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: The nurse who caused the error is not responsible for completing an incident report, which is a tool for quality improvement and risk management. The incident report should include the facts of the error, the actions taken, and the outcome of the client.
Choice B rationale: The nurse who identifies the error should notify the nurse who caused the error, the charge nurse, and the provider, but they are and they are responsible for completing the report.
Choice C rationale: The quality improvement committee may review incident reports but is not directly responsible for completing them.
Choice D rationale: The charge nurse may oversee the incident report process but is not primarily responsible for completing it.

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

Correct Answer is D

Explanation

Choice A rationale: Metronidazole is not a beta-lactam antibiotic and does not typically cause cross-reactivity in individuals with penicillin allergies.
Choice B rationale: Clarithromycin is a macrolide antibiotic and is not associated with cross-reactivity in penicillin-allergic individuals.
Choice C rationale: Vancomycin is not a beta-lactam antibiotic and does not typically cause cross-reactivity in individuals with penicillin allergies.
Choice D rationale: Ceftriaxone belongs to the beta-lactam antibiotic class, which includes penicillins, and can potentially cause cross-reactivity in individuals with a history of anaphylactic reactions to 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

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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