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?

Potassium chloride 10 mEq/hr

Bicarbonate by IV infusion

Subcutaneous insulin injections

0.9% sodium chloride 15 mL/kg/hr

Answer and Explanation

The Correct Answer is D

Choice A rationale: While potassium replacement is important in diabetic ketoacidosis, fluid resuscitation to restore intravascular volume, improve renal perfusion, and flush out ketones.
Choice B rationale: Bicarbonate infusion might be considered in severe acidosis, but fluid administration is the priority.
Choice C rationale: The priority intervention for a client with diabetic ketoacidosis and very high blood glucose levels is to initiate fluid resuscitation to restore intravascular volume, improve renal perfusion, and flush out ketones.
Choice D rationale: The first intervention the nurse should initiate is fluid resuscitation with 0.9% sodium chloride at a rate of 15 mL/kg/hr to restore intravascular volume, improve renal perfusion, and flush out ketones.

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Correct Answer is B

Explanation

Choice A rationale: Nausea can be a common side effect of osmotic laxatives but may not directly indicate fluid volume deficit.
Choice B rationale: Oliguria (decreased urine output) can indicate fluid volume deficit in a client taking an osmotic laxative due to potential excessive fluid loss or dehydration.
Choice C rationale: Weight gain is not typically associated with fluid volume deficit; rather, it could indicate fluid retention.
Choice D rationale: Headaches might occur due to various reasons but might not directly indicate fluid volume deficit in this context.

A. Recurrent headaches B. BP 92/60 mm Hg C. Hypothyroidism D. History of alcohol use disorder

Correct Answer is D

Explanation

Choice A rationale: Recurrent headaches might indicate the need for acetaminophen rather than warranting a provider notification.
Choice B rationale: Low blood pressure (BP 92/60 mm Hg) is not a contraindication for acetaminophen use.
Choice C rationale: Hypothyroidism might not directly impact the administration of acetaminophen.
Choice D rationale: Acetaminophen is metabolized by the liver and can cause hepatotoxicity in high doses or in clients who have liver impairment. A history of alcohol use disorder can indicate chronic liver damage and increase the risk of adverse effects from acetaminophen. Therefore, the nurse should notify the provider before administering the medication to this client.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is taking an osmotic laxative. Which of the following findings should the nurse identify as an indication of fluid volume deficit?

Correct Answer is B

Explanation

A nurse is reviewing a client's medical record before administering acetaminophen 650 mg PO every 6 hr. Which of the following findings indicates a need for the nurse to notify the provider?

Correct Answer is D

Explanation

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