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 B

Explanation

Choice A Reason:

Conivaptan hydrochloride is a vasopressin receptor antagonist used to treat hyponatremia associated with SIADH. It works by blocking the action of ADH, thereby promoting water excretion without losing sodium. This medication is appropriate for managing SIADH.

Choice B Reason:

Vasopressin, also known as antidiuretic hormone (ADH), is not appropriate for a patient with SIADH. SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Administering vasopressin would exacerbate the condition by increasing water retention and further lowering sodium levels.

Choice C Reason:

Sodium chloride tablets are used to manage hyponatremia by increasing sodium levels in the blood. This treatment is appropriate for patients with SIADH to help correct the sodium imbalance caused by excessive ADH.

Choice D Reason:

Tolvaptan is another vasopressin receptor antagonist that is used to treat hyponatremia associated with SIADH. It helps to increase serum sodium levels by promoting water excretion while retaining sodium. This medication is suitable for managing SIADH.

A. You have many dangerously low blood sugar levels. B. Your average blood sugar is high. C. Your blood sugar is too high after meals. D. Your blood sugar is very unstable.

Correct Answer is B

Explanation

Choice A Reason:

This statement is incorrect because a hemoglobin A1C level of 9% indicates that the client’s blood sugar levels have been consistently high over the past two to three months. Hemoglobin A1C is a measure of average blood glucose levels, not low blood sugar levels. Therefore, it would be inappropriate to suggest that the client has dangerously low blood sugar levels based on this result.

Choice B Reason:

This statement is correct because a hemoglobin A1C level of 9% indicates that the client’s average blood sugar levels are high. Hemoglobin A1C reflects the average blood glucose levels over the past two to three months. A normal A1C level is below 5.7%, while an A1C level between 5.7% and 6.4% indicates prediabetes, and an A1C level of 6.5% or higher indicates diabetes. Therefore, an A1C level of 9% clearly shows that the client’s average blood sugar is high.

Choice C Reason:

This statement is partially correct but not the most appropriate. While it is true that a high hemoglobin A1C level can indicate that blood sugar levels are high after meals, it is not specific enough. Hemoglobin A1C measures the average blood glucose levels over a period of time, not just after meals. Therefore, the statement “Your average blood sugar is high” is more accurate and appropriate.

Choice D Reason:

This statement is incorrect because it is too vague and does not provide specific information about the client’s blood sugar levels. While a high hemoglobin A1C level can indicate variability in blood sugar levels, it primarily reflects the average blood glucose levels over the past two to three months. Therefore, it would be more appropriate to state that the client’s average blood sugar is high.

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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

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Explanation

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Correct Answer is B

Explanation

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