A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

NPH insulin

Insulin glargine

Insulin detemir

Regular Insulin

Answer and Explanation

The Correct Answer is D

A. NPH insulin: NPH insulin, also known as Neutral Protamine Hagedorn, is an intermediate acting insulin. It has a slower onset of action and a longer duration compared to regular insulin. It is not the best choice for treating diabetic ketoacidosis (DKA) because it does not act quickly enough to lower dangerously high blood glucose levels in this acute situation.

B. Insulin glargine: Insulin glargine is a long-acting basal insulin. It has a slow, steady release and provides a consistent level of insulin over an extended period. Like NPH insulin, it is not suitable for rapidly lowering blood glucose levels in a DKA emergency.

C. Insulin detemir: Insulin detemir is another long-acting basal insulin similar to glargine. It has a slow onset and provides a sustained release of insulin. It is not the first-line choice for treating DKA due to its slower action.

D. Regular Insulin: Regular insulin, also known as short-acting or fast-acting insulin, has a rapid onset of action. When administered intravenously, it can quickly lower blood glucose levels. This makes it the preferred choice for treating diabetic ketoacidosis (DKA) where prompt action is essential to correct the severe hyperglycemia and associated metabolic imbalances.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Drowsiness is not a typical manifestation of thyrotoxicosis. Instead, individuals with thyrotoxicosis often experience restlessness and anxiety due to excessive thyroid hormone levels.

B. Dry skin is more commonly associated with hypothyroidism (insufficient thyroid hormone levels), rather than thyrotoxicosis (excessive thyroid hormone levels).

C. Bradycardia (slower than normal heart rate) is a symptom of hypothyroidism, not thyrotoxicosis. In thyrotoxicosis, tachycardia (an abnormally rapid heart rate) is a common finding.

D. Correct. Heat intolerance is a classic symptom of thyrotoxicosis. Excessive thyroid hormone levels can lead to an increased metabolic rate, making individuals more sensitive to heat.

A. Glucocorticoid medications B. Oral hypoglycemic medications C. Dextrose 5% in 0.45% sodium chloride D. 0.9% sodium chloride

Correct Answer is D

Explanation

A. Glucocorticoid medications are not the primary treatment for diabetic ketoacidosis (DKA). They may be used in specific situations, but they are not the first-line treatment.

B. Oral hypoglycemic medications are not appropriate for a client with DKA. DKA is a serious condition that requires prompt treatment with insulin and intravenous fluids.

C. Dextrose 5% in 0.45% sodium chloride is not the initial treatment for DKA. This solution contains dextrose, which would raise the blood glucose levels, but it does not provide the necessary insulin to address the underlying issue of insulin deficiency.

D. Correct. The initial treatment for DKA involves administering intravenous fluids, typically with 0.9% sodium chloride (normal saline). This helps to restore blood volume, correct electrolyte imbalances, and gradually lower the high blood glucose levels. Insulin is also administered concurrently to address the underlying insulin deficiency.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect?

Correct Answer is D

Explanation

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

Correct Answer is D

Explanation

A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?

When preparing to provide morning medications, the nurse would give levothyroxine (Synthroid) ordered daily in which of the following ways?

The nurse is reviewing a teaching tool created for insulin therapy Which statement on the tool should be corrected? Select all that apply.

The primary health-care provider prescribes a cough syrup 0.4 g every 4 hours. The dosage strength of the syrup is 100 mg/5 mL. The medication bottle contains a measuring spoon that measures in teaspoons and tablespoons. How many teaspoons will the nurse instruct the client to take?

A nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HbA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels?

A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)