A nurse is providing care for several clients who have type 2 diabetes mellitus. Which of the following clients is most at risk for developing hyperosmolar hyperglycemic syndrome (HHS)?

A client admitted for hip fracture surgery.

A client who is awaiting cataract surgery.

A client who is receiving an antibiotic for a urinary tract infection.

A client who is being evaluated for a breast lump.

Answer and Explanation

The Correct Answer is C

Choice A reason:

A client admitted for hip fracture surgery is at risk for various complications, but not specifically for hyperosmolar hyperglycemic syndrome (HHS). HHS is more commonly triggered by infections, severe dehydration, or other acute illnesses. While surgery can be a stressor, it is not as directly linked to HHS as infections are.

Choice B reason:

A client who is awaiting cataract surgery is not typically at high risk for developing HHS. Cataract surgery is generally a planned and controlled procedure that does not usually involve the acute stressors or infections that can precipitate HHS.

Choice C reason:

A client who is receiving an antibiotic for a urinary tract infection is at a higher risk for developing HHS. Infections are a common precipitating factor for HHS because they can cause significant stress on the body, leading to elevated blood glucose levels. The body’s response to infection can exacerbate hyperglycemia, especially in individuals with type 2 diabetes.

Choice D reason:

A client who is being evaluated for a breast lump is not typically at high risk for HHS. While the evaluation process can be stressful, it does not usually involve the acute physiological stressors or infections that are more directly linked to the development of HHS.

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Correct Answer is A

Explanation

Choice A Reason:

Dietary and fluid restrictions are crucial for managing heart failure. Patients with heart failure often experience fluid retention, which can exacerbate symptoms such as swelling, shortness of breath, and fatigue. By restricting fluid intake, patients can help prevent fluid overload. Additionally, dietary modifications, such as reducing sodium intake, can help manage blood pressure and reduce the risk of fluid retention. Sodium causes the body to retain water, which can increase the workload on the heart. Therefore, a low-sodium diet is often recommended for heart failure patients. These restrictions are essential to prevent the worsening of heart failure symptoms and to improve the patient’s quality of life.

Choice B Reason:

Encouraging increased mobility is generally beneficial for overall health, but it must be approached cautiously in heart failure patients. While regular physical activity can help improve cardiovascular health and overall well-being, it is important to tailor the exercise regimen to the patient’s condition. Overexertion can lead to worsening symptoms or complications. Therefore, while increased mobility can be part of the management plan, it should be done under medical supervision and is not the primary lifestyle modification for heart failure management.

Choice C Reason:

Cessation of hormonal supplements may be relevant for some patients, particularly if the supplements are contributing to fluid retention or other adverse effects. However, this is not a standard recommendation for all heart failure patients. The decision to stop hormonal supplements would depend on the individual patient’s medical history and the specific supplements they are taking. It is not a general lifestyle modification for heart failure management.

Choice D Reason:

Cessation of intravenous (IV) drug use is important for patients who may be using IV drugs, as this can lead to infections, endocarditis, and other complications that can worsen heart failure. However, this recommendation is specific to patients with a history of IV drug use and is not a general lifestyle modification for all heart failure patients. The primary focus for most heart failure patients would be on managing fluid and dietary intake.

A. Heart murmur B. Chest pain C. Varicose veins D. Palpitations E. Abdominal pain

Correct Answer is ["A","B","D"]

Explanation

Choice A reason:

Heart murmur is a common manifestation of valvular dysfunction. It occurs when there is turbulent blood flow across a damaged or abnormal heart valve. This can be due to stenosis (narrowing of the valve) or regurgitation (leakage of the valve). The murmur’s characteristics, such as timing, location, and intensity, can help in diagnosing the specific type of valvular disease. For example, a systolic murmur might indicate aortic stenosis or mitral regurgitation, while a diastolic murmur could suggest aortic regurgitation or mitral stenosis.

Choice B reason:

Chest pain is another symptom that can be associated with valvular dysfunction. This pain can result from increased workload on the heart due to inefficient blood flow through the valves. Conditions like aortic stenosis can lead to angina (chest pain) because the heart muscle may not receive enough oxygenated blood. This symptom is particularly concerning and warrants immediate medical attention to prevent complications such as myocardial infarction.

Choice C reason:

Varicose veins are not typically associated with valvular dysfunction in the heart. They are more related to issues with the veins in the legs, where the valves that prevent backflow of blood become weakened or damaged. This condition is generally referred to as chronic venous insufficiency and is not directly linked to the heart’s valvular problems.

Choice D reason:

Palpitations, or the sensation of irregular or rapid heartbeats, are common in clients with valvular dysfunction. These can occur due to arrhythmias, which are often seen in conditions like mitral valve prolapse or aortic regurgitation. The irregular heartbeats can be a result of the heart trying to compensate for the inefficient blood flow caused by the faulty valve.

Choice E reason:

Abdominal pain is not a typical manifestation of valvular dysfunction. While severe heart conditions can sometimes lead to generalized symptoms, abdominal pain is more commonly associated with gastrointestinal issues rather than heart valve problems. Therefore, it is not a primary symptom to anticipate in clients with valvular dysfunction.

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A nurse is providing care for several clients who have type 2 diabetes mellitus. Which of the following clients is most at risk for developing hyperosmolar hyperglycemic syndrome (HHS)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who has heart failure. Which of the following lifestyle modifications should the nurse include in the discharge teaching?

Correct Answer is A

Explanation

A nurse is assessing a client who has valvular dysfunction. Which of the following manifestations should the nurse anticipate? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

A nurse is preparing to administer medications to a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following medications should the nurse question?

A nurse is providing discharge teaching to a client who has heart failure. Which of the following lifestyle modifications should the nurse include in the discharge teaching?

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