A nurse in a mental health clinic is assessing a client prior to their appointment with the provider
show:
Exhibits

Complete the diagram by dragging from the choices below to specify the following:

which condition the client is most likely experiencing

Two actions for the nurse take to address this condition

Two parameters for the nurse to monitor to assess the client's progress

Answer and Explanation

The Correct Answer is []

Potential Condition: Narcissistic Personality Disorder (NPD)

The client shows classic traits of NPD, including: Grandiosity: Claims their office is "falling apart without me." Entitlement and arrogance: Shows irritation at being brought to the appointment and lacks insight into why others might be concerned. Lack of empathy: Belittles a homeless person and fails to understand the inappropriateness of the remark. Boasting: Exaggerates the achievements of their children, aligning with inflated self-image.

Actions to Take

Maintain a neutral demeanor: Helps the nurse stay objective and reduces the likelihood of reinforcing the client’s manipulative or confrontational behaviors.

Avoid becoming defensive when the client makes disparaging remarks: Clients with NPD may challenge or provoke others; staying calm avoids power struggles and maintains therapeutic boundaries.

Parameters to Monitor

Manipulative behavior: Clients with NPD may attempt to control or influence others to serve their own needs.

Lack of empathy: Key diagnostic feature of NPD; monitoring helps assess therapeutic progress or regression.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Malignant hypertension is a hypertensive emergency characterized by extremely high blood pressure with end-organ damage. It is not typically associated with diabetic ketoacidosis (DKA), which more commonly presents with hypotension due to dehydration.
B. Acetone odor to breath is a hallmark sign of DKA. It results from the buildup of ketones (especially acetone) in the blood due to the breakdown of fat for energy when insulin is insufficient. This gives the breath a characteristic fruity or nail-polish-like odor.
C. Cheyne-Stokes breathing is a pattern of periodic breathing often seen in neurologic or end-of-life conditions, not typically associated with DKA. In DKA, Kussmaul respirations—deep and rapid breathing—are more characteristic as the body attempts to compensate for metabolic acidosis.
D. Blood glucose level below 40 mg/dL indicates severe hypoglycemia, which is the opposite of DKA. DKA typically presents with hyperglycemia, usually with blood glucose levels above 250 mg/dL.

A. Dextrose 5% in 0.45% sodium chloride B. Oral hypoglycemic medications C. Glucocorticoid medications D. 0.9% sodium chloride IV bolus

Correct Answer is D

Explanation

A. Dextrose 5% in 0.45% sodium chloride is incorrect. Dextrose is not typically given in the initial management of diabetic ketoacidosis (DKA) because it can elevate blood glucose levels further. The primary goal in treating DKA is to lower the blood glucose level and correct the acidosis, not to add glucose to the system at this stage.
B. Oral hypoglycemic medications are not appropriate in DKA. The client is in a state of severe hyperglycemia and acidosis, and oral medications are ineffective for rapid glucose control in this emergency. Insulin is the treatment of choice.
C. Glucocorticoid medications are not indicated in DKA treatment. Glucocorticoids could actually worsen hyperglycemia, and they are not used to treat DKA.
D. 0.9% sodium chloride IV bolus is correct. In DKA, dehydration is common due to osmotic diuresis, and the priority treatment is to restore fluid balance. An IV bolus of normal saline (0.9% sodium chloride) is the first step to rehydrate the client and improve circulation. Once hydration begins, insulin therapy is typically initiated to reduce blood glucose and address the acidosis.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect?

Correct Answer is B

Explanation

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

Correct Answer is D

Explanation

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