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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 A

Explanation

A. Obtain the patient's blood glucose level between 2a.m-4a.m – Correct Answer. The Somogyi effect occurs when nighttime hypoglycemia triggers a rebound hyperglycemia in the morning. Checking the blood glucose level during the early morning hours helps confirm this phenomenon.

B. Check the patient for a change in level of consciousness between 2a.m-4a.m – Incorrect. While severe hypoglycemia can affect consciousness, the best way to confirm the Somogyi effect is through blood glucose monitoring.

C. Withhold the nighttime snack and check the glucose at 6:00 a.m. – Incorrect. A nighttime snack can help prevent the hypoglycemia that leads to the Somogyi effect.

D. Administer an increased dose of NPH insulin in the evening. – Incorrect. Increasing insulin could worsen nighttime hypoglycemia, making the Somogyi effect worse.

A. Neutropenic B. Contact C. Droplet D. Bleeding

Correct Answer is D

Explanation

A. Neutropenic – Used for low WBC count, not platelets.

B. Contact – Used for infections like C. diff or MRSA.

C. Droplet – Used for respiratory illnesses like flu or meningitis.

D. Bleeding – Correct Answer. A low platelet count increases the risk of bleeding, so bleeding precautions are necessary (e.g., soft toothbrush, avoiding IM injections, fall precautions).

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

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