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 B
Explanation
Choice A reason: Absence seizures involve brief staring spells, not continuous tonic-clonic movements. The patient’s prolonged, unresponsive seizure activity indicates status epilepticus, so this is incorrect for the seizure type.
Choice B reason: Status epilepticus is continuous or recurrent seizures lasting over 5 minutes, often tonic-clonic, with unresponsiveness, tachycardia, and hypertension. This matches the patient’s presentation, making it the correct type.
Choice C reason: Myoclonic seizures cause brief muscle jerks, not prolonged tonic-clonic activity. Status epilepticus describes the continuous seizure state, so this is incorrect for the observed seizure.
Choice D reason: Tonic-clonic seizure is a single event, but continuous activity suggests status epilepticus. The prolonged duration and unresponsiveness point to status, so this is incorrect.
Correct Answer is B
Explanation
Choice A reason: Redness and heat are local inflammatory signs, occurring at the injury site due to vasodilation. Systemic manifestations, like fever and leukocytosis, affect the whole body, reflecting immune activation, so this is incorrect for systemic inflammation.
Choice B reason: Fever and leukocytosis are systemic manifestations of inflammation, involving the entire body. Fever results from cytokine release, and leukocytosis indicates increased white blood cells, both reflecting widespread immune response, making this the correct choice for systemic effects.
Choice C reason: Pain and edema are primarily local inflammatory responses, occurring at the site of injury or infection. Systemic effects, like fever and leukocytosis, involve broader physiological changes, so this is incorrect for systemic inflammation manifestations.
Choice D reason: Formation of exudates is a local inflammatory response, involving fluid leakage at the injury site. Systemic manifestations, such as fever and leukocytosis, affect the whole body, so this is incorrect for the systemic category of inflammation.
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