The nurse is caring for a 22-year-old female patient who is brought to the emergency department with a new onset of blurred vision and headache. Use the chart to answer the questions.
The nurse recognizes the patient is demonstrating signs of diabetic ketoacidosis (DKA). Which findings support this recognition? Select all that apply.
(Select All that Apply.)
Acetone breath and respiratory pattern
Blurred vision and headache
Nausea and vomiting
History of type 1 DM Appendix removal at age 7
Weekend alcohol ingestion
Tachycardia and hypotension
Insulin pump turned off
Correct Answer : A,C,F,G
A. Acetone breath, characterized by a fruity or acetone-like odor on the patient's breath, is a classic sign of DKA. In addition, Kussmaul respirations, which are deep and labored breathing patterns, can occur as the body attempts to compensate for metabolic acidosis in DKA.
C. Nausea and vomiting are common symptoms of DKA and can occur due to metabolic acidosis, electrolyte imbalances, and gastrointestinal disturbances associated with the condition.
F. Tachycardia and hypotension are signs of hemodynamic instability, which can occur in severe cases of DKA due to dehydration, electrolyte imbalances, and the systemic effects of metabolic acidosis.
G. Turning off an insulin pump can lead to insulin deficiency, which is a precipitating factor for DKA, particularly in patients with type 1 diabetes who rely on continuous insulin therapy. This finding is consistent with the development of DKA.
B. Blurred vision and headache can be symptoms of DKA, although they are not specific to this condition. Elevated blood glucose levels and dehydration associated with DKA can lead to osmotic diuresis and subsequent fluid shifts, which may manifest as headache and visual disturbances.
D. A history of type 1 diabetes mellitus (DM) predisposes the patient to DKA but the history of appendix removal at age 7 is not directly relevant to the current presentation of DKA.
E. Alcohol ingestion can contribute to the development of DKA by inhibiting gluconeogenesis and promoting ketoacidosis, particularly if the patient is not consuming adequate carbohydrates and insulin. However, it is not a direct sign of DKA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
B. Beta-blocking medications, such as propranolol and metoprolol, can worsen asthma symptoms in some individuals by constricting the airways. Patients with asthma should avoid or use caution with beta-blockers, especially non-selective ones, as they can trigger or exacerbate asthma attacks.
C. Exposure to secondhand smoke is a well-established trigger for asthma symptoms and can exacerbate respiratory inflammation and airway hyperresponsiveness. Patients with asthma should avoid exposure to secondhand smoke whenever possible to reduce the risk of asthma exacerbations.
D. Carpeting and drapes can harbor dust mites, pet dander, and other allergens that can trigger asthma symptoms in susceptible individuals. Patients with asthma may benefit from removing carpeting and minimizing soft furnishings in the bedroom to reduce exposure to allergens and improve air quality.
E. Pets, particularly those with fur or feathers, can be potent allergens for individuals with asthma. Patients with asthma should consider removing pets from the home or at least keeping them out of the bedroom to minimize exposure to pet dander.
A. Cardiovascular exercise can trigger asthma symptoms in some individuals but it is not typically recommended to eliminate exercise altogether. Instead, patients with asthma should be encouraged to engage in physical activities that are well-tolerated and to use appropriate preventive measures, such as pre-exercise bronchodilator therapy and warm-up exercises, to minimize symptoms.

Correct Answer is C
Explanation
C. Medical nutrition therapy for diabetes involves creating a well-balanced, individualized meal plan that meets the patient's nutritional needs while helping to manage blood glucose levels. This approach can be healthy for the entire family and does not require separate meals or special foods. It promotes overall healthy eating habits that everyone can benefit from.
A. Low-carbohydrate diets may be considered for some patients but the emphasis of a diabetic diet is not necessarily on high-protein intake. Instead, the focus is on balanced meals that include appropriate amounts of carbohydrates, proteins, and fats.
B. People with diabetes do not require special foods; rather, they need to make healthier choices from the foods available. The emphasis is on a balanced diet that can include regular foods, with modifications to portion sizes and meal timing to manage blood glucose levels effectively.
D. It is not necessary to completely avoid sugars and fats; rather, the focus should be on moderating intake and choosing healthier options. For example, limiting added sugars and unhealthy fats (like trans fats and saturated fats) is important, but healthy fats (such as those from nuts, seeds, and avocados) can be part of a balanced diet.
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