A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?

4 oz diet soda

1 tsp sugar

4 oz skim milk

Graham crackers

Answer and Explanation

The Correct Answer is D

A. 4 oz diet soda: Diet soda contains artificial sweeteners, not real sugar, and therefore will not effectively raise blood glucose levels. It's not suitable for treating hypoglycemia.

B. 1 tsp sugar: While 1 tsp of sugar can provide some glucose, the amount is insufficient to treat hypoglycemia effectively. The American Diabetes Association recommends 15 grams of fast-acting carbohydrates, which is equivalent to about 4 teaspoons of sugar, not 1.

C. 4 oz skim milk: Skim milk contains both carbohydrates (approximately 12 grams of carbohydrates per 8 oz, so 4 oz would provide around 6 grams) and protein. While it can help raise blood glucose, it may not provide the recommended 15 grams of fast-acting carbohydrates to treat hypoglycemia quickly enough.

D. Graham crackers: Foods with a high glycemic index (GI), such as graham crackers, can cause blood sugar levels to rise relatively quickly. Graham crackers, being high in refined carbohydrates, can indeed result in a rapid increase in blood glucose levels compared to low-GI foods.

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Correct Answer is C

Explanation

A. Increased pulmonary artery wedge pressure (PAWP): PAWP measures left atrial pressure, which is typically increased in left-sided heart failure, not right-sided. Right-sided heart failure leads to systemic congestion rather than pulmonary congestion.

B. Decreased specific gravity: Specific gravity measures urine concentration. It is not a primary indicator of heart failure. Heart failure usually affects fluid balance rather than specific urine concentration.

C. Elevated central venous pressure (CVP): CVP reflects the pressure in the right atrium and central veins, which is elevated in right-sided heart failure due to the backup of blood in the systemic circulation. This results in increased venous pressure.

D. Decreased brain natriuretic peptide (BNP): BNP levels are typically elevated in heart failure, as they reflect the degree of ventricular stretching and fluid overload. A decrease would not be expected in acute heart failure.

A. Ketones present in urine B. Elevated C-peptide blood level C. Serum blood glucose 300 mg/dL D. HbA1c 12.6% E. Hypertension F. ABG results

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

Explanation

☑️ Ketones present in urine: The presence of ketones in urine indicates that the body is breaking down fats for energy due to insufficient insulin, a hallmark of DKA. This ketogenesis occurs when the body cannot utilize glucose properly, leading to the production of ketone bodies which are excreted in the urine.

☐ Elevated C-peptide blood level: Elevated C-peptide levels typically indicate that the pancreas is still producing insulin. In the context of DKA, particularly in Type 1 diabetes, C-peptide levels are usually low or undetectable due to the lack of insulin production. Therefore, elevated C-peptide is not a risk factor for DKA.

☑️ Serum blood glucose 300 mg/dL: Elevated blood glucose levels (≥250 mg/dL) are a significant risk factor for DKA. Hyperglycemia indicates poor glycemic control, which, if prolonged and severe, can lead to ketone production and subsequent ketoacidosis.

☑️ HbA1c 12.6%: An HbA1c level of 12.6% indicates chronic poor blood glucose control. A normal HbA1c is below 5.7%, and levels above 6.5% suggest diabetes. This very high level suggests persistent hyperglycemia, increasing the risk for acute complications like DKA.

☐ Hypertension: Hypertension is not directly related to DKA. While it is a common comorbidity in diabetes, it does not contribute to the metabolic conditions leading to ketoacidosis. DKA is more closely related to hyperglycemia, insulin deficiency, and increased ketone production rather than blood pressure levels.

☑️ ABG results: The ABG results indicate metabolic acidosis, a hallmark of DKA. The low pH (7.20) and low bicarbonate (HCO3- at 12 mEq/L) confirm acidosis, and in the context of hyperglycemia and ketonuria, it strongly suggests DKA. The normal PaCO2 suggests that there is no significant respiratory compensation for the metabolic acidosis.

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A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?

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Naxlex Comprehensive Predictor Exams

A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse is caring for a client in the emergency department. Exhibits Which of the following assessment findings would indicate to the nurse that the client is at risk for developing diabetic ketoacidosis (DKA)? (Select All that Apply.)

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

Explanation

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