A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

Insulin glargine

Regular insulin

Insulin detemir

NPH insulin

Answer and Explanation

The Correct Answer is B

Choice A reason: Insulin glargine is not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 24 hours and no peak effect. It is used to provide basal insulin coverage and prevent hyperglycemia.

Choice B reason: Regular insulin is the type of insulin to use for diabetic ketoacidosis, as it is a short-acting insulin that has an onset of 30 to 60 minutes and a peak of 2 to 4 hours. It is used to lower the blood glucose level rapidly and correct the acidosis.

Choice C reason: Insulin detemir is also not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 12 to 24 hours and no peak effect. It is also used to provide basal insulin coverage and prevent hyperglycemia.

Choice D reason: NPH insulin is also not the type of insulin to use for diabetic ketoacidosis, as it is an intermediate-acting insulin that has an onset of 2 to 4 hours and a peak of 4 to 12 hours. It is used to provide intermediate insulin coverage and prevent hyperglycemia.

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Correct Answer is B

Explanation

Choice A reason: Hyperkalemia is not the correct answer. Hyperkalemia is a high level of potassium in the blood. Corticosteroids do not cause hyperkalemia, but rather hypokalemia. Hyperkalemia may be caused by other factors such as renal failure, acidosis, or potassium-sparing diuretics.

Choice B reason: Hypokalemia is the correct answer. Hypokalemia is a low level of potassium in the blood. Corticosteroids can cause hypokalemia by increasing the excretion of potassium and sodium in the urine. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.

Choice C reason: Hypermagnesemia is not the correct answer. Hypermagnesemia is a high level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypermagnesemia may be caused by other factors such as renal failure, excessive antacid use, or magnesium-containing laxatives.

Choice D reason: Hypomagnesemia is not the correct answer. Hypomagnesemia is a low level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypomagnesemia may be caused by other factors such as malnutrition, alcoholism, or diuretic use.

A. Vaginal cultures B. Complete blood count C. Serum potassium level D. Pregnancy test

Correct Answer is C

Explanation

Choice A reason: Vaginal cultures are not necessary for oral contraceptive therapy. They are used to diagnose infections such as bacterial vaginosis, yeast infection, or sexually transmitted diseases.

Choice B reason: Complete blood count is not essential for oral contraceptive therapy. It is used to measure the number and types of blood cells, such as red blood cells, white blood cells, and platelets.

Choice C reason: Serum potassium level is the most important laboratory test for oral contraceptive therapy. This is because some oral contraceptives can increase the risk of hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause serious complications such as cardiac arrhythmias, muscle weakness, and paralysis.

Choice D reason: Pregnancy test is not a laboratory test, but a urine test. It is important to rule out pregnancy before starting oral contraceptive therapy, but it is not the most important test for the nurse to assess.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

Correct Answer is B

Explanation

A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy?

Correct Answer is C

Explanation

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