A 65-year-old patient with type 2 diabetes has a urinary tract infection (UTI). The unlicensed assistive personnel (UAP) reported to the nurse that the patient's blood glucose is 642 mg/dL and the patient is hard to arouse. When the nurse assesses the urine, there are no ketones present.

What collaborative care should the nurse expect for this patient?

Administer IV fluids rapidly to correct dehydration.

Routine insulin therapy and exercise

Cardiac monitoring to detect potassium changes

Administer a different antibiotic for the UTI.

Answer and Explanation

The Correct Answer is A

Choice A rationale: This patient is likely experiencing hyperosmolar hyperglycemic state (HHS). Rapid administration of IV fluids is crucial to correct severe dehydration associated with HHS.

Choice B rationale: Routine insulin therapy and exercise might be components of diabetes management but wouldn't directly address the immediate concern of severe dehydration and high blood glucose.

Choice C rationale: Cardiac monitoring for potassium changes might be necessary but isn't the primary immediate intervention for HHS.

Choice D rationale: Administering a different antibiotic for the UTI is incorrect, because there is no evidence that the current antibiotic is ineffective or causing adverse effects. The UTI may have triggered the HHS, but it is not the main problem that needs to be addressed urgently.

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Correct Answer is D

Explanation

Choice A rationale: Fluoxymesterone is a synthetic forms of testosterone that can worsen BPH by increasing the level of DHT.

Choice B rationale: Danazol is a synthetic forms of testosterone that can worsen BPH by increasing the level of DHT.

Choice C rationale: Methyltestosterone is a synthetic forms of testosterone that can worsen BPH by increasing the level of DHT.

Choice D rationale: Finasteride is a medication that inhibits the conversion of testosterone to dihydrotestosterone (DHT), which is a hormone that stimulates the growth of the prostate gland. By reducing the level of DHT, finasteride can shrink the enlarged prostate and improve urinary symptoms in men with benign prostatic hyperplasia (BPH). The other choices are not appropriate for BPH.

A. A 42-yr-old patient with secondary amenorrhea who says that her last menstrual cycle was 3 months ago B. A 19-yr-old patient with menorrhagia who has been using superabsorbent tampons and has fever with weakness C. A 22-yr-old patient with persistent red-brown vaginal drainage 3 days after having balloon thermotherapy D. A 35-yr-old patient with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago

Correct Answer is B

Explanation

Choice A rationale: The 42-yr-old patient with secondary amenorrhea may have menopause, pregnancy, or a hormonal disorder. This is less urgent compared to the 19- year old patient.

Choice B rationale: This patient may have toxic shock syndrome, which is a life- threatening complication of tampon use that can cause organ failure and shock. The nurse should assess the patient's vital signs, remove the tampon, and initiate fluid resuscitation and antibiotic therapy.

Choice C rationale: This patient may have an infection or a complication of the balloon thermotherapy, which is a procedure to destroy the endometrial lining of the uterus and is not an emergency compared to the 19 year old.

Choice D rationale: This patient may have a displacement or perforation of the IUD, which is a contraceptive device that releases progestin into the uterus. However, this is not urgent compared to the 19 year old.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). Which of the following medications should the nurse plan to administer?

Correct Answer is D

Explanation

The nurse in the women's health clinic has four patients who are waiting to be seen. Which patient should the nurse see first?

Correct Answer is B

Explanation

The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?

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