The PMHNP is treating a 17-year-old girl who is an inpatient on an eating disorder unit. This patient has type 1 diabetes in addition to bulimia nervosa. Today she complains of dizziness, nausea, confusion, and weakness. What is her most likely diagnosis?
Severe dehydration
Diabetic ketoacidosis
Acute renal failure
Myocardial toxicity
The Correct Answer is B
Choice A reason: Severe dehydration can cause dizziness and weakness, but the presence of confusion and nausea in a type 1 diabetic patient raises concern for metabolic disturbance rather than isolated dehydration.
Choice B reason: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketonemia, dehydration, nausea, vomiting, weakness, and altered mental status. Patients with type 1 diabetes, particularly those with eating disorders, are at increased risk due to insulin omission or inadequate intake.
Choice C reason: Acute renal failure can present with nausea, confusion, and weakness, but there is no information suggesting a sudden change in kidney function or laboratory evidence in this scenario.
Choice D reason: Myocardial toxicity is unlikely in this presentation; while electrolyte disturbances may affect the heart, the immediate constellation of symptoms in a type 1 diabetic points more toward DKA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Herbal therapy involves ingestion of plant-based remedies, whereas this patient is using inhalation for relaxation.
Choice B reason: Supplements refer to ingestible vitamins or minerals, not inhaled essential oils.
Choice C reason: Vitamins are micronutrients taken orally for nutritional purposes, not for relaxation via olfactory stimulation.
Choice D reason: Aromatherapy uses essential oils to promote physical and psychological well-being through scent, which is exactly the method employed by this patient.
Correct Answer is D
Explanation
Choice A reason: Aspirin would not address the underlying cause of facial nerve inflammation and offers only analgesic benefit.
Choice B reason: Antibiotics are indicated if bacterial infection is present, but this presentation is consistent with Bell’s palsy, which is idiopathic or viral in origin.
Choice C reason: Surgery is reserved for cases involving trauma or tumor-related nerve compression, not idiopathic facial paralysis.
Choice D reason: Corticosteroids are the first-line treatment for Bell’s palsy, which is an acute, unilateral facial nerve paralysis due to inflammation and edema of the facial nerve. Steroids reduce nerve swelling and improve recovery of function if initiated within 72 hours of symptom onset.
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