The nurse is caring for a patient with diabetes who presents with a hyperglycemic emergency. The patient's lab values are in the chart below. Which healthcare provider's (HCP) order will the nurse implement?

Administer intravenous normal saline 300 mL/hour

Administer regular insulin 20 units subcutaneously

Start bicarbonate infusion intravenously

Administer potassium chloride 40 mEq orally

Answer and Explanation

The Correct Answer is A

Choice A reason: Administering intravenous normal saline at 300 mL/hour is the appropriate initial intervention for a patient presenting with a hyperglycemic emergency. Fluid replacement is crucial to correct dehydration and improve circulatory volume, which will help improve renal perfusion and facilitate the excretion of excess glucose and ketones.

Choice B reason: Administering regular insulin 20 units subcutaneously is not the immediate priority. Intravenous insulin is preferred in a hyperglycemic emergency to ensure rapid and effective lowering of blood glucose levels.

Choice C reason: Starting a bicarbonate infusion intravenously is not indicated unless there is severe acidosis (pH < 7.0) or the patient is in shock. The pH of 7.20, while low, can typically be corrected with fluid and insulin therapy.

Choice D reason: Administering potassium chloride 40 mEq orally is not necessary at this point. The potassium level of 3.6 mEq/L is within the normal range, and potassium should be monitored and replaced as needed during ongoing treatment, especially when insulin therapy is initiated.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

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

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Kussmaul breathing is a sign of metabolic acidosis, not metabolic alkalosis. It is characterized by deep, labored breathing as the body tries to expel excess carbon dioxide.

Choice B reason: Positive Chvostek sign is an indication of hypocalcemia, which can be associated with metabolic alkalosis. It is a facial muscle twitch that occurs when the facial nerve is tapped.

Choice C reason: Hematemesis, or vomiting blood, is not a clinical manifestation of metabolic alkalosis. It is more related to gastrointestinal bleeding.

Choice D reason: Distended jugular veins are more commonly associated with conditions such as heart failure and fluid overload, not specifically with metabolic alkalosis.

A. Increase vitamin D levels with regular sun exposure. B. Utilize an evidence-based smoking cessation program. C. Eliminate all gluten, dairy, and seed oils from the diet. D. Avoid receiving the influenza, COVID, and shingles vaccine.

Correct Answer is B

Explanation

Choice A reason: Increasing vitamin D levels with regular sun exposure may be beneficial for overall health but is not specifically targeted at preventing flares and complications of SLE. SLE patients are often advised to avoid excessive sun exposure as it can trigger flares and exacerbate symptoms.

Choice B reason: Utilizing an evidence-based smoking cessation program is important for SLE patients, as smoking can worsen the symptoms and complications associated with the disease. Smoking has been linked to increased disease activity, higher risk of cardiovascular complications, and reduced effectiveness of certain medications in SLE patients. Quitting smoking can improve overall health outcomes and reduce the risk of flares and complications.

Choice C reason: Eliminating all gluten, dairy, and seed oils from the diet is not universally recommended for SLE patients. While some patients may have specific dietary triggers or intolerances, there is no broad evidence suggesting that such eliminations are necessary for all SLE patients. A balanced, nutritious diet tailored to the individual's needs is more appropriate.

Choice D reason: Avoiding the influenza, COVID, and shingles vaccines is not recommended for SLE patients. In fact, vaccinations can help prevent infections that could trigger SLE flares or complications. It is important for SLE patients to discuss their vaccination schedule with their healthcare provider to ensure they are appropriately protected.

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 nurse is caring for a patient with diabetes who presents with a hyperglycemic emergency. The patient's lab values are in the chart below. Which healthcare provider's (HCP) order will the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who presents with metabolic alkalosis. Upon assessing the patient, which clinical manifestation will the nurse expect to find?

Correct Answer is B

Explanation

The nurse is caring for a patient with systemic lupus erythematosus (SLE). What health education will the nurse teach the patient to prevent flares and complications of this condition?

Correct Answer is B

Explanation

The nurse is teaching the patient about the medication albuterol for the treatment of chronic obstructive pulmonary disease (COPD). Which medication adverse effect will the nurse teach the patient to monitor for and report?

The nurse is admitting an older adult with heart failure to the cardiac unit. The nurse notes dyspnea on exertion, fatigue, and 3+ pitting edema in the ankles. What priority actions will the nurse implement for this patient?

The nurse is providing care to a patient admitted with an exacerbation of Crohn's disease and a history of diabetes. The patient is receiving total parenteral nutrition (TPN) through a central venous access device. Which intervention will the nurse implement while caring for this patient?

The nursing student is reviewing the chart of a patient admitted with ulcerative colitis. Which findings will the student identify to the nursing instructor as consistent with the patient's diagnosis? (Select All That Apply)

The nurse is caring for a patient with type 2 diabetes who reports diaphoresis and palpitations. A blood glucose check reveals a level of 55 mg/dL. What is the nurse's immediate intervention?

The nurse is creating a home care checklist for a patient diagnosed with inflammatory bowel disease (IBD) who is being discharged. The patient had an ostomy from a previous surgery. What interventions will the nurse include in this plan?

The nurse is caring for a patient after a recent kidney transplant. What statement will the nurse include when teaching the patient about preventing organ rejection?