A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?

Bicarbonate 26 mEq/L

Serum pH 7.32

Creatinine 1.2 mg/dL

BUN 20 mg/dL

Answer and Explanation

The Correct Answer is B

A) Bicarbonate 26 mEq/L: A bicarbonate level of 26 mEq/L is within the normal range (22-28 mEq/L) and does not indicate metabolic acidosis, which is characteristic of diabetic ketoacidosis (DKA). In DKA, bicarbonate levels are usually decreased due to buffering of the excess acids.

B) Serum pH 7.32: A serum pH of 7.32 is indicative of acidemia, which is consistent with metabolic acidosis seen in DKA. The pH is typically lower than the normal range (7.35-7.45) in DKA due to the accumulation of ketoacids.

C) Creatinine 1.2 mg/dL: A creatinine level of 1.2 mg/dL is slightly elevated but does not specifically indicate metabolic acidosis. Elevated creatinine may suggest renal impairment but is not directly linked to the acid-base disturbance seen in DKA.

D) BUN 20 mg/dL: A blood urea nitrogen (BUN) level of 20 mg/dL is elevated and may indicate dehydration or kidney dysfunction but does not specifically diagnose the acid-base imbalance associated with DKA. In DKA, bicarbonate and pH levels are more directly affected.

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Correct Answer is B

Explanation

A) Decreased deep-tendon reflexes: Decreased deep-tendon reflexes can indicate hyperkalemia, which occurs when potassium levels are too high. This is not a sign of effective potassium chloride supplementation for hypokalemia, as it suggests an imbalance in the opposite direction.

B) Regular heart rhythm: A regular heart rhythm is a key indicator that potassium levels are within the normal range. Potassium is crucial for proper cardiac function, and maintaining an adequate level helps prevent arrhythmias and supports effective heart rhythms.

C) Hypoactive bowel sounds: Hypoactive bowel sounds can be associated with various conditions, including electrolyte imbalances like hypokalemia. However, the presence of hypoactive bowel sounds does not directly indicate that potassium chloride supplementation is effective.

D) Respiratory rate 10/min: A respiratory rate of 10/min is below the normal range and can be a sign of respiratory depression or other issues. This finding does not relate to the effectiveness of potassium chloride supplements in treating hypokalemia.

A. Hiccups B. Anxiousness C. Cough D. Rhinorrhea

Correct Answer is C

Explanation

A) Hiccups: Hiccups are not a common adverse effect of lisinopril. While they can be bothersome, they are not typically associated with this medication. Monitoring for more significant side effects is crucial, but hiccups alone are not usually indicative of a serious reaction.

B) Anxiousness: Anxiousness or anxiety is not a typical side effect of lisinopril. While anxiety can occur due to various factors, it is not directly linked to the use of lisinopril. The focus should be on more specific adverse effects related to the medication.

C) Cough: A persistent, dry cough is a well-documented adverse effect of lisinopril. Angiotensin-converting enzyme (ACE) inhibitors like lisinopril can cause a cough due to the accumulation of bradykinin. This side effect is significant and often leads to discontinuation of the medication.

D) Rhinorrhea: Rhinorrhea, or a runny nose, is not a common adverse effect of lisinopril. Although it can occur with other conditions or medications, it is not specifically associated with ACE inhibitors. Monitoring for more characteristic side effects of lisinopril is important.

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A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is taking potassium chloride supplements daily for hypokalemia. Which of the following findings should indicate to the nurse the supplements are effective?

Correct Answer is B

Explanation

A nurse is caring for a client who has hypertension and is taking lisinopril. The nurse should monitor the client for which of the following findings as an adverse effect of lisinopril?

Correct Answer is C

Explanation

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