A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 800 mg/dL.
Which of the following interventions should the nurse initiate first?

Subcutaneous insulin injections.

Bicarbonate by IV infusion.

0.9% sodium chloride 15 m/kg/hr.

Potassium chloride 10 mEq/hr.

Answer and Explanation

The Correct Answer is C

The first intervention for a client with diabetic ketoacidosis and a blood glucose level of 800 mg/dL should be to initiate fluid replacement therapy with 0.9% sodium chloride at a rate of 15 mL/kg/hr.

This will help to replace fluids lost through excessive urination and to dilute the excess sugar in the blood.

Choice A is wrong because subcutaneous insulin injections are not the first intervention for diabetic ketoacidosis.

Insulin therapy is generally given intravenously.

Choice B is wrong because bicarbonate by IV infusion is not the first intervention for diabetic ketoacidosis.

Choice D is wrong because potassium chloride at a rate of 10 mEq/hr is not the first intervention for diabetic ketoacidosis.

Electrolyte replacement may be necessary to replace minerals such as sodium, potassium, and chloride, but this is not the first intervention 2.

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Correct Answer is D

Explanation

Improved cognition should indicate to the nurse that the treatment with a hypertonic solution for hyponatremia is effective.

Hyponatremia can cause confusion and other neurological symptoms, so an improvement in cognition would suggest that the treatment is working to correct the electrolyte imbalance.

Choice A is wrong because Chvostek’s sign is a clinical sign of hypocalcemia, not hyponatremia.

Choice B is wrong because while vomiting can be a symptom of hyponatremia, a decrease in vomiting alone does not necessarily indicate that the treatment is effective.

Choice C is wrong because while hyponatremia can cause cardiac arrhythmias, the absence of arrhythmias alone does not necessarily indicate that the treatment is effective.

A. Vancomycin. B. Clarithromycin. C. Metronidazole. D. Ceftriaxone.

Correct Answer is D

Explanation

Ceftriaxone is contraindicated for this client because it is a cephalosporin antibiotic, which has a similar structure to penicillin and can cause cross-reactivity in individuals with a penicillin allergy.

Choice A is wrong because Vancomycin is not a beta-lactam antibiotic and does not have cross-reactivity with penicillin.

Choice B is wrong because Clarithromycin is a macrolide antibiotic and does not have cross-reactivity with penicillin.

Choice C is wrong because Metronidazole is a nitroimidazole antibiotic and does not have cross-reactivity with penicillin.

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A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 800 mg/dL. Which of the following interventions should the nurse initiate first?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 800 mg/dL.
Which of the following interventions should the nurse initiate first?