A nurse is assessing a client who has type 1 diabetes mellitus and has a blood glucose level of 550 mg/dL. Which of the following should the nurse assess the client for if diabetic ketoacidosis (DKA) is suspected?
Dizziness
Nervousness
Mental status changes
Cool, clammy skin
The Correct Answer is C
Choice A reason: Dizziness can be a symptom of DKA due to dehydration; however, it is not as specific as mental status changes.
Choice B reason: Nervousness is not a specific symptom of DKA and can be related to high blood glucose levels rather than DKA itself.
Choice C reason: Mental status changes such as confusion or altered consciousness are significant indicators of DKA and require immediate medical atention.
Choice D reason: Cool, clammy skin is not typically associated with DKA; instead, DKA can present with dry skin and mouth due to dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
Choice A reason: Proper hand hygiene is essential before connecting the tubing to the catheter to prevent infections, which is a key component of CAPD management.
Choice B reason: There is no requirement to lay down while the dialysis solution dwells in the peritoneal cavity. Patients can move around and continue with their daily activities.
Choice C reason: Regularly weighing oneself is important to monitor fluid balance and the effectiveness of the dialysis, making it a crucial part of home dialysis management.
Choice D reason: CAPD typically involves multiple exchanges throughout the day, not just one instillation at bedtime.
Choice E reason: Monitoring blood pressure is important for managing fluid balance and cardiovascular health in patients on dialysis.
Correct Answer is B
Explanation
Choice A reason: The bladder is not where renal calculi typically begin to form; it is where they may end up if they travel down from the kidneys.
Choice B reason: Renal calculi commonly begin forming at the renal papilla, which is part of the kidney where urine collects before it flows into the ureter.
Choice C reason: The ureter is not the typical starting point for the formation of renal calculi, though stones can travel through it.
Choice D reason: The urethra is not a common site for the formation of renal calculi; it is the duct through which urine is discharged.
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