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 C
Explanation
Choice A rationale
Low urine output could be due to dehydration, medication effects, or stress. While it warrants further assessment, it is not typically associated with immediate life-threatening complications in the context of PUD.
Choice B rationale
Vomiting after a meal can occur in PUD due to delayed gastric emptying or irritation. However, it does not immediately indicate a complication requiring urgent follow-up unless accompanied by other symptoms such as severe pain or hematemesis.
Choice C rationale
Blood in the stool may indicate gastrointestinal bleeding, a serious complication of PUD. This finding requires immediate evaluation to determine the source and extent of bleeding, as it can lead to hypovolemic shock if untreated.
Choice D rationale
Abdominal discomfort is common in PUD due to gastric irritation or acid-related issues. While it requires management, it does not typically signal an urgent complication unless associated with other alarming symptoms.
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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