A nurse is collecting data from a client who has diabetes mellitus.
Which of the following findings indicates that the client is experiencing DKA?

Confusion

Polydipsia

Rapid pulse

Clammy skin

Answer and Explanation

Correct Answer : A,B,C

Choice A rationale:

Confusion can be a symptom of Diabetic Ketoacidosis (DKA). DKA is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.

Choice B rationale:

Polydipsia, or excessive thirst, is another common symptom of DKA. High blood sugar levels can cause increased urination, leading to dehydration and an increased feeling of thirst.

Choice C rationale:

A rapid pulse is also a symptom of DKA. This is because the body is trying to compensate for the low amount of fluid in your blood vessels due to dehydration.

Choice D rationale:

Clammy skin is not typically a symptom of DKA. It’s more commonly associated with hypoglycemia (low blood sugar), not hyperglycemia (high blood sugar) which is what occurs in DKA1.

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Correct Answer is D

Explanation

Choice A rationale:

Acyclovir is an antiviral medication used to treat infections caused by certain types of viruses. It is primarily used for the treatment of herpes simplex virus infections, chickenpox, and shingles. However, it is not typically used as an anti-HIV drug.

Choice B rationale:

Ribavirin is an antiviral medication used to treat hepatitis C and certain other viral infections. While it has broad-spectrum antiviral activity, it is not specifically used to prevent mother-to-child transmission of HIV.

Choice C rationale:

Foscarnet is an antiviral medication used to treat or prevent cytomegalovirus (CMV) retinitis in individuals with AIDS. It is also used to treat cold sores and genital herpes. However, it is not the first-line choice for preventing mother-to-child transmission of HIV.

Choice D rationale:

Zidovudine, also known as AZT, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is generally safe for use during pregnancy and is commonly used to prevent mother-to-child transmission of HIV12. It works by inhibiting the reverse transcriptase enzyme, thereby blocking viral replication. The use of Zidovudine and other antiretroviral drugs in pregnant women with HIV has significantly reduced the rate of mother-to-child transmission of the virus.

A. Shortness of breath B. Black hairy tongue C. Itching D. Swelling of the tongue E. Wheezing

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

Explanation

Choice A rationale:

Shortness of breath is a common symptom of a hypersensitivity reaction. This occurs because the body’s immune system responds to a foreign substance, known as an antigen, by producing specific antibodies. This immune response can cause inflammation and swelling in various parts of the body, including the airways, leading to shortness of breath.

Choice B rationale:

A black hairy tongue is not typically associated with a hypersensitivity reaction. It is a condition that causes the tongue to appear black and hairy, and it’s usually caused by an overgrowth of bacteria or yeast on the tongue. It’s not related to allergies or hypersensitivity reactions.

Choice C rationale:

Itching is another common symptom of a hypersensitivity reaction. When the body encounters an antigen, it triggers an immune response that releases chemicals like histamine. Histamine can cause itching, among other symptoms.

Choice D rationale:

Swelling of the tongue can be a symptom of a severe hypersensitivity reaction known as anaphylaxis. This is a medical emergency that requires immediate attention. The swelling is caused by inflammation in response to an antigen.

Choice E rationale:

Wheezing is a symptom of a hypersensitivity reaction, specifically type I hypersensitivity. This type of reaction includes allergic disorders, which affect the lungs among other parts of the body. The immune response to an antigen can cause the airways to narrow and produce a wheezing sound.

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A nurse is collecting data from a client who has diabetes mellitus. Which of the following findings indicates that the client is experiencing DKA?

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Naxlex Comprehensive Predictor Exams

The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?

Correct Answer is D

Explanation

During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)

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

Explanation

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A nurse is collecting data from a client who has diabetes mellitus.
Which of the following findings indicates that the client is experiencing DKA?