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 B
Explanation
A. Several episodes of black and tarry stools: This indicates melena, which is typically associated with upper gastrointestinal bleeding, not specifically Crohn's disease.
B. Several episodes of hematochezia per day: Hematochezia (fresh blood in stools) can occur in Crohn's disease due to inflammation and ulceration in the intestines.
C. Post-alcohol ingestion epigastric pain: This is more commonly associated with gastritis or peptic ulcer disease, not Crohn's disease.
D. An oral temperature of 102°F: While fever can occur in Crohn's disease during acute flare-ups, it is not a specific or definitive symptom of the condition. The primary symptoms are gastrointestinal in nature, such as abdominal pain and altered bowel habits.
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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