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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Correct Answer is C

Explanation

A. Chronic pulmonary disease: Chronic pulmonary disease, such as COPD, affects the lungs and respiratory system but is not a primary risk factor for peripheral artery disease (PAD), which is caused by atherosclerosis affecting peripheral circulation.
B. Rheumatic fever: Rheumatic fever is associated with inflammatory damage to the heart valves due to a streptococcal infection, but it does not increase the risk of developing PAD, which is vascular in nature and primarily driven by atherosclerotic risk factors.
C. Body mass index of 35: A BMI of 35 indicates obesity, which significantly increases the risk for atherosclerosis and related conditions like PAD. Obesity contributes to poor lipid profiles, hypertension, and insulin resistance, all of which promote arterial narrowing and plaque buildup.
D. History of venous thrombosis: Venous thrombosis affects the venous system and is different from arterial disease. While it may signal vascular issues, it is not considered a direct risk factor for PAD, which involves arterial—not venous—occlusion.

A. Proximal acinar emphysema B. Centrilobular emphysema C. Panacinar emphysema D. Distal acinar emphysema

Correct Answer is D

Explanation

A. Proximal acinar emphysema: This subtype typically affects the central or proximal parts of the acini, and it is less commonly associated with pneumothorax. The condition primarily affects the respiratory bronchioles.
B. Centrilobular emphysema: Centrilobular emphysema involves the upper lobes and is commonly associated with smoking, but it does not directly lead to pneumothorax as often as distal acinar emphysema.
C. Panacinar emphysema: Panacinar emphysema affects the entire acinus, including the alveoli. Although it can cause significant respiratory issues, it is less strongly associated with pneumothorax compared to distal acinar emphysema.
D. Distal acinar emphysema: Distal acinar emphysema involves the distal parts of the acinus and is often seen in the upper lobes of the lungs. It is strongly associated with the development of pneumothorax, as the damage to the lung tissue can lead to spontaneous ruptures in the alveolar walls, causing air to leak into the pleural space.

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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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Naxlex Comprehensive Predictor Exams

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