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 D

Explanation

A. Dextrose 5% in 0.45% sodium chloride IV. – Incorrect. Dextrose is given later, after blood glucose drops below 250 mg/dL to prevent hypoglycemia.

B. Oral hypoglycemic medications. – Incorrect. DKA requires IV insulin, not oral medications.

C. Glucocorticoid medications. – Incorrect. Glucocorticoids can worsen hyperglycemia by increasing blood sugar.

D. 0.9% sodium chloride IV. – Correct Answer. Fluid resuscitation with normal saline is the first priority to correct hypovolemia caused by osmotic diuresis in DKA.

A. Milk and turkey slices B. Fish and cottage cheese C. Spinach and beef D. Yogurt and mozzarella

Correct Answer is C

Explanation

A. Milk and turkey slices. – Incorrect. Milk can inhibit iron absorption, and turkey is not a rich source of iron.

B. Fish and cottage cheese. – Incorrect. Cottage cheese is low in iron, and while some fish contain iron, they are not the best sources.

C. Spinach and beef. – Correct Answer. Both are excellent sources of iron, which helps improve hemoglobin levels in iron-deficiency anemia.

D. Yogurt and mozzarella. – Incorrect. Dairy products do not provide significant iron and may inhibit its absorption.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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