrazinamide. This medication can cause hepatotoxicity, so regular monitoring of liver function is essential to detect any potential liver damage early.
Choice D rationale

Thyroid function studies are not required for clients taking pyrazinamide. This medication does not typically affect thyroid function.

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A nurse is providing care for an older adult client who has hyperglycemia, polydipsia, and polyuria. Which of the following manifestations supports the clinical presentation of hyperosmolar hyperglycemic syndrome (HHS)? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about monitoring weight with a client who has chronic kidney disease. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who has tuberculosis and is about to start taking pyrazinamide. The nurse should identify that the client needs which of the following tests while taking this medication therapy?

Correct Answer is C

Explanation

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