A client in DKA is ordered regular insulin at 7 units per hour for the current blood glucose level. The institution protocol is to add 100 units of regular insulin to a 150 ml bag of normal saline. What is the correct rate for the nurse to set the IV pump for this dose?

(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

The Correct Answer is ["10.5"]

Step 1: Determine the concentration of insulin in the IV bag. 100 units of insulin are added to 150 mL of normal saline.

100 units ÷ 150 mL = (100 ÷ 150) = 0.6667 units per mL Result: 0.6667 units per mL

Step 2: Calculate the rate in mL per hour needed to deliver 7 units per hour. 7 units per hour ÷ 0.6667 units per mL = (7 ÷ 0.6667) = 10.5 mL per hour Result: 10.5 mL per hour

The correct rate for the nurse to set the IV pump is 10.5 mL per hour.

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Correct Answer is D

Explanation

Choice A Reason: Is not responding to other clients on the unit.

While a lack of response to other clients can indicate social withdrawal and isolation, which are common in depressive episodes, it does not necessarily indicate an immediate risk to the client’s safety. This behavior is concerning but does not require the highest priority intervention compared to other behaviors that may indicate a risk of self-harm or suicidal ideation.

Choice B Reason: Is refusing to take their prescribed mood stabilizer.

Refusing medication is a significant concern as it can lead to worsening of symptoms and destabilization of the client’s condition. However, this behavior does not indicate an immediate risk to the client’s safety. The nurse should address this issue promptly, but it is not the highest priority compared to behaviors that suggest suicidal ideation.

Choice C Reason: Angrily argues with another client stating, “God is dead.”

This behavior indicates agitation and potential conflict with others, which can be problematic in a clinical setting. However, it does not directly suggest an immediate risk to the client’s safety. The nurse should intervene to de-escalate the situation and provide support, but this is not the highest priority compared to signs of suicidal ideation.

Choice D Reason: States, “There is no future when you feel so depressed.”

This statement is highly concerning as it indicates feelings of hopelessness and potential suicidal ideation. Expressions of hopelessness and statements about the future being bleak are significant risk factors for suicide. The nurse should prioritize this behavior for immediate intervention to assess the client’s risk of self-harm and provide appropriate support and safety measures.

A. Cardiac dysrhythmia resulting in cardiac arrest B. Endocrine imbalance causing amenorrhea C. Decreased metabolism causing cold intolerance D. Glucose intolerance resulting in hypoglycemia

Correct Answer is A

Explanation

a. Cardiac dysrhythmia resulting in cardiac arrest

Explanation of Choices

Choice A Reason: Cardiac Dysrhythmia Resulting in Cardiac Arrest

Cardiac dysrhythmias, or irregular heartbeats, are a significant health complication associated with anorexia nervosa. These dysrhythmias can result from electrolyte imbalances, particularly low potassium levels (hypokalemia), which are common in individuals with anorexia due to malnutrition and purging behaviors. Severe dysrhythmias can lead to cardiac arrest, making this one of the most critical and potentially fatal complications of anorexia nervosa. The heart muscle can weaken due to prolonged malnutrition, leading to a condition known as myocardial atrophy, which further increases the risk of cardiac complications.

Choice B Reason: Endocrine Imbalance Causing Amenorrhea

Amenorrhea, or the absence of menstruation, is a common endocrine complication in females with anorexia nervosa. This condition occurs due to the body’s response to severe weight loss and malnutrition, which disrupts the normal production of reproductive hormones. While amenorrhea is a significant health issue, it is not as immediately life-threatening as cardiac dysrhythmias. Amenorrhea can lead to long-term complications such as infertility and osteoporosis but does not typically result in acute medical emergencies.

Choice C Reason: Decreased Metabolism Causing Cold Intolerance

Decreased metabolism and cold intolerance are common symptoms in individuals with anorexia nervosa. The body reduces its metabolic rate in response to prolonged starvation to conserve energy. This can lead to a lower body temperature and increased sensitivity to cold. While uncomfortable and indicative of severe malnutrition, decreased metabolism and cold intolerance are not as immediately dangerous as cardiac dysrhythmias. These symptoms reflect the body’s adaptation to a state of energy deficiency but do not pose an immediate threat to life.

Choice D Reason: Glucose Intolerance Resulting in Hypoglycemia

Hypoglycemia, or low blood sugar, can occur in individuals with anorexia nervosa due to inadequate food intake. However, glucose intolerance and hypoglycemia are less common and less severe complications compared to cardiac dysrhythmias. Hypoglycemia can cause symptoms such as dizziness, confusion, and fainting, but it is typically manageable with appropriate nutritional support. It does not carry the same immediate risk of fatality as cardiac dysrhythmias.

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Naxlex Comprehensive Predictor Exams

A client diagnosed with bipolar disorder is experiencing a severe depressive episode. Which client behavior would alert the nurse to the highest priority intervention? The client:

Correct Answer is D

Explanation

The nurse is aware that the major health complication associated with anorexia nervosa is:

Correct Answer is A

Explanation

The intervention appropriate for a client who has been manipulating others and has a diagnosis of antisocial personality disorder is to:

The nurse is planning a psycho-education group for clients diagnosed with borderline personality disorder. The nurse understands that which aspect of group intervention is most essential initially to establish a trusting nurse-patient relationship?

A client presents to the Emergency Department (ED) after ingesting phencyclidine (PCP). Characteristic behaviors of an individual who has ingested PCP include:

An individual with a history of antisocial personality disorder was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected?

In assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to observe?

The nurse is educating clients about recovery from alcohol abuse. Which statement by the client indicates that learning has occurred?

A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?

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