14:20: 87-year-old client admitted to the ED from the independent living apartment with a new report of episodic acute confusion. urinary frequency and incontinence, and severe fatigue. The child states that the client is independent in ADCs and has no history of dementia.
15:30: Normal BMP and CBC results, except for WBCs of 16,000/mm3 (16 x 109 /L) with bands greater than 10%.
Based on the assessment findings presented which condition would the nurse suspect?
Diabetic ketoacidosis
Dehydration
Urinary tract infection
Hepatitis
The Correct Answer is C
Based on the assessment findings presented, the nurse would suspect a urinary tract infection (UTI). The client's symptoms of acute confusion, urinary frequency and incontinence, and elevated WBC count with bands suggest a possible infection. Dehydration or diabetic ketoacidosis could also cause confusion and fatigue, but these conditions are less likely given the normal BMP and CBC results.
Hepatitis would not typically present with these specific symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["D","F","G"]
Explanation
Option A is incorrect because administering an ACE inhibitor may be a part of the patient's regular medication regimen, but it is not specific to preventing complications of diabetes mellitus while in the hospital.
Option b is incorrect because administering intravenous fluids at a high rate may result in fluid overload, electrolyte imbalances, and other complications, which may not be appropriate for this patient.
Option c is incorrect because administering glucagon is not a preventative measure, but rather an intervention for treating hypoglycemia.
Option d is correct because ensuring a well-lit path to the bathroom is important for fall prevention, but it does not directly address the prevention of complications of diabetes mellitus.
Option e is incorrect because encouraging the client to drink sugar-free liquids is a general recommendation for maintaining hydration and may not be specific to preventing complications of diabetes mellitus.
Option f is correct because teaching the client to rise slowly from the bed is important for preventing orthostatic hypotension, but it does not directly address the prevention of complications of diabetes mellitus.
Option g is correct because Patients with diabetes mellitus are at risk for hypoglycemia when taking insulin or oral hypoglycemic agents. Proper coordination of meal-time insulin with food delivery and consumption can help prevent hypoglycemia or hyperglycemia. This includes ensuring that the patient receives insulin at the appropriate time in relation to meals and monitoring blood glucose levels regularly.
Correct Answer is B
Explanation
This is because the persistent dysuria suggests that the initial treatment was not effective, and there may be a possibility of a resistant organism. Obtaining a midstream urine specimen for culture and sensitivity testing will help identify the specific microorganism causing the infection and determine the most effective antibiotic to use. The nurse should also instruct the patient to continue to drink plenty of fluids, as this will help flush out the bacteria and relieve symptoms. The nurse may suggest the use of acetaminophen (Tylenol) to relieve discomfort, but this should not be the only action taken, as treating the underlying infection is crucial. The nurse should not tell the patient to take trimethoprim and sulfamethoxazole for an additional three days, as the initial treatment was not effective, and a different course of treatment may be required based on the results of the urine culture and sensitivity testing.
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