The nurse is caring for a patient with type 2 diabetes who has been diagnosed with hyperglycemic hyperosmolar syndrome. What clinical manifestation will the nurse expect to find in this patient?

Arterial pH less than 7.3

Altered mental status

Presence of ketones in urine

Serum bicarbonate less than 15 mEq/L

Answer and Explanation

The Correct Answer is B

Choice A reason: An arterial pH less than 7.3 indicates acidosis, which is common in diabetic ketoacidosis but not typical in hyperglycemic hyperosmolar syndrome. Patients with hyperglycemic hyperosmolar syndrome typically have a near-normal pH.

Choice B reason: Altered mental status is a significant clinical manifestation in hyperglycemic hyperosmolar syndrome due to severe hyperglycemia and the hyperosmolar state, which can lead to dehydration and impaired brain function.

Choice C reason: The presence of ketones in urine is more commonly associated with diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome. The absence of significant ketonemia differentiates hyperglycemic hyperosmolar syndrome from diabetic ketoacidosis.

Choice D reason: Serum bicarbonate less than 15 mEq/L is indicative of metabolic acidosis, typically seen in diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome, where bicarbonate levels are usually normal or slightly decreased.

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Correct Answer is B

Explanation

Choice A reason: Administering a platelet transfusion immediately is not indicated for a platelet count of 45,000/mm³. While this is below the normal range, it is not critically low. Platelet transfusions are typically reserved for patients with life-threatening bleeding or extremely low platelet counts.

Choice B reason: Monitoring the patient for signs of bleeding and educating about bleeding precautions is the appropriate intervention. Patients with thrombocytopenia are at an increased risk of bleeding, and it is essential to educate them on how to minimize this risk, such as avoiding activities that can cause injury, using a soft toothbrush, and avoiding over-the-counter medications that can affect platelet function.

Choice C reason: Administering aspirin to reduce the risk of clot formation is incorrect. Aspirin is an antiplatelet agent that can increase the risk of bleeding in patients with thrombocytopenia. It should be avoided unless specifically prescribed for another condition with close monitoring.

Choice D reason: Encouraging the patient to engage in regular physical exercise to improve circulation is not appropriate in this context. While physical activity is generally beneficial, it should be done with caution in patients with thrombocytopenia to avoid injury and bleeding. The focus should be on safety and bleeding precautions.

A. Acute pain B. Infection

Correct Answer is B

Explanation

Choice A reason: While acute pain is a possibility in peripheral neuropathy, infection poses a more serious risk. The sensory deficits in peripheral neuropathy can lead to unnoticed injuries and subsequent infections, especially in the lower extremities.

Choice B reason: Infection is a major risk in patients with peripheral neuropathy due to the loss of sensation, which can result in unnoticed injuries that can become infected. Additionally, high blood sugar levels in diabetes can impair the immune response, making infections more likely and harder to heal.

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The nurse is caring for a patient with type 2 diabetes who has been diagnosed with hyperglycemic hyperosmolar syndrome. What clinical manifestation will the nurse expect to find in this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with thrombocytopenia who has a platelet count of 45,000/mm³. What nursing intervention will the nurse implement to manage this condition?

Correct Answer is B

Explanation

The nurse is caring for a patient with diabetes who is exhibiting signs and symptoms of peripheral neuropathy. What will the nurse identify as a risk for this patient?

Correct Answer is B

Explanation

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