A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 100 mg/dl. Which of the following interventions should the nurse initiate first?

Potassium chloride 10 mEq/hr

Bicarbonate by IV infusion

Subcutaneous insulin injections

0.99% sodium chloride 15 mL/kg/hr

Answer and Explanation

The Correct Answer is D

A. Potassium chloride 10 mEq/hr:
While potassium replacement is crucial in DKA, initiating it before fluid resuscitation can lead to further complications. Insulin administration can drive potassium back into cells, potentially causing hypokalemia. Fluid resuscitation helps address dehydration and electrolyte imbalances.
B. Bicarbonate by IV infusion:

Bicarbonate therapy is generally reserved for severe cases of acidosis, and its use in DKA is controversial. In this scenario, the blood glucose level is not significantly elevated, and the focus should be on fluid resuscitation and insulin administration.
C. Subcutaneous insulin injections:
While insulin is a critical component of DKA management, it should be administered intravenously for faster and more precise control of blood glucose levels. Subcutaneous insulin injections are not the initial route of administration in DKA.
D. 0.9% sodium chloride 15 mL/kg/hr:
This is the correct answer. The first step in DKA management is fluid resuscitation with isotonic saline (0.9% sodium chloride). The goal is to address dehydration, restore intravascular volume, and improve perfusion. Insulin therapy and other interventions follow fluid resuscitation.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

A. I will check the client's INR before administering the heparin:
Checking the International Normalized Ratio (INR) is more relevant for monitoring the effects of warfarin, not heparin. Heparin is typically monitored by activated partial thromboplastin time (aPTT) or anti-Xa levels.
B. "I will apply pressure for 1 minute after the injection:"
Applying gentle pressure to the injection site for about 1 minute after administering heparin is appropriate to prevent bleeding or bruising. Since heparin is an anticoagulant, there's an increased risk of bleeding at the injection site.
C. I will massage the site after injecting the heparin:
Massaging the site after injecting heparin is not recommended. It can increase the risk of hematoma formation. After subcutaneous injection, it is generally advised to avoid massaging the site.
D. I will aspirate before administering the heparin:
Aspiration is not recommended when administering heparin subcutaneously, as it can increase the risk of tissue damage and bruising. The nurse should inject the heparin without aspirating.

A. Oxygen saturation 96% B. PaCO2 30 mm Hg C. Decrease in protein D. Increase in BP

Correct Answer is D

Explanation

A. Oxygen saturation 96%:
Oxygen saturation at 96% is within the normal range and may not be directly influenced by the infusion of albumin. Albumin administration is more related to improving intravascular volume and blood pressure.
B. PaCO2 30 mm Hg:
The partial pressure of carbon dioxide (PaCO2) is a measure of respiratory status. Albumin infusion is not directly associated with changes in PaCO2.
C. Decrease in protein:
Albumin is a protein, and its infusion would not lead to a decrease in protein levels. In fact, albumin administration increases the oncotic pressure in the intravascular space, helping to retain fluid and improve blood volume.
D. Increase in BP:
This is the correct answer. Albumin is a colloid solution that increases oncotic pressure in the bloodstream. By increasing oncotic pressure, albumin helps to draw fluid from the interstitial space into the vascular space, thereby increasing blood volume. This can contribute to an increase in blood pressure, which is a desired effect in the management of shock.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 100 mg/dl. Which of the following interventions should the nurse initiate first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse is teaching a newly licensed nurse about administering heparin to a client. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect

Correct Answer is D

Explanation

A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

A client who has Graves' disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?

A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

A nurse is teaching a class about administering IV fluids to treat dehydration. The nurse should include in the teaching that which of the following laboratory values indicates effective treatment of dehydration?

A nurse is caring for a client who is receiving intravenous therapy and observes redness and inflammation along the vein. The nurse should identify this finding as which of the following complications of IV therapy?

A nurse in a provider's office is preparing to teach a middle adult client who has a new diagnosis of metabolic syndrome and an HbA1c of 6 Which of the following medications should the nurse plan to teach the client about first?

A nurse is caring for a client who is receiving ceftriaxone intravenously. Which of the following manifestations should the nurse identify as an allergic reaction?

A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?