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A nurse is caring for a client who has type 2 diabetes mellitus and notes the client is declining. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?

Hypertension

Fruity breath

Ketosis

Glucose level of 650 mg/dL

Answer and Explanation

The Correct Answer is D

A. Hypertension can be a symptom of many conditions and is not specific to HHS.

B. Fruity breath is typically associated with diabetic ketoacidosis (DKA) due to the presence of acetone, not HHS.

C. Ketosis is a key feature of DKA, not HHS. In HHS, ketosis is usually absent or minimal.

D. A glucose level of 650 mg/dL is indicative of HHS, which is characterized by extremely high blood glucose levels without significant ketosis. HHS often occurs in type

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Correct Answer is B

Explanation

A. Popping sounds, also known as crackles, are typically associated with fluid in the alveoli, often seen in conditions like pneumonia or heart failure, not pleurisy.

B. Loud, grating sounds, known as pleural friction rub, are characteristic of pleurisy. This sound is produced by the inflamed pleural surfaces rubbing together during respiration.

C. Snoring sounds, or rhonchi, are usually heard in conditions involving airway obstruction by mucus, such as bronchitis, rather than pleurisy.

D. Squeaky, musical sounds, or wheezing, are associated with airway narrowing, such as in asthma or chronic obstructive pulmonary disease (COPD), and are not typically heard in pleurisy.

A. Reduce cholesterol and saturated fat intake. B. Sustain hyperglycemia to reduce deterioration of nerve cells. C. Maintain optimal blood pressure to prevent kidney damage. D. Increase physical activity and daily exercise. E. Enroll in a smoking cessation program.

Correct Answer is ["A","C","D","E"]

Explanation

A. Reducing cholesterol and saturated fat intake is important for managing cardiovascular health, which is crucial for clients with diabetes to prevent complications such as heart disease and stroke.

B. Sustaining hyperglycemia is incorrect; it actually contributes to complications like neuropathy, retinopathy, and nephropathy. The goal is to maintain blood glucose levels within the target range.

C. Maintaining optimal blood pressure is essential in preventing diabetic nephropathy, as high blood pressure can damage the kidneys and worsen diabetic kidney disease.

D. Increasing physical activity helps improve insulin sensitivity, control blood glucose levels, and reduce the risk of complications associated with diabetes.

E. Smoking cessation is critical in reducing the risk of cardiovascular disease, which is higher in clients with diabetes. Smoking can exacerbate the complications of diabetes.

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A nurse is caring for a client who has type 2 diabetes mellitus and notes the client is declining. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?

Nursing Test Bank

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