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

Answer and Explanation

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.

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Correct Answer is ["A","B","C","E"]

Explanation

A. Chocolate can relax the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus and exacerbate symptoms. Therefore, it is advisable for clients with GERD to avoid chocolate.
B. Tomato-based products are acidic and can aggravate GERD symptoms. Tomatoes are naturally acidic, which can contribute to increased acidity in the stomach and exacerbate reflux symptoms.
C. Spicy and high-fat foods, such as hot and spicy pork rinds, can trigger GERD symptoms by increasing stomach acid production and relaxing the LES. Spicy foods can irritate the esophagus and exacerbate symptoms such as heartburn and reflux.
E. Oranges and other citrus fruits are acidic and can irritate the esophagus, exacerbating GERD symptoms. The acidity in oranges can increase stomach acid production and contribute to reflux.
D. Green beans are generally considered safe for individuals with GERD. They are low in fat and acidity, making them less likely to trigger reflux symptoms.

A. 1 B. 2 C. 3 D. 4

Correct Answer is B

Explanation

McBurney's point is located approximately one-third of the distance from the anterior superior iliac spine (ASIS) to the umbilicus (navel), on the right side of the abdomen.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a new diagnosis of GERD is preparing for discharge from the hospital. Which foods will the nurse teach this client to avoid? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","E"]

Explanation

The client has a possible diagnosis of appendicitis. On physical examination, the nurse should assess for tenderness on palpation at McBurney's point, located at which pictured site?

Correct Answer is B

Explanation

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