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 B

Explanation

B. After ESWL for a urinary stone, it is essential to monitor the client's urine characteristics (such as color, clarity, and presence of blood) and output. The presence of hematuria is a common and expected finding after ESWL due to the disruption of tissue and blood vessels during the procedure. Monitoring urine output helps assess renal function and ensures adequate hydration, which is crucial for flushing out stone fragments.
A. While monitoring urine specific gravity can provide information about the concentration of urine, and assessing antigen levels may be relevant in certain contexts, these parameters are not typically the most important information to collect immediately after extracorporeal shock-wave lithotripsy (ESWL) for a urinary stone.
C. While it is important to monitor the surgical site for signs of infection or complications after any procedure, ESWL is a non-invasive procedure performed externally, typically without any incisions.
D. While obtaining clean catch urine specimens for urinalysis and culture may be relevant for assessing urinary tract infection or other urinary abnormalities, it is not typically the most important information to collect immediately after ESWL.

A. pain is relieved by belching. B. eating food relieves pain. C. pain is aggravated by eating. D. pain occurs on the right side of the abdomen.

Correct Answer is B

Explanation

B. Eating food relieves pain is typical of a duodenal ulcer. In the duodenum, food intake stimulates the release of pancreatic juices which comprises of bicarbonate. Bicarbonate neutralizes acid relieving pain.
A. Belching can help release gas from the stomach, which may provide temporary relief from pain caused by excess gastric acid irritating the ulcer.
C. Pain is aggravated by eating is typical of gastric ulcer. Food intake stimulates the secretion of gastric acid which irritates gastric ulcer aggravating pain.
D. Pain associated with duodenal ulcers typically occurs in the upper central or upper right quadrant 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 who has a confirmed urinary stone in the proximal left ureter undergoes extracorporeal shock- wave lithotripsy. What Information is most Important for the nurse to collect after lithotripsy?

Correct Answer is B

Explanation

The nurse is recording data obtained from a client's admission assessment. Which notation is most consistent with the presence of a duodenal ulcer? The client states that:

Correct Answer is B

Explanation

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