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 A

Explanation

Choice A rationale
Confusion is a unique symptom of urinary tract infections (UTIs) in older adults. It is often the first and sometimes the only symptom, making it a critical indicator for this age group.
Choice B rationale
Urinary retention can occur in any age group with a UTI and is not unique to older adults.
Choice C rationale

Incontinence is a common symptom of UTIs but is not unique to older adults.
Choice D rationale
Low back pain can be a symptom of UTIs but is not unique to older adults.

A. Frothy sputum. B. Dependent edema. C. Jugular distention. D. Nocturnal polyuria.

Correct Answer is A

Explanation

Choice A rationale
Frothy sputum is a symptom of left-sided heart failure due to pulmonary congestion and edema.
Choice B rationale
Dependent edema is more commonly associated with right-sided heart failure.
Choice C rationale
Jugular distention is also more commonly associated with right-sided heart failure.
Choice D rationale
Nocturnal polyuria can occur in heart failure but is not specific to left-sided heart failure.

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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 assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?

Correct Answer is A

Explanation

A nurse is caring for an older adult client who has left-sided heart failure. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

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