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 C
Explanation
Choice A Reason:
Previous stroke is not directly associated with an increased risk of status asthmaticus. While individuals with certain medical conditions, such as neurological disorders, may have an increased risk of complications from severe asthma exacerbations, a previous stroke alone is not a recognized risk factor for status asthmaticus.
Choice B Reason:
Irritants and hypersensitivity to medications, may trigger asthma exacerbations, but they are not specific risk factors for status asthmaticus. Asthma exacerbations triggered by irritants or medications can typically be managed with appropriate treatment measures and do not necessarily lead to status asthmaticus.
Choice C Reason:
Previous intubation due to status asthmaticus episode is correct. Status asthmaticus is a severe and life-threatening asthma exacerbation that is unresponsive to standard treatment measures such as bronchodilators and corticosteroids. It is characterized by prolonged and severe bronchospasm, airway inflammation, and respiratory distress.
Choice D Reason:
Bronchial pneumonia is not a known risk factor for status asthmaticus. Bronchial pneumonia, or pneumonia affecting the bronchi and lungs, is a separate respiratory condition caused by bacterial, viral, or fungal infections. While pneumonia can exacerbate asthma symptoms in individuals with asthma, it is not specifically associated with an increased risk of status asthmaticus.
Correct Answer is B
Explanation
Choice A Reason:
"I have signed up for an aerobics class three times a week." This statement is incorrect. Participating in aerobics classes three times a week may not be suitable for someone with spinal stenosis, as certain movements and high-impact activities common in aerobics classes can exacerbate symptoms and increase the risk of injury to the spine.
Choice B Reason:
"I ride my bicycle every day." This statement is correct. Cycling is generally considered a low-impact exercise that can be beneficial for individuals with spinal stenosis, as it helps improve cardiovascular fitness without placing excessive stress on the spine. Riding a bicycle regularly may be a suitable exercise option for this client.
Choice C Reason:
"I like to jog a half a mile every day." This statement is incorrect. Jogging involves repetitive impact and can place significant stress on the spine, which may exacerbate symptoms of spinal stenosis. It is generally not recommended for individuals with spinal stenosis due to the high-impact nature of the activity.
Choice D Reason:
"I enjoy doing circuit training once a week.": Circuit training typically involves a combination of aerobic and strength-training exercises performed in rapid succession. While some components of circuit training, such as strength training, can be beneficial for individuals with spinal stenosis, the intensity and variety of exercises in circuit training may not be suitable for everyone with this condition.
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