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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is A
Explanation

Expired medications should not be used and should be disposed of properly. The best way to do this is to return them to the pharmacy for proper disposal.
Choice B is wrong because flushing medications down the toilet can contaminate the water supply and harm the environment.
Choice C is wrong because expired medications should not be placed back in the medication cart as they may accidentally be used.
Choice D is wrong because notifying the provider about expired medications is not necessary as it is the responsibility of the nurse to properly dispose of them.
Correct Answer is A
Explanation
The nurse should monitor the client for hearing loss because it is a potential adverse effect of erythromycin.
Choice B is wrong because a high-fiber diet to prevent constipation is not mentioned as a necessary action when administering erythromycin lactobionate IV bolus.
Choice C is wrong because erythromycin lactobionate IV bolus should not be administered over 10 min; bolus injection (IV push) is contraindicated.
Choice D is wrong because erythromycin lactobionate should not be reconstituted with a 5% dextrose solution; it should be reconstituted with sterile water for injection.
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