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SAUNDERS NCLEX ENDOCRINE 2024/2025 FINAL EXAM (QUESTIONS AND VERIFIED ANSWERS) RATED A+
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SAUNDERS NCLEX ENDOCRINE2024/2025 FINAL EXAM
(QUESTIONS AND VERIFIED
ANSWERS) RATED A+
A client is brought to the emergency department in an unresponsive state, and
a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse
would immediately prepare to ini;ate which an;cipated health care provider's
prescrip;on?
1.
Endotracheal intuba;on
2.
100 units of NPH insulin
3.
Intravenous infusion of normal saline
4.
Intravenous infusion of sodium bicarbonate
Intravenous infusion of normal saline
The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS)
is to rehydrate the client to restore fluid volume and to correct electrolyte
deficiency. Intravenous (IV) fluid replacement is similar to that administered in
diabe;c ketoacidosis (DKA) and begins with IV infusion of normal saline.
Regular insulin, not NPH insulin, would be administered. The use of sodium
bicarbonate to correct acidosis is avoided because it can precipitate a further
,drop in serum potassium levels. Intuba;on and mechanical ven;la;on are not
required to treat HHS.
An external insulin pump is prescribed for a client with diabetes mellitus. When
the client asks the nurse about the func;oning of the pump, the nurse bases
the response on which informa;on about the pump?
1.
It is ;med to release programmed doses of either short-dura;on or NPH insulin
into the bloodstream at specific intervals.
2.
It con;nuously infuses small amounts of NPH insulin into the bloodstream
while regularly monitoring blood glucose levels.
3.
It is surgically aVached to the pancreas and infuses regular insulin into the
pancreas. This releases insulin into the bloodstream.
4.
It administers a small con;nuous dose of short-dura;on insulin
subcutaneously. The client can self-administer an addi;onal bolus dose from
the pump before each meal.
It administers a small con;nuous dose of short-dura;on insulin
subcutaneously. The client can self-administer an addi;onal bolus dose from
the pump before each meal.
An insulin pump provides a small con;nuous dose of short-dura;on (rapid- or
short-ac;ng) insulin subcutaneously throughout the day and night. The client
can self-administer an addi;onal bolus dose from the pump before each meal
,as needed. Short-dura;on insulin is used in an insulin pump. An external pump
is not aVached surgically to the pancreas.
A client with a diagnosis of diabe;c ketoacidosis (DKA) is being treated in the
emergency department. Which findings support this diagnosis? Select all that
apply.
1.
Increase in ph
2.
Comatose state
3.
Deep, rapid breathing
4.
Decreased urine output
5.
Elevated blood glucose level
2.
Comatose state
3.
Deep, rapid breathing
5.
Elevated blood glucose level
Because of the profound deficiency of insulin associated with DKA, glucose
cannot be used for energy and the body breaks down fat as a secondary source
of energy. Ketones, which are acid byproducts of fat metabolism, build up and
, the client experiences a metabolic ketoacidosis. High serum glucose
contributes to an osmo;c diuresis and the client becomes severely dehydrated.
If untreated, the client will become comatose due to severe dehydra;on,
acidosis, and electrolyte imbalance. Kussmaul's respira;ons, the deep rapid
breathing associated with DKA, is a compensatory mechanism by the body. The
body aVempts to correct the acido;c state by blowing off carbon dioxide
(CO2), which is an acid. In the absence of insulin, the client will experience
severe hyperglycemia. Op;on 1 is incorrect because in acidosis the ph would
be low. Op;on 4 is incorrect because a high serum glucose will result in an
osmo;c diuresis and the client will experience polyuria.
The nurse teaches a client with diabetes mellitus about differen;a;ng between
hypoglycemia and ketoacidosis. The client demonstrates an understanding of
the teaching by sta;ng that a form of glucose should be taken if which
symptom or symptoms develop? Select all that apply.
1.
Polyuria
2.
Shakiness
3.
Palpita;ons
4.
Blurred vision
5.
Lightheadedness
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