A nurse is providing care for an older adult client who has hyperglycemia, polydipsia, and polyuria. Which of the following manifestations supports the clinical presentation of hyperosmolar hyperglycemic syndrome (HHS)? (Select All that Apply.)
Acetone breath.
Fever.
Serum glucose 800 mg/dL (74 to 106 mg/dL).
Serum bicarbonate 15 mEq/L (21 to 28 mEq/L).
Insidious onset.
Correct Answer : B,C,E
Choice A rationale
Acetone breath is a characteristic symptom of diabetic ketoacidosis (DKA), not hyperosmolar hyperglycemic syndrome (HHS). In DKA, the body produces ketones, leading to a fruity or acetone-like breath odor. HHS, on the other hand, does not typically involve significant ketone production.
Choice B rationale
Fever can be a manifestation of HHS, often due to an underlying infection or illness that precipitates the hyperglycemic state. Infections are common triggers for HHS, leading to elevated body temperature.
Choice C rationale
Serum glucose levels of 800 mg/dL are indicative of HHS. HHS is characterized by extremely high blood glucose levels, often exceeding 600 mg/dL, without significant ketoacidosis.
Choice D rationale
Serum bicarbonate levels of 15 mEq/L are more indicative of DKA rather than HHS. In HHS, bicarbonate levels are usually within the normal range because there is no significant ketoacidosis.
Choice E rationale
Insidious onset is a hallmark of HHS. The condition develops gradually over days to weeks, unlike DKA, which has a more rapid onset.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale
Osteoarthritis is not caused by inflammation that affects both joints and other body tissues. This description is more characteristic of rheumatoid arthritis, which is an autoimmune disease that causes systemic inflammation.
Choice B rationale
Osteoarthritis does not occur in phases with crystal deposits. This description is more characteristic of gout, which involves the deposition of urate crystals in joints and soft tissues.
Choice C rationale
Osteoarthritis is primarily due to the aging process and results in the disintegration of cartilage in a joint. This leads to pain, stiffness, and reduced joint function.
Choice D rationale
Osteoarthritis is not due to the loss of calcium in the bones. This description is more characteristic of osteoporosis, which is a condition that weakens bones and increases the risk of fractures.
Correct Answer is A
Explanation
Choice A rationale
Elevated creatinine is a common finding in clients with chronic kidney disease due to decreased renal function and impaired clearance of creatinine from the blood.
Choice B rationale
Decreased urine specific gravity is not typically associated with chronic kidney disease. Clients with chronic kidney disease may have an increased or normal urine specific gravity.
Choice C rationale
Hypokalemia is not a typical finding in chronic kidney disease. Clients with chronic kidney disease are more likely to have hyperkalemia due to impaired renal excretion of potassium.
Choice D rationale
Decreased BUN (blood urea nitrogen) is not expected in chronic kidney disease. Elevated BUN levels are more common due to reduced renal clearance of urea.
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