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.

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Correct Answer is B

Explanation

Choice A reason: Encouraging the patient to engage in moderate exercise to improve circulation is not appropriate during a sickle cell crisis. Exercise can increase oxygen demand and exacerbate the crisis. Rest and avoiding strenuous activities are recommended.

Choice B reason: Applying warm compresses to the painful areas can help reduce discomfort and improve circulation. Warmth helps relax muscles and dilate blood vessels, providing relief during a sickle cell crisis.

Choice C reason: Suggesting the patient drink caffeinated beverages to stay alert and energized is not appropriate. Caffeine can cause dehydration, which can worsen the sickling of red blood cells. Maintaining hydration with water and non-caffeinated beverages is essential.

Choice D reason: Recommending cold showers to help reduce pain and swelling is incorrect. Cold can cause vasoconstriction, which can worsen pain and reduce blood flow to affected areas. Warm compresses are preferred.

A. Bronchoconstriction B. Pulmonary edema C. Hemoptysis D. Pneumothorax

Correct Answer is A

Explanation

Choice A reason:

Bronchoconstriction is the hallmark of COPD. The narrowing of the airways produces wheezing that is heard throughout the lung fields, making this finding consistent with the patient’s condition.

Choice B reason:

Pulmonary edema usually causes crackles (rales), not widespread wheezing. It’s more related to fluid overload in the lungs rather than airway narrowing.

Choice C reason:

Hemoptysis involves coughing up blood. This symptom does not correlate with wheezing and would be noted as blood in the sputum, not an audible finding on auscultation.

Choice D reason:

Pneumothorax typically presents with diminished or absent breath sounds on the affected side, not diffuse wheezing. It is more associated with sudden chest pain and respiratory distress.

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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

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Correct Answer is A

Explanation

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