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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Swollen and enlarged veins, also known as varicose veins, are a common manifestation of peripheral venous disease (PVD). This condition occurs when the valves in the veins become weak or damaged, leading to blood pooling and increased pressure within the veins. This results in the veins becoming enlarged, twisted, and visible under the skin1. Varicose veins can cause discomfort, pain, and a heavy feeling in the legs. They are often exacerbated by prolonged standing or sitting and can be a cosmetic concern as well.
Choice B Reason:
Loss of pigmentation over the shin area is not typically associated with peripheral venous disease. This symptom is more commonly seen in conditions such as chronic venous insufficiency (CVI), where prolonged venous hypertension leads to skin changes, including hyperpigmentation and lipodermatosclerosis. However, it is not a primary manifestation of PVD itself.
Choice C Reason:
A shiny appearance to the lower extremities is more commonly associated with peripheral arterial disease (PAD) rather than peripheral venous disease. In PAD, reduced blood flow to the extremities can cause the skin to become thin, shiny, and hairless. This is due to the lack of oxygen and nutrients reaching the skin and underlying tissues. In contrast, PVD primarily affects the veins and does not typically cause these skin changes.
Choice D Reason:
Diminished hair growth on the lower extremities is another symptom more commonly associated with peripheral arterial disease (PAD). In PAD, the reduced blood flow to the extremities can lead to hair loss, as the hair follicles do not receive adequate oxygen and nutrients. Peripheral venous disease, on the other hand, does not usually cause hair loss. Instead, it is characterized by symptoms related to venous insufficiency, such as varicose veins, swelling, and skin changes.
Correct Answer is C
Explanation
Choice A Reason:
Taking levothyroxine with high-protein foods can interfere with the absorption of the medication. High-protein foods can bind to the medication, reducing its effectiveness. Therefore, it is not recommended to take levothyroxine with high-protein foods.
Choice B Reason:
While it is important to take levothyroxine with a full glass of water to ensure the tablet is swallowed properly and to aid in its absorption, taking it with fruit juice is not recommended. Certain juices, like grapefruit juice, can interfere with the absorption of levothyroxine.
Choice C Reason:
Levothyroxine should be taken on an empty stomach, ideally 30 to 60 minutes before breakfast or at least 3 to 4 hours after the last meal. This timing helps ensure optimal absorption of the medication. Food can significantly reduce the absorption of levothyroxine, making it less effective.
Choice D Reason:
Taking levothyroxine during a meal is not recommended because food can interfere with the absorption of the medication. It is best to take it on an empty stomach to ensure maximum absorption and effectiveness.
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