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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: An allergy to sulfa drugs is important as some diabetes medications, like sulfonylureas, contain components related to sulfa drugs, which could cause an allergic reaction in susceptible individuals.
Choice B rationale: Smoking cessation and lifestyle history are important but might not directly impact initial diabetes treatment options.
Choice C rationale: Numbness in the soles of the feet might indicate neuropathy, a common complication of diabetes, but is not directly related to the choice of initial treatment.
Choice D rationale: While obesity is a risk factor for Type 2 diabetes, it's less critical for immediate treatment decisions compared to drug allergies that could impact medication choices.
Correct Answer is C
Explanation
Choice A rationale: Conus medullaris syndrome involves injury or compression to the end portion of the spinal cord and can present with various symptoms but not necessarily lack of normal sympathetic outflow leading to shock.
Choice B rationale: Concussion is a mild traumatic brain injury, and the symptoms described align more with spinal cord injury leading to neurogenic shock.
Choice C rationale: Neurogenic shock occurs due to the loss of sympathetic tone and is characterized by bradycardia, low blood pressure, and vasodilation following spinal cord injury at or above the level of the sixth thoracic vertebra.
Choice D rationale: Diffuse axonal injury typically presents with more widespread brain injury-related symptoms and is not associated with the specific spinal cord-related symptoms described.
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