A patient who is unconscious and has a pulse is brought to the emergency department. The patient is wearing a Medic-Alert bracelet indicating type 1 diabetes mellitus. The nurse will anticipate an order to administer
glucagon.
orange juice.
insulin.
cardiopulmonary resuscitation (CPR).
The Correct Answer is A
A. glucagon: In an unconscious patient with type 1 diabetes, hypoglycemia is a likely cause of altered consciousness. Glucagon raises blood glucose by stimulating glycogen breakdown in the liver, providing rapid correction when the patient cannot safely swallow oral carbohydrates. Prompt administration prevents further neurologic compromise.
B. orange juice: Oral glucose sources like juice are ineffective and unsafe in an unconscious patient because they cannot swallow, increasing the risk of aspiration. Administration requires the patient to be alert and able to safely ingest liquids.
C. insulin: Insulin lowers blood glucose and would worsen hypoglycemia in an unconscious diabetic patient. Administering insulin in this scenario could lead to severe neurologic injury or death.
D. cardiopulmonary resuscitation (CPR): CPR is indicated only if the patient is pulseless or not breathing adequately. Since this patient has a pulse and the immediate concern is hypoglycemia, CPR is not the appropriate intervention at this time.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Gastric lavage: Gastric lavage is rarely used and is only indicated shortly after ingestion of a potentially life-threatening oral toxin. In this scenario, the patient is already unconscious with respiratory arrest, and the timing and unknown drug make lavage less effective and potentially risky.
B. Naloxone: Naloxone is an opioid antagonist that rapidly reverses respiratory depression caused by opioid overdose. Administering it can restore adequate ventilation and consciousness in patients with suspected opioid toxicity. It is the first-line treatment in emergency settings for opioid-induced respiratory compromise.
C. Activated charcoal: Activated charcoal can bind certain ingested toxins in the gastrointestinal tract, but it is ineffective for opioids that have already been absorbed or for patients who are unconscious and intubated. Its use is limited in this acute scenario.
D. Flumazenil: Flumazenil reverses benzodiazepine effects, not opioids. Administering it would not improve respiratory depression caused by an opioid overdose and could precipitate seizures in patients with chronic benzodiazepine use. It is not indicated in this situation.
Correct Answer is D
Explanation
A. Continue the amiodarone infusion at 1 mg/min.: Continuing the infusion despite bradycardia and hypotension could worsen hemodynamic instability. The patient is showing signs of significant adverse effects, making it unsafe to maintain the current rate.
B. Increase the rate of the amiodarone infusion to 1.5 mg/min.: Increasing the infusion would exacerbate bradycardia and hypotension, further compromising cardiac output. Higher doses are contraindicated in the presence of hemodynamic instability.
C. Decrease the rate of the amiodarone infusion to 0.5 mg/min.: Reducing the rate may slightly lessen adverse effects but does not adequately address the immediate risk posed by low heart rate and hypotension. Stopping the infusion is safer until the provider evaluates the patient.
D. Stop the infusion of amiodarone.: The patient exhibits hypotension and bradycardia, which are serious adverse effects of IV amiodarone. Stopping the infusion prevents further cardiovascular compromise while notifying the provider for further orders and possible interventions to stabilize the patient.
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