A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

Decreasing smoking

Increasing fluid intake

Increasing daily exercise

Decreasing intake of red meat

Answer and Explanation

The Correct Answer is B

A. Decreasing smoking: While smoking cessation is important for general health, it is not directly related to the prevention or management of HHS. Addressing dehydration and glucose control takes precedence in the acute management and prevention of recurrence.
B. Increasing fluid intake: Adequate hydration is the most critical aspect of preventing HHS, as dehydration is a key precipitating factor. Clients with HHS experience significant fluid loss, and increasing fluid intake helps maintain circulatory volume and reduce blood glucose concentration.
C. Increasing daily exercise: Although regular exercise helps with long-term diabetes control, it must be approached cautiously in clients recovering from HHS. Excessive or poorly timed physical activity could exacerbate glucose fluctuations if not coordinated with meals and insulin.
D. Decreasing intake of red meat: Diet modifications may help in overall health, but red meat intake is not directly linked to HHS prevention. The immediate concern is managing hydration and glucose levels to prevent another crisis.

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Correct Answer is A

Explanation

A. The client who had general anesthesia for back surgery 4 hr ago: General anesthesia can cause temporary urinary retention by affecting the bladder’s ability to contract and reducing the sensation of needing to urinate. Clients who have recently undergone surgery, especially under general anesthesia, are at a higher risk for urinary retention.
B. The client who was treated with antibiotics for a staphylococcal infection of the skin 2 weeks ago: Although antibiotics may affect the urinary tract, there is no direct correlation between the recent treatment of a staphylococcal infection and urinary retention. This client would not be at the greatest risk compared to those who recently had surgery under anesthesia.
C. The client who reported eating a diet high in calcium oxalate: A diet high in calcium oxalate can lead to kidney stones, but it is not typically associated with urinary retention. Retention is more closely related to factors such as surgery or neurological conditions.
D. The client who has a history of liver failure: While liver failure can have multiple effects on the body, urinary retention is not a primary concern. Liver failure more commonly leads to fluid imbalance and ascites, not direct impairment of bladder function.

A. Only the flail segment pulling inward during expiration B. The entire chest pulling inward during expiration C. The entire chest pushing outward during inspiration D. Only the flail segment pulling inward during inspiration

Correct Answer is D

Explanation

A. Only the flail segment pulling inward during expiration: During expiration, the pressure inside the chest decreases, and typically the chest wall recoils outward. A flail segment moves abnormally in the opposite direction during inspiration, not expiration.
B. The entire chest pulling inward during expiration: Inward movement of the entire chest during expiration is not characteristic of flail chest. This could suggest severe respiratory distress or chest wall weakness, but not the hallmark sign of flail chest.
C. The entire chest pushing outward during inspiration: This is a normal movement during inspiration and not specific to flail chest. In flail chest, the abnormality is seen in the flail segment, not the entire chest.
D. Only the flail segment pulling inward during inspiration: This is the classic finding in flail chest. Due to the broken ribs losing continuity with the rest of the rib cage, the flail segment moves paradoxically—inward during inspiration and outward during expiration—opposite to the normal chest wall motion.

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A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a group of clients on a medical surgical unit. Which of the following clients is at greatest risk for urinary retention?

Correct Answer is A

Explanation

A nurse is assessing a client who has flail chest. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

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