You are an RN in a busy Emergency Department who is caring for a patient who was brought in for an acute asthma attack about 5 minutes ago. Upon arrival, the patient was loudly wheezing and able to talk in 4 to 5 word sentences. A couple of minutes later as you are charting, you notice that you can no longer hear the patient wheezing. You know you should now.

Reassess the client for a potential life-threatening development

Prepare the client for discharge

Chart that the patient has improved on their own

Return the Albuterol to medication bin as you will no longer need it

Answer and Explanation

The Correct Answer is A

A.   The absence of wheezing in a patient with an acute asthma attack is a critical sign. It may indicate that the patient is deteriorating rapidly, and their airways are closing significantly. This is a life-threatening situation requiring immediate intervention.
B.   A patient with an acute asthma attack would not be discharged without significant improvement and stabilization.
C.   While it might seem like an improvement, the absence of wheezing in this context is a red flag and not a positive sign.
D.   The patient may still require additional bronchodilators or other interventions.

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Correct Answer is A

Explanation

A. When blood sugar levels increase, the pancreas releases insulin. Insulin helps glucose move from the bloodstream into the cells for energy.
B. While the liver plays a crucial role in blood sugar regulation, the pancreas and its hormones, insulin and glucagon, are primarily responsible.
C. When blood sugar levels fall, the pancreas releases glucagon, not insulin.
D. Glucagon is released when blood sugar levels are low, not high.

A. Rapidly administer an IV infusion of 0.9% sodium chloride B. Administer an IV infusion of Insulin Glargine at 3 units/kg/hr C. Add glucose to the IV infusion when blood glucose is 350 mg/dL D. Administer a slow IV infusion of 3% sodium chloride

Correct Answer is A

Explanation

A. Patients with DKA are severely dehydrated due to osmotic diuresis caused by hyperglycemia. Rapid fluid resuscitation with normal saline (0.9% sodium chloride) is crucial to correct fluid and electrolyte imbalances.
B. Insulin Glargine is a long-acting insulin not suitable for acute management of DKA. Rapid-acting insulin, such as regular insulin, is used in an IV infusion.
C. Glucose is not added to the IV infusion during the initial phase of DKA treatment. The focus is on correcting fluid and electrolyte imbalances and lowering blood glucose with insulin.
D. 3% sodium chloride is a hypertonic solution used in specific circumstances, not for initial fluid resuscitation in DKA.

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Naxlex Comprehensive Predictor Exams

An RN preceptor is reviewing blood sugar control with a newly graduated nurse. Which of the following represents the normal process of how the body regulates blood sugar levels:

Correct Answer is A

Explanation

A nurse is reviewing the medical record for a client who is to begin therapy for DKA. Which of the following prescriptions should the nurse expect?

Correct Answer is A

Explanation

Which of the following can lead to an acute rise in blood sugar levels?

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