A patient with diabetes mellitus (DM) developed a serum glucose of 900 and an elevated serum osmolality. The patient then became unconscious. What pathological process most likely caused the altered neurologic status?
The brain cells became edematous because of a blood to tissue shift of fluid.
Hyperinsulinemia caused hypoglycemia and a tonic clonic seizure.
The brain cells became dehydrated because of fluid shirting out of the cells.
Fluid volume overload caused higher pressure in the brain tissue
The Correct Answer is C
A. The brain cells became edematous because of a blood to tissue shift of fluid: This describes cerebral edema, which is not typically caused by hyperglycemia.
B. Hyperinsulinemia caused hypoglycemia and a tonic-clonic seizure: The scenario describes hyperglycemia, not hypoglycemia.
C. The brain cells became dehydrated because of fluid shifting out of the cells:. In hyperglycemic hyperosmolar syndrome (HHS), extremely high blood glucose leads to increased serum osmolality, causing water to move out of brain cells, leading to dehydration and altered consciousness.
D. Fluid volume overload caused higher pressure in the brain tissue: Fluid volume overload is not the primary issue in this scenario; rather, dehydration is the concern due to hyperglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Positive Brudzinski's sign: A positive Brudzinski's sign, which involves involuntary flexion of the hips and knees when the neck is flexed, is a common finding in meningitis (both viral and bacterial).
B. Dysarthria and double vision: These symptoms are not typical of viral meningitis; they are more often associated with neurological disorders such as multiple sclerosis.
C. Petechiae and purpura: These are more commonly associated with bacterial meningitis, particularly meningococcal meningitis, rather than viral meningitis.
D. Positive Babinski's reflex: A positive Babinski’s reflex indicates an upper motor neuron lesion and is not specific to meningitis.
Correct Answer is A
Explanation
A. Esophageal varices: Coffee-ground emesis suggests upper gastrointestinal bleeding, which is often due to ruptured esophageal varices in patients with cirrhosis.
B. Colorectal cancer: This condition typically presents with lower gastrointestinal symptoms such as changes in bowel habits or blood in the stool, not coffee-ground emesis.
C. Inflammatory bowel disease: This condition can cause gastrointestinal bleeding but is more commonly associated with symptoms like diarrhea and abdominal pain rather than coffee-ground emesis.
D. Appendicitis: This condition typically presents with right lower quadrant pain, not upper GI bleeding.
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