A nurse is providing care for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following is a clinical manifestation of HHS?

Insulin resistance

Metabolic acidosis

Hypervolemia

Ketosis

Answer and Explanation

The Correct Answer is A

A. Insulin resistance: HHS typically occurs in clients with type 2 diabetes who have some circulating insulin, but not enough to prevent severe hyperglycemia. Insulin resistance is a key feature, as it allows glucose levels to rise without triggering significant fat breakdown or ketone production.
B. Metabolic acidosis: Metabolic acidosis is more commonly seen in diabetic ketoacidosis (DKA) due to the accumulation of ketones. In HHS, acidosis is usually absent or only mild because fat breakdown is minimal.
C. Hypervolemia: HHS leads to profound dehydration due to osmotic diuresis caused by severe hyperglycemia. Clients are more likely to be hypovolemic rather than hypervolemic due to fluid losses.
D. Ketosis: Unlike DKA, HHS generally does not present with significant ketosis because the body retains enough insulin to prevent fat breakdown. The absence of ketosis is one of the key diagnostic differences between the two conditions.

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Free Nursing Study Resources

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

Explanation

A. Maintain ventriculostomy at the correct position: It is critical to ensure the ventriculostomy drainage system is maintained at the prescribed height (usually at the level of the external auditory meatus) to accurately measure intracranial pressure (ICP) and safely drain cerebrospinal fluid. Incorrect positioning can lead to over- or under-drainage, which could worsen the client’s neurological status.
B. Elevate the head of the bed to 15%: Elevation of the head of the bed is recommended to promote venous drainage and reduce ICP, but 15% is too low to be effective. The recommended elevation is generally 30 degrees, not 15%, for optimal ICP management in clients with TBI. Elevating it only 15% may not sufficiently reduce intracranial pressure.
C. Maintain enteral feedings: Clients with TBI are at high risk for malnutrition due to increased metabolic demands. Early enteral nutrition supports healing, maintains gut integrity, and prevents complications such as infection or poor wound healing. It is an essential part of TBI care.
D. Administer pain medication as needed: Pain and agitation can increase ICP. Administering pain medications as needed helps control these stressors, thereby maintaining a more stable intracranial environment. Proper pain control is a key aspect of neuroprotection.
E. Maintain the neck in the midline position: Keeping the neck in a neutral midline position helps promote cerebral venous drainage and reduces the risk of increased ICP. Neck flexion or rotation can obstruct venous outflow and worsen intracranial hypertension, making this a vital positioning intervention.

A. "Avoid foods that have been fried." B. "Avoid consuming undercooked foods." C. "Avoid using decongestants for seasonal allergies/colds due to their positive link to developing a peptic ulcer," D. "Avoid using hormone replacement therapy as this can increase your risk for a peptic ulcer."

Correct Answer is A

Explanation

A. "Avoid foods that have been fried.": Fried foods are high in fat, which can increase stomach acid production and irritate the gastric mucosa, contributing to the development of peptic ulcers. Avoiding such foods can help reduce the risk of ulcer formation.
B. "Avoid consuming undercooked foods.": While undercooked foods can carry the risk of infection, particularly from bacteria like H. pylori, this statement is more relevant to food safety and does not directly address the risk of peptic ulcers.
C. "Avoid using decongestants for seasonal allergies/colds due to their positive link to developing a peptic ulcer.": Decongestants are not typically associated with an increased risk of peptic ulcers. The main culprits for ulcers are NSAIDs, alcohol, smoking, and H. pylori infection.
D. "Avoid using hormone replacement therapy as this can increase your risk for a peptic ulcer.": Hormone replacement therapy (HRT) is not a major factor in the development of peptic ulcers. The primary risk factors include NSAID use, smoking, and infection with H. pylori.

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A nurse is providing care for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following is a clinical manifestation of HHS?

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