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Malignant hypertension is not a manifestation of diabetic ketoacidosis. Malignant hypertension refers to a severe, rapidly progressive elevation in blood pressure that can cause end-organ damage such as retinal hemorrhages, renal failure, or encephalopathy. While DKA can cause hemodynamic instability due to dehydration and electrolyte imbalance, it does not directly cause malignant hypertension. Blood pressure changes in DKA are more often related to hypovolemia and shock rather than hypertensive crises.

Blood glucose level below 40 mg/dL is not expected in diabetic ketoacidosis. DKA is characterized by severe hyperglycemia, typically with blood glucose levels greater than 250 mg/dL. Hypoglycemia occurs when insulin or oral hypoglycemic agents are excessive relative to glucose intake, but in DKA, the problem is insulin deficiency leading to uncontrolled hyperglycemia. Therefore, a glucose level below 40 mg/dL would be inconsistent with the pathophysiology of DKA and would instead suggest an insulin overdose or other hypoglycemic condition.

Cheyne-Stokes breathing is not typical of diabetic ketoacidosis. Cheyne-Stokes respiration is a cyclical pattern of breathing characterized by periods of apnea followed by gradually increasing and then decreasing tidal volumes, often seen in conditions such as heart failure, stroke, or traumatic brain injury. In DKA, the expected respiratory pattern is Kussmaul respirations—deep, rapid breathing—as the body attempts to compensate for metabolic acidosis by blowing off carbon dioxide. Cheyne-Stokes breathing does not serve the same compensatory purpose and is not associated with DKA.

Allowing the client to pace alone until physically tired is not therapeutic. While pacing is a form of physical release, leaving the client alone may increase feelings of isolation and does not provide emotional support or guidance. It also risks escalation of anxiety without intervention.

Instructing the client to sit down and stop pacing is inappropriate. This directive is controlling and invalidates the client’s coping mechanism. It may increase agitation and resistance, worsening the anxiety. Clients with generalized anxiety disorder need supportive interventions rather than commands that restrict their behavior.

Having a staff member escort the client to her room is not the best intervention. Forcing isolation may reinforce avoidance behaviors and does not help the client learn adaptive coping strategies. It may also be perceived as punitive, which can damage therapeutic rapport.

Taking art lessons to relieve stress is a positive coping mechanism and does not indicate a substance use disorder. Engaging in creative activities can help reduce anxiety and promote emotional regulation. This statement reflects adaptive behavior rather than maladaptive patterns associated with substance misuse.

Hanging out with friends who are a support system is also a protective factor against substance use disorder. Social support networks can provide accountability, encouragement, and emotional stability. This statement demonstrates healthy social engagement rather than evidence of a disorder.

Being focused and having goals is a sign of motivation and future orientation. Individuals with substance use disorders often struggle with impaired functioning, lack of direction, and diminished motivation due to the effects of substance misuse. Therefore, this statement does not indicate a disorder.

Providing an activity schedule that changes from day to day is inappropriate for a client with Alzheimer’s disease. These clients benefit from routine and consistency, which reduce confusion and anxiety. Frequent changes increase disorientation and agitation.

Rotating assignment of daily caregivers is not therapeutic. Clients with Alzheimer’s disease often struggle with recognition and memory. Consistency in caregivers fosters trust, reduces anxiety, and enhances cooperation. Rotating caregivers would increase confusion and distress.

Limiting time for the client to perform activities is counterproductive. Clients with Alzheimer’s disease often require extra time to process instructions and complete tasks.

Checking the client’s medication record is not necessary in this situation. The lithium level is therapeutic at 1.0 mEq/L, and there is no indication of refusal or noncompliance. While reviewing medication records is part of routine care, it does not directly address the current scenario.

Preparing for gastric lavage is unnecessary. Gastric lavage is indicated in cases of acute toxicity or overdose. A lithium level of 1.0 mEq/L is not toxic and does not warrant emergency intervention.

Holding the medication and assessing for toxicity is inappropriate because the lithium level is not elevated. Toxicity typically occurs at levels above 1.5 mEq/L, with early signs including nausea, vomiting, tremors, and confusion. Since the client’s level is therapeutic, withholding the medication would risk destabilizing treatment.

A tumor blocking the gallbladder is not the typical cause of gallstones or the need for a cholecystectomy. Tumors can obstruct bile flow, but this is a rare etiology compared to gallstone formation. The majority of cholecystectomies are performed due to gallstones obstructing bile ducts, not tumors.

A viral infection of the gallbladder is not a recognized cause of gallstone disease. While infections can cause inflammation in other organs, gallstones are formed primarily from imbalances in bile composition, such as excess cholesterol or bilirubin. Viral infection is not a standard explanation for gallbladder removal.

While cholesterol contributes to gallstone formation, the gallbladder becomes inflamed due to obstruction, not simply the presence of cholesterol. Cholesterol stones are common, but the clinical problem arises when they block bile ducts. Therefore, this explanation is incomplete and less accurate than option C.

Bleeding is not a typical adverse effect of haloperidol. Antipsychotics do not directly affect platelet function or coagulation pathways. Bleeding would be more associated with anticoagulants or certain chemotherapeutic agents.

Pancreatitis is not a common adverse effect of haloperidol. Pancreatitis is more often linked to medications such as valproic acid or corticosteroids. Haloperidol’s mechanism of action does not involve pancreatic inflammation.

Cataracts are not associated with haloperidol use. Cataracts can occur with long-term use of certain medications such as corticosteroids, but haloperidol does not cause lens opacity.

Insulin detemir is a long-acting insulin used for basal control. It is not appropriate for acute management of diabetic ketoacidosis because it does not act quickly enough to lower dangerously high blood glucose levels.

NPH insulin is an intermediate-acting insulin. It has a delayed onset and is not suitable for emergency treatment of DKA. It is used for maintenance therapy rather than acute correction.

Insulin glargine is a long-acting insulin that provides steady basal coverage. Like detemir, it is not appropriate for acute management of DKA because it cannot rapidly reduce blood glucose levels.

Encouraging frequent ambulation is not a priority intervention in acute glomerulonephritis. The condition involves inflammation of the glomeruli, often following a streptococcal infection, leading to impaired renal function, fluid retention, and hypertension. Rest and limited activity are recommended to reduce metabolic demands and allow the kidneys to recover. Ambulation does not address the underlying pathology and may worsen fatigue.

Encouraging increased fluid intake is contraindicated. Clients with acute glomerulonephritis often have reduced urine output, fluid retention, and hypertension. Increasing fluid intake can exacerbate edema and worsen cardiovascular strain. Fluid restriction is typically required to prevent complications.

Obtaining weight weekly is insufficient. Daily weights are necessary to monitor fluid balance and detect subtle changes in edema or fluid retention. Weekly measurements would delay recognition of worsening fluid overload, which can be life-threatening in acute glomerulonephritis.