A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.2; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium 2 mEq/L; serum sodium 130 mEq/L. The patient reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?
Increased glucose use causes the shift of fluid from the intravascular to the intracellular spaces
Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss
Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic acidosis
Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis
The Correct Answer is D
Choice A reason: Increased glucose use doesn’t occur in DKA; insulin deficiency reduces glucose uptake. Fluid shifts are due to osmotic diuresis, not intravascular to intracellular movement, so this is incorrect for DKA’s mechanism.
Choice B reason: DKA involves metabolic, not respiratory, acidosis from ketones. Protein catabolism occurs, but fatty acid use and ketogenesis are primary, leading to acidosis and diuresis, so this is incorrect.
Choice C reason: Increased glucose and fatty acids contribute, but the mechanism is decreased glucose use causing ketogenesis. This option omits ketogenesis, a key DKA feature, so it’s less precise and incorrect.
Choice D reason: Insulin deficiency in DKA reduces glucose use, leading to fatty acid breakdown, ketogenesis, metabolic acidosis (pH 7.2), and osmotic diuresis (electrolyte loss). This fully explains the lab values, making it correct.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Pulmonary emboli are a priority in ARDS, as they can cause or worsen hypoxemia and lung injury. Emboli block pulmonary arteries, leading to ventilation-perfusion mismatch, a common ARDS trigger, making this the correct condition to assess first.
Choice B reason: Pneumonia may contribute to ARDS but is less urgent than pulmonary emboli, which can rapidly cause life-threatening hypoxia. Emboli are a more immediate concern in ARDS, so this is incorrect.
Choice C reason: Acute pulmonary edema is linked to heart failure, not a primary ARDS cause. Pulmonary emboli directly trigger ARDS’s acute lung injury, making this less critical and incorrect for priority assessment.
Choice D reason: Heart failure may cause pulmonary edema but isn’t a primary ARDS trigger. Pulmonary emboli are a more urgent cause of ARDS-related hypoxia, so this is incorrect.
Correct Answer is D
Explanation
Choice A reason: Nerve damage from the prosthetic may cause local discomfort, but pain in the entire absent arm suggests phantom limb pain. This is less likely than neural misfiring, so it’s incorrect.
Choice B reason: Heart attack referred pain typically affects the left arm but is unlikely in a prosthetic limb. Phantom limb pain explains pain in the absent arm, so this is incorrect.
Choice C reason: Muscle strain affects existing muscles, not a prosthetic arm. Phantom limb pain, from neural signals in the brain, explains pain in the missing limb, so this is incorrect.
Choice D reason: Phantom limb pain occurs when the brain perceives pain in an amputated limb, common in prosthetic users. This matches Mr. Jones’s pain in his prosthetic arm, making it correct.
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