The patient's meal has been delivered, and the nurse checks the patient's pre-meal blood sugar.
The result is 50 mg/dL. The patient is clammy, diaphoretic, and non-arousable.
The next step the nurse should take is:
Administer 1 mg Glucagon IM.
Administer 25 g of dextrose IVP.
Hold the insulin and encourage the patient to eat their meal.
Administer 7 units of Humalog insulin.
The Correct Answer is B
Choice A rationale
Administering 1 mg of glucagon intramuscularly stimulates glycogenolysis in the liver, increasing blood glucose levels. However, it is slower in onset compared to IV dextrose, which is critical in a non-arousable patient with a dangerously low blood glucose level of 50 mg/dL. Time efficiency is vital in this emergency.
Choice B rationale
Administering 25 g of dextrose IV pushes glucose directly into the bloodstream, providing an immediate increase in blood glucose. This is the most appropriate action for a non-arousable, hypoglycemic patient. Normal blood glucose ranges between 70-100 mg/dL fasting, making this an emergency requiring prompt correction.
Choice C rationale
Encouraging the patient to eat may be effective in mild hypoglycemia, but not for a critically low level like 50 mg/dL in a non-arousable patient. This delay can result in prolonged neuroglycopenic effects, worsening the patient’s condition.
Choice D rationale
Administering 7 units of Humalog insulin would worsen the hypoglycemia by facilitating glucose uptake into cells, which is contraindicated in this situation. Instead, glucose administration is required to correct the hypoglycemia immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Checking plantar and dorsiflexion assesses neurological status requiring nursing expertise and cannot be delegated to UAP.
Choice B rationale
Log rolling every 2 hours maintains spinal alignment post-laminectomy, a straightforward, standardized task suitable for experienced UAP.
Choice C rationale
PCA assessment involves evaluating pain control methods, which require critical nursing judgments and is not appropriate to delegate.
Choice D rationale
Determining readiness to ambulate involves comprehensive assessment skills, evaluating multiple factors like pain, strength, and hemodynamic stability, beyond UAP’s scope of practice. .
Correct Answer is A
Explanation
Choice A rationale
Appendicitis is the leading cause of emergency abdominal surgeries, accounting for a significant percentage globally. It results from inflammation of the appendix, often due to obstruction by fecalith or lymphoid hyperplasia. This condition progresses to localized infection, abscess formation, and potential rupture, requiring urgent surgical intervention to prevent life-threatening complications.
Choice B rationale
The assertion that appendicitis is not the most common reason for emergency abdominal surgery contradicts epidemiological data. Diseases like cholecystitis or bowel obstructions occur less frequently and often have alternate non-surgical management options. Appendicitis’s acute presentation and high risk of complications necessitate surgery, maintaining its predominance in emergency settings.
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