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A nurse is assessing a 19-year-old patient who was brought to the ED in sickle cell crisis. Which of the following findings should the nurse expect?

High fever

Constipation

Bradycardia

Pain

Answer and Explanation

The Correct Answer is D

A. High fever. – Incorrect. Fever can occur with infection but is not a hallmark sign of sickle cell crisis.

B. Constipation. – Incorrect. Constipation is not a defining symptom of sickle cell crisis.

C. Bradycardia. – Incorrect. Tachycardia, not bradycardia, is common due to pain and hypoxia.

D. Pain. – Correct Answer. Severe pain is the most common symptom of sickle cell crisis due to vaso-occlusion and ischemia.

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Correct Answer is B

Explanation

A. 8:00 AM to 11:00 AM. – Incorrect. NPH insulin peaks in 6–14 hours, not within a few hours.

B. 2:00 PM to 5:00 PM. – Correct Answer. NPH insulin peaks around 6–14 hours, making this the most likely time for hypoglycemia.

C. 2:00 AM to 5:00 AM. – Incorrect. This would be the peak time for evening NPH insulin, not morning administration.

D. 10:00 PM to 12:00 AM. – Incorrect. NPH insulin does not peak this late when given in the morning.

A. Give potassium intravenously. B. Administer D5 NS with the insulin drip. C. Administer 3% NS at 200ml/hr D. Expect the insulin drip to be discontinued.

Correct Answer is B

Explanation

A. Give potassium intravenously. – The potassium level is 3.7 (within normal range 3.5–5.0), so potassium is not needed yet.

B. Administer D5 NS with the insulin drip. – Correct Answer. Once glucose drops to ≤200 mg/dL, dextrose is added to prevent hypoglycemia while continuing insulin to correct ketoacidosis.

C. Administer 3% NS at 200 mL/hr. – Hypertonic saline is used for severe hyponatremia, which is not the case here.

D. Expect the insulin drip to be discontinued. – The insulin drip is not discontinued until ketoacidosis has fully resolved (when HCO3 > 18, pH > 7.3, and anion gap normalizes).

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A nurse is assessing a 19-year-old patient who was brought to the ED in sickle cell crisis. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What time of day would a nurse expect to see signs of hypoglycemia in a patient following NPH insulin (intermediate acting) given at 7:30am?

Correct Answer is B

Explanation

A patient with diabetic ketoacidosis (DKA) has been receiving insulin for 6 hours. Laboratory finding are Na+ 131, K+ 3.7, CL- 102, HCO3 22, and glucose 170. Which action should the nurse take?

Correct Answer is B

Explanation

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