Adults 2 Sim 2 Quiz

QUESTION 2 1. A client is admitted to a hospital with a diagnosis if diabetic ketoacidosis. The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of short-acting insulin is initiated, along with intravenous rehydration with normal saline. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which item? Ampule of 50% dextrose NPH insulin subcutaneously Intravenous fluids containing dextrose Phenytoin (Dilantin) for the prevention of seizures

c Intravenous fluids containing dextrose Rationale: During management of DKA, when the blood glucose level falls to 250 to 300 mg/dL, the infusion rate is reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL, or until the client recovers from ketosis. Fifty percent dextrose is used to treat hypoglycemia. NPH insulin is not used to treat DKA. Phenytoin (Dilantin) is not a usual treatment measure for DKA.

QUESTION 3 1. The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which of the following symptoms develop? Select all that apply. Polyuria Shakiness Lightheadedness Fruit breath odor

b, c Shakiness Lightheadedness

1. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings should the nurse expect to note as confirming this diagnosis? Select all that apply. Increase in pH Deep, rapid breathing Decreased urine output Elevated blood glucose level Low plasma bicarbonate level

b, d, e Deep, rapid breathing Elevated blood glucose level Low plasma bicarbonate level Rationale: In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmaul's respirations (deep and rapid breathing pattern) would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis.

QUESTION 5 1. The nurse is assigned to a patient who was recently diagnosed with a terminal illness. During morning care, the patient asks about organ donation. The nurse should: a. Have the patient first discuss the subject with their family b. Suggest the patient delay making a decision at this time c. Assist the patient to obtain the necessary information to make this decision d. Contact the primary provider so consent can be obtained from the family

c

QUESTION 4 1. A newly graduated nurse is assigned to his/her first dying patient. The nurse is best prepared to care for this patient if he/she: Completed a course dealing with death and dying Is able to control his/her own emotions about death Has experienced the death of a loved one Has developed a personal understanding of his/her own feelings about death

c Has experienced the death of a loved one

QUESTION 6 1. It is crucial for family members to remain at the bedside during withdrawal of life-sustaining measures until patient death occurs. True False

False