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 B

Explanation

A. Respiratory alkalosis, fully compensated: pH is low normal (7.35), and the bicarbonate (HCO3-) level is low (21 mEq/L), indicating metabolic acidosis, not respiratory alkalosis. Respiratory alkalosis would present with a high pH and low PaCO2.
B. Metabolic acidosis, partially compensated: The pH is slightly acidic (7.35), and the bicarbonate level is low (21 mEq/L), indicating metabolic acidosis. The PaCO2 level is normal, suggesting partial compensation by the respiratory system, but the body has not fully compensated for the acidosis yet.
C. Respiratory acidosis, fully compensated: Respiratory acidosis would present with an elevated PaCO2 and a low pH, which is not the case here. The PaCO2 is normal at 40 mmHg, so this option is incorrect.
D. Metabolic acidosis, fully compensated: While the client does have metabolic acidosis, the respiratory system has not fully compensated for the acidosis, as evidenced by the normal PaCO2 level. Therefore, the compensation is partial, not full.

A. Drooling B. Anhidrosis C. Tremors D. Rigidity

Correct Answer is B

Explanation

A. Drooling: Drooling is a common symptom of Parkinson’s disease due to impaired swallowing and decreased muscle control, and anticholinergic agents may actually help reduce it. Therefore, it is not a side effect that the client needs to report, but rather an expected symptom that may improve with medication.
B. Anhidrosis: Anhidrosis, or the inability to sweat, is a significant side effect of anticholinergic medications. This condition can lead to overheating and heatstroke, especially in warm environments. Clients should report this side effect immediately, as it may require dose adjustment or discontinuation of the medication.
C. Tremors: Tremors are a hallmark symptom of Parkinson’s disease, not a side effect of anticholinergic medications. These medications are often prescribed to reduce tremors, so the presence of tremors would not typically indicate a medication issue unless they worsen unexpectedly.
D. Rigidity: Rigidity is another classic motor symptom of Parkinson’s disease. Anticholinergic drugs do not typically cause or worsen rigidity. If rigidity persists or worsens, it may indicate disease progression rather than a medication side effect.

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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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Correct Answer is B

Explanation

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Explanation

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