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A nurse is assessing a patient who has diabetes mellitus. Which of the following findings is a manifestation of hypoglycemia?

Bradycardia

Fruity odor on the client's breath

Vomiting

Cool, clammy skin

Answer and Explanation

The Correct Answer is D

A. Bradycardia is not a typical sign of hypoglycemia; tachycardia is more common.

B. A fruity odor on the breath is a sign of diabetic ketoacidosis (DKA) (hyperglycemia).

C. Vomiting is more common in hyperglycemia/DKA rather than hypoglycemia.

D. Hypoglycemia presents with cool, clammy skin, sweating, confusion, and tremors due to the release of epinephrine.

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Correct Answer is D

Explanation

A. Incorrect. Never insert anything into a seizing patient's mouth, as it can cause injury.

B. Incorrect. The bed should be in the lowest position to prevent falls.

C. Incorrect. Keeping lights on is unnecessary and can cause sensory overstimulation.

D. Correct. IV access is important in case emergency medications (e.g., lorazepam) are needed during a seizure.

A. Clarify the prescription because the insulin should not be administered at this time. B. Hold breakfast for one hour after the insulin administration. C. Administer insulin when breakfast arrives. D. Check the blood glucose immediately after breakfast.

Correct Answer is C

Explanation

A. Clarify the prescription because the insulin should not be administered at this time. – Incorrect. Aspart insulin is rapid-acting and should be given with meals to prevent post-meal hyperglycemia.

B. Hold breakfast for one hour after the insulin administration. – Incorrect. Rapid-acting insulin peaks quickly (within 30-90 minutes), so delaying food increases the risk of hypoglycemia.

C. Administer insulin when breakfast arrives. – Correct Answer. Aspart insulin should be given right before or with food to match glucose absorption and prevent hypoglycemia.

D. Check the blood glucose immediately after breakfast. – Incorrect. Blood glucose should be checked before insulin administration to ensure appropriate dosing.

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A nurse is assessing a patient who has diabetes mellitus. Which of the following findings is a manifestation of hypoglycemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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