A nurse is caring for a client in the emergency department.

Exhibits
For each assessment finding, click to specify if the assessment finding is consistent with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar state (HHS). Each finding may support more than 1 disease process.
Assessment Findings: DKA /HHS

Skin turgor

Urine ketones

Blood pH greater than expected reference range

Blood glucose greater than expected reference range

Creatinine greater than expected reference range

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A,B"},"E":{"answers":"A,B"}}

A)   Slight tenting of the skin indicates dehydration, which is consistent with both DKA and HHS.
B)   The presence of ketones in the urine is a hallmark of DKA, as it indicates the body is using fat for energy due to a lack of insulin.
C)   A pH of 7.30 is lower than the normal range, suggesting acidosis, which is characteristic of DKA.
D)   A blood glucose level of 468 mg/dL is significantly higher than the normal range, which is a common finding in both DKA and HHS.
E)   An elevated creatinine level indicates kidney dysfunction, which can be a result of dehydration seen in both DKA and HHS.

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Correct Answer is B

Explanation

A. Changing dressings is important but not the priority over assessing cardiac status in an electrical shock injury.
B. Obtaining an ECG is the priority to assess for any cardiac dysrhythmias, which can be immediate and life-threatening consequences of electrical shock injuries.
C. Administering pain medication can be done once the client's cardiac status has been evaluated and stabilized.
D. While maintaining adequate urine output is important, assessing cardiac status takes precedence.

A. "You will need to take an antiviral medication for 6 months." B. "You will need cryotherapy for 1 to 2 weeks," C. "You will need three follow-up blood tests within a 24-month period." D. "You will need to be monitored for 15 minutes after receiving each medication dose."

Correct Answer is C

Explanation

A. Syphilis is a bacterial infection, so antiviral medication is not appropriate.

Treatment typically involves antibiotics, such as penicillin.

B. Cryotherapy is not a standard treatment for primary syphilis. Antibiotics are the primary treatment.

C. This is in line with the treatment guidelines for syphilis, which involve antibiotic therapy and follow-up testing to ensure the infection is fully resolved. The tests are done at 3, 6, and 12 months after completion of treatment.
D. Monitoring after medication doses may be necessary for certain medications but is not specifically indicated for primary syphilis.

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Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is managing the care of a client who has an electrical shock injury. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse is providing instructions to a client who has primary syphilis. Which of the following instructions should the nurse include in the discharge plan?

Correct Answer is C

Explanation

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