A nurse is providing education to a client who has hypoglycemia. Which of the following information should the nurse include about the regulation of blood glucose levels?

The adrenal glands release epinephrine and norepinephrine to respond to low blood glucose.

The liver releases glucagon to regulate blood glucose levels.

Glycogenesis occurs in the pancreas when blood glucose levels fall.

The brain uses protein for energy if glucose levels fall too low.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

The adrenal glands play a crucial role in responding to low blood glucose levels by releasing epinephrine (adrenaline) and norepinephrine. These hormones help to increase blood glucose levels by stimulating glycogenolysis (the breakdown of glycogen to glucose) and gluconeogenesis (the production of glucose from non-carbohydrate sources) in the liver. This response is part of the body’s fight-or-flight mechanism, which ensures that sufficient glucose is available for immediate energy needs.

Choice B Reason:

The liver does not release glucagon; rather, it responds to glucagon, which is released by the pancreas. Glucagon stimulates the liver to convert stored glycogen into glucose (glycogenolysis) and to produce glucose from non-carbohydrate sources (gluconeogenesis). This process helps to raise blood glucose levels when they are low.

Choice C Reason:

Glycogenesis is the process of converting glucose into glycogen for storage, and it occurs primarily in the liver and muscle cells, not in the pancreas. The pancreas releases insulin to promote glycogenesis when blood glucose levels are high, but it does not perform glycogenesis itself.

Choice D Reason:

The brain primarily uses glucose for energy and does not switch to using protein unless glucose levels are extremely low and prolonged. In such cases, the brain can use ketone bodies derived from fat as an alternative energy source. Protein is not a primary energy source for the brain under normal conditions.

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Correct Answer is ["D"]

Explanation

Choice A Reason:

A urine specific gravity of 1.010 falls within the normal range of 1.005 to 1.0301. This value does not indicate hyponatremia. In SIADH, urine is often more concentrated due to the retention of water, leading to higher specific gravity values.

Choice B Reason:

Respiratory alkalosis is not a typical manifestation of hyponatremia. It is usually associated with conditions that cause hyperventilation, such as anxiety or high altitude. SIADH typically does not cause respiratory alkalosis.

Choice C Reason:

Diarrhea is not a direct manifestation of hyponatremia. While diarrhea can lead to electrolyte imbalances, including hyponatremia, it is not a symptom caused by SIADH5. SIADH leads to water retention and dilutional hyponatremia, not diarrhea.

Choice D Reason:

Diminished reflexes are a manifestation of hyponatremia. Low sodium levels affect neuromuscular function, leading to symptoms such as muscle weakness, cramps, and diminished reflexes7. This is a direct result of the electrolyte imbalance caused by SIADH.

A. Acetone breath B. Fever C. 68 years of age D. Serum glucose 800 mg/dL (74 to 106 mg/dL) E. Serum bicarbonate 15 mEq/L (21 to 28 mEq/L) F. Insidious onset

Correct Answer is ["B","D","E","F"]

Explanation

Choice A reason: Acetone Breath

Acetone breath is typically associated with diabetic ketoacidosis (DKA), not hyperosmolar hyperglycemic syndrome (HHS). In DKA, the body produces high levels of ketones, leading to a fruity or acetone-like breath odor. HHS, on the other hand, does not usually involve significant ketone production, so acetone breath is not a characteristic feature of HHS.

Choice B reason: Fever

Fever can be a clinical manifestation of HHS, often indicating an underlying infection, which is a common precipitating factor for HHS. Infections can exacerbate hyperglycemia and contribute to the development of HHS, making fever a relevant symptom to consider.

Choice C reason: 68 Years of Age

While age itself is not a clinical manifestation, HHS predominantly affects older adults, particularly those with type 2 diabetes. Therefore, being 68 years old is consistent with the typical demographic affected by HHS, but it is not a direct clinical manifestation.

Choice D reason: Serum Glucose 800 mg/dL

A serum glucose level of 800 mg/dL is significantly elevated and is a hallmark of HHS2. Normal serum glucose levels range from 74 to 106 mg/dL. Such high levels of glucose are indicative of severe hyperglycemia, which is a defining characteristic of HHS.

Choice E reason: Serum Bicarbonate 15 mEq/L

A serum bicarbonate level of 15 mEq/L is below the normal range of 21 to 28 mEq/L. This indicates metabolic acidosis, which can occur in HHS due to severe dehydration and impaired renal function. Although metabolic acidosis is more pronounced in DKA, it can still be present in HHS.

Choice F reason: Insidious Onset

HHS typically has an insidious onset, developing slowly over days to weeks. This gradual progression contrasts with the rapid onset of DKA and is a key feature in the clinical presentation of HHS.

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A nurse is providing education to a client who has hypoglycemia. Which of the following information should the nurse include about the regulation of blood glucose levels?

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Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings are manifestations of hyponatremia? (Select All that Apply)

Correct Answer is ["D"]

Explanation

A nurse is providing care for an older adult client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following clinical manifestations support the diagnosis? Select all that apply.

Correct Answer is ["B","D","E","F"]

Explanation

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