A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

Decreasing smoking

Increasing fluid intake

Increasing daily exercise

Decreasing intake of red meat

Answer and Explanation

The Correct Answer is B

A. Decreasing smoking: While smoking cessation is important for general health, it is not directly related to the prevention or management of HHS. Addressing dehydration and glucose control takes precedence in the acute management and prevention of recurrence.
B. Increasing fluid intake: Adequate hydration is the most critical aspect of preventing HHS, as dehydration is a key precipitating factor. Clients with HHS experience significant fluid loss, and increasing fluid intake helps maintain circulatory volume and reduce blood glucose concentration.
C. Increasing daily exercise: Although regular exercise helps with long-term diabetes control, it must be approached cautiously in clients recovering from HHS. Excessive or poorly timed physical activity could exacerbate glucose fluctuations if not coordinated with meals and insulin.
D. Decreasing intake of red meat: Diet modifications may help in overall health, but red meat intake is not directly linked to HHS prevention. The immediate concern is managing hydration and glucose levels to prevent another crisis.

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Correct Answer is A

Explanation

A. 3% sodium chloride: A serum sodium level of 115 mEq/L is dangerously low, indicating severe hyponatremia. The nurse should anticipate that a hypertonic saline solution such as 3% sodium chloride will be prescribed to rapidly increase the sodium concentration in the blood and treat the underlying SIADH.
B. Dextrose 5% in 0.99% sodium chloride: This is an isotonic solution and would not be suitable for treating severe hyponatremia in SIADH, as it would not significantly increase sodium levels. Hypertonic saline solutions are more appropriate for severe cases of hyponatremia.
C. Dextrose 5% in 0.45% sodium chloride: This solution is hypotonic and could worsen hyponatremia by diluting the sodium further. It should not be used to treat SIADH with severely low sodium levels.
D. 0.9% sodium chloride: Normal saline (0.9% sodium chloride) is isotonic and would not correct the low sodium levels as effectively as hypertonic saline. While it is used in less severe cases, 3% sodium chloride is necessary in cases of severe hyponatremia.

A. Systemic lupus erythematosus B. Acute HIV C. Chronic HIV D. Discoid lupus erythematosus

Correct Answer is A

Explanation

A. Systemic lupus erythematosus: The butterfly-shaped rash, along with symptoms like fatigue, hair loss, and memory issues, is characteristic of systemic lupus erythematosus (SLE), an autoimmune disease. The rash typically appears across the cheeks and nose and is a hallmark sign of SLE, often triggered by sunlight exposure.
B. Acute HIV: Acute HIV infection may cause symptoms like fatigue, but it typically does not present with the specific butterfly-shaped rash seen in SLE. The rash associated with HIV is generally more generalized and not localized like the characteristic lupus rash.
C. Chronic HIV: Chronic HIV can present with fatigue and other symptoms, but it does not cause the butterfly-shaped rash seen in lupus. HIV-related rashes are more often generalized or occur due to secondary infections, not the distinct butterfly pattern seen in lupus.
D. Discoid lupus erythematosus: Discoid lupus erythematosus (DLE) can cause skin lesions, including facial rashes, but it does not present with the same systemic symptoms (like fatigue, hair loss, and memory issues) as systemic lupus erythematosus. DLE affects only the skin, whereas SLE affects multiple organs.

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A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to provide care for a client in the emergency department who has syndrome of inappropriate antidiuretic hormone (SIADH). The client has a serum sodium of 115 mEq/L (136-145 mEq/L). Which of the following IV solutions should the nurse anticipate will be prescribed?

Correct Answer is A

Explanation

A nurse is completing an assessment on a client who reports severe fatigue, hair loss, and trouble remembering things. The nurse notes a butterfly-shaped rash on the client's face. Which of the following conditions is the client likely experiencing?

Correct Answer is A

Explanation

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