A nurse is caring for a group of clients in a medical unit. Which of the following clients is at the highest risk for developing osmotic cerebral edema?
A client with a decreased potassium level
A client with a decreased serum glucose
A client with an increased hemoglobin A1C
A client with an increased creatinine level
None
None
The Correct Answer is B
Choice A Reason:
A client with a decreased potassium level is incorrect. Hypokalemia (decreased potassium level) can cause various neurological symptoms, but it doesn't directly lead to osmotic cerebral edema.
Choice B Reason:
When plasma glucose levels are rapidly lowered, an osmotic gradient develops between the brain and plasma, which can lead to cerebral edema. Brain cells pull water from the plasma, resulting in widespread edema.
Choice C Reason:
While HbA1c is an important marker of diabetes control and may indicate poor long-term management, it does not directly relate to the acute metabolic derangements (e.g., rapid osmotic shifts, severity of acidosis) that predispose to cerebral edema in DKA.
Choice D Reason:
A client with an increased creatinine level is incorrect. Elevated creatinine levels typically indicate kidney dysfunction or dehydration, but they don't directly cause osmotic cerebral edema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Dyspnea is not commonly seen in other chronic conditions of the aging older adult: This statement is incorrect. Dyspnea, or difficulty breathing, can occur in various chronic conditions commonly seen in aging adults, such as chronic obstructive pulmonary disease (COPD), heart failure, and pulmonary fibrosis, among others. Dyspnea can be a symptom of respiratory or cardiovascular issues and is not exclusive to asthma.
Choice B Reason:
Aging is associated with decreased sensitivity to medications: This statement is generally incorrect. Aging can affect drug metabolism and clearance, leading to changes in medication sensitivity. Older adults may have altered pharmacokinetics and pharmacodynamics, which can increase their sensitivity to certain medications, particularly those with sedative or CNS depressant effects. This increased sensitivity can potentially increase the risk of adverse drug reactions.
Choice C Reason:
Adverse reactions to medications in the aging older adult are lower: This statement is incorrect. While some physiological changes associated with aging may decrease the risk of adverse drug reactions, such as decreased renal function and altered drug metabolism, older adults are still at risk for adverse drug reactions due to factors such as polypharmacy, drug interactions, and increased sensitivity to medications.
Choice D Reason:
Physiological changes in the respiratory system can mimic the presence of airway obstruction: This statement is true. Physiological changes in the aging respiratory system, such as decreased lung elasticity, increased chest wall stiffness, and reduced respiratory muscle strength, can mimic the symptoms of airway obstruction seen in conditions like asthma or COPD. These changes can lead to decreased lung function, reduced exercise tolerance, and increased susceptibility to respiratory infections.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A Reason:
Chronic cough is correct. Persistent cough is a common symptom of COPD, often occurring due to irritation and inflammation in the airways.
Choice B Reason:
Sputum production is correct. COPD patients frequently experience increased mucus production, leading to coughing up phlegm or sputum, especially in the morning.
Choice C Reason:
Dyspnea is correct. Shortness of breath or dyspnea is a hallmark symptom of COPD, particularly during physical activity or exertion, and it tends to worsen as the disease progresses.
Choice D Reason:
Wheezing occurs due to narrowed airways and increased airway resistance. It is more noticeable during expiration but can also be present during inspiration in severe cases.
Choice E Reason:
Chest tightness is incorrect. While chest tightness can occur in COPD, it is typically more associated with asthma. However, some individuals with COPD may experience chest tightness, especially during exacerbations or when airflow is significantly limited.
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