A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNK) is made. The nurse prepares for the administration of which initial therapy?
Administration of glucagon
Large amounts of IV saline solution
Long-acting IV insulin
Oxygen by nasal cannula
The Correct Answer is B
B. Large amounts of IV saline solution: This is the correct initial therapy. HHNK is characterized by severe dehydration due to osmotic diuresis resulting from hyperglycemia. Therefore, the administration of large amounts of IV saline solution is essential to correct dehydration, restore intravascular volume, and improve tissue perfusion.
A. Glucagon is typically administered to treat severe hypoglycemia, not hyperglycemia.
C. Short-acting or regular insulin is administered initially to lower blood glucose levels rapidly. Long-acting insulin formulations may be used later to maintain glycemic control once the acute phase is managed.
D. Oxygen therapy may be indicated if the client is hypoxic, but it is not the initial therapy for HHNK. The priority in HHNK is to correct dehydration and hyperglycemia through fluid resuscitation and insulin therapy, respectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Emptying the bladder before and after sexual intercourse can help flush out bacteria that may have entered the urethra during sexual activity, reducing the risk of UTIs. Therefore, this statement indicates effective understanding of preventive measures.
B. Regularly emptying the bladder helps prevent the buildup of bacteria in the urinary tract, reducing the risk of UTIs. Therefore, this statement indicates effective understanding of preventive measures.
C. Using vaginal sprays and douches can disrupt the natural balance of bacteria in the vagina and increase the risk of UTIs and other vaginal infections. Therefore, this statement indicates a misunderstanding of preventive measures and could potentially contribute to an increased risk of UTIs.
D. Wiping from front to back after urination helps prevent the spread of bacteria from the anal area to the urethra, reducing the risk of UTIs. Therefore, this statement indicates effective understanding of preventive measures.
Correct Answer is D
Explanation
D. This candidate has obesity-related comorbidities such as hypertension and gallstones, which may indicate a higher risk of complications from obesity. With a BMI of 42, this individual meets the criteria for bariatric surgery. Additionally, being older than 18 years old and having obesity-related comorbidities make this candidate a potentially suitable candidate for bariatric surgery.
A. Bariatric surgery may not be appropriate for individuals with severe alcohol addiction or unstable cardiovascular conditions like congestive heart failure. Additionally, with a BMI of 30, this candidate is considered overweight but may not meet the criteria for bariatric surgery.
B. Bariatric surgery is not typically recommended for adolescents with a BMI in the normal weight range (18.5 to 24.9), such as this candidate. Furthermore, severe acne alone would not be a sufficient indication for bariatric surgery.
C. Bariatric surgery candidates should be mentally stable and capable of understanding and adhering to the necessary pre- and postoperative guidelines.
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