The elderly client is admitted to the intensive care department with severe Hyperglycemic-Hyperosmolar State (HHS). Which collaborative intervention should the nurse include in the plan of care?

Administer intermediate-acting insulin

Infuse 0.9% Normal Saline intravenously

Monitor arterial blood gas results

Perform blood glucose checks daily

Answer and Explanation

The Correct Answer is B

A. Administer intermediate-acting insulin: Intermediate-acting insulin is not used in the treatment of HHS. In HHS, the primary goal is to lower blood glucose levels gradually using short-acting insulin to prevent rapid changes in glucose and fluid shifts.

B. Infuse 0.9% Normal Saline intravenously: IV fluids are a critical part of the treatment for HHS. 0.9% Normal Saline is used to correct dehydration and restore circulatory volume, which is a major concern in HHS. The goal is to gradually rehydrate the client while simultaneously lowering blood glucose levels.

C. Monitor arterial blood gas results: While monitoring arterial blood gases (ABG) is important for assessing acid-base balance, it is not the priority intervention for HHS. The primary focus should be on correcting hyperglycemia and dehydration first.

D. Perform blood glucose checks daily: Blood glucose monitoring should be more frequent than daily in a client with HHS. It is critical to monitor blood glucose levels every hour or as frequently as needed to assess the effectiveness of interventions and guide insulin therapy.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Decreased free thyroxine index: In Graves' disease, there is an overproduction of thyroid hormones, including thyroxine (T4), leading to an increase in the free thyroxine index, not a decrease. Elevated T4 levels are typical in hyperthyroidism associated with Graves' disease.

B. Decreased thyroid stimulating hormone (TSH): In Graves' disease, the body produces excess thyroid hormones, which suppresses the pituitary gland’s production of TSH. As a result, TSH levels are typically low in Graves' disease.

C. Decreased triiodothyronine (T3): Graves' disease usually results in increased levels of T3 and T4 due to the overactive thyroid. A decrease in T3 would be inconsistent with the hyperthyroid state seen in this disorder.

D. Decreased thyrotropin receptor antibodies: In Graves' disease, there is an increase in thyrotropin receptor antibodies, which stimulate the thyroid to produce excess thyroid hormones. These antibodies are often elevated, not decreased.

A. 60 B. 15 C. 45 D. 30

Correct Answer is B

Explanation

A. 60: An onset of action of 60 minutes is characteristic of some types of short-acting insulin (like Regular insulin) but not rapid-acting insulins such as Humalog (Lispro). Rapid-acting insulins are designed to work much faster to cover post-meal glucose excursions.

B. 15: Humalog (insulin lispro) is a rapid-acting insulin analog, with a quick onset of action. Its effects begin within 5 to 15 minutes after subcutaneous injection, making it ideal for administration just before or immediately after a meal to manage the rise in blood glucose.

C. 45: An onset of 45 minutes would be slower than what is expected for a rapid-acting insulin like Humalog. This timeframe is closer to the onset of Regular insulin, which requires administration 30-45 minutes before a meal.

D. 30: While 30 minutes is a common instruction for administering Regular insulin before a meal, it is not the typical onset time for rapid-acting insulins like Humalog (Lispro). Humalog's action begins much sooner, allowing for greater flexibility in meal timing.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The elderly client is admitted to the intensive care department with severe Hyperglycemic-Hyperosmolar State (HHS). Which collaborative intervention should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is in a provider's office is reviewing the health record of a client who is being evaluated for Grave's disease. Which of the following is an expected laboratory finding for this client?

Correct Answer is B

Explanation

The human insulin whose onset of action occurs within ________ minutes is Humalog (Lispro).

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who is scheduled for a blood test to measure her thyroid-stimulating hormone (TSH) level. Which of the following statements should the nurse give?

When a patient who is 8 hours postoperative from a total thyroidectomy shows a positive Chvostek's sign and complains of muscle cramps, the nurse interprets these assessments as indicative of:

The nurse is caring for a client with an autoimmune disease characterized by the production of antibodies that destroy essential enzymes needed for the production of T 3 and T4. This nurse is aware that this client is experiencing:

The major goal of medical nutrition therapy for clients with diabetes mellitus is to:

The nurse is aware that diabetics are prone to infection, which can be attributed to:

A patient has asked why she needs to exercise. The nurse tells her that if the diabetic patient exercises, then the insulin requirement

The nurse is providing an in-service on thyroid disorders. One of the attendees asks the nurse. "Why don't the people in the United States get goiters as often? Which statement by the nurse is the best response?