A patient with diabetic ketoacidosis (DKA) has been receiving insulin for 6 hours. Laboratory finding are Na+ 131, K+ 3.7, CL- 102, HCO3 22, and glucose 170. Which action should the nurse take?

Give potassium intravenously.

Administer D5 NS with the insulin drip.

Administer 3% NS at 200ml/hr

Expect the insulin drip to be discontinued.

Answer and Explanation

The Correct Answer is B

A. Give potassium intravenously. – The potassium level is 3.7 (within normal range 3.5–5.0), so potassium is not needed yet.

B. Administer D5 NS with the insulin drip. – Correct Answer. Once glucose drops to ≤200 mg/dL, dextrose is added to prevent hypoglycemia while continuing insulin to correct ketoacidosis.

C. Administer 3% NS at 200 mL/hr. – Hypertonic saline is used for severe hyponatremia, which is not the case here.

D. Expect the insulin drip to be discontinued. – The insulin drip is not discontinued until ketoacidosis has fully resolved (when HCO3 > 18, pH > 7.3, and anion gap normalizes).

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Correct Answer is C

Explanation

A. Clarify the prescription because the insulin should not be administered at this time. – Incorrect. Aspart insulin is rapid-acting and should be given with meals to prevent post-meal hyperglycemia.

B. Hold breakfast for one hour after the insulin administration. – Incorrect. Rapid-acting insulin peaks quickly (within 30-90 minutes), so delaying food increases the risk of hypoglycemia.

C. Administer insulin when breakfast arrives. – Correct Answer. Aspart insulin should be given right before or with food to match glucose absorption and prevent hypoglycemia.

D. Check the blood glucose immediately after breakfast. – Incorrect. Blood glucose should be checked before insulin administration to ensure appropriate dosing.

A. Inserting an indwelling urinary catheter B. Putting a nasogastric (NG) tube in place C. Maintaining a patent airway D. Administering an enema daily

Correct Answer is C

Explanation

A. Inserting an indwelling urinary catheter – Incorrect. While catheterization may be necessary, it is not the highest priority for an unconscious patient.

B. Putting a nasogastric (NG) tube in place – Incorrect. NG tube placement can be useful for feeding or decompressing the stomach, but airway management takes precedence.

C. Maintaining a patent airway – Correct Answer. Airway patency is the top priority in an unconscious patient to prevent aspiration, hypoxia, or respiratory failure.

D. Administering an enema daily – Incorrect. This is not a priority in unconscious patients.

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A patient with diabetic ketoacidosis (DKA) has been receiving insulin for 6 hours. Laboratory finding are Na+ 131, K+ 3.7, CL- 102, HCO3 22, and glucose 170. Which action should the nurse take?

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Naxlex Comprehensive Predictor Exams

A type 1 diabetic patient is scheduled to receive their morning dose of aspart (rapid acting) insulin. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

Which nursing intervention takes highest priority for the nurse caring for an unconscious patient?

Correct Answer is C

Explanation

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