A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?

Bicarbonate 26 mEq/L

Serum pH 7.32

Creatinine 1.2 mg/dL

BUN 20 mg/dL

Answer and Explanation

The Correct Answer is B

A) Bicarbonate 26 mEq/L: A bicarbonate level of 26 mEq/L is within the normal range (22-28 mEq/L) and does not indicate metabolic acidosis, which is characteristic of diabetic ketoacidosis (DKA). In DKA, bicarbonate levels are usually decreased due to buffering of the excess acids.

B) Serum pH 7.32: A serum pH of 7.32 is indicative of acidemia, which is consistent with metabolic acidosis seen in DKA. The pH is typically lower than the normal range (7.35-7.45) in DKA due to the accumulation of ketoacids.

C) Creatinine 1.2 mg/dL: A creatinine level of 1.2 mg/dL is slightly elevated but does not specifically indicate metabolic acidosis. Elevated creatinine may suggest renal impairment but is not directly linked to the acid-base disturbance seen in DKA.

D) BUN 20 mg/dL: A blood urea nitrogen (BUN) level of 20 mg/dL is elevated and may indicate dehydration or kidney dysfunction but does not specifically diagnose the acid-base imbalance associated with DKA. In DKA, bicarbonate and pH levels are more directly affected.

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Correct Answer is A

Explanation

A) "Central vision loss is affected first.": This statement is accurate as macular degeneration primarily affects the macula, which is responsible for central vision. Clients with macular degeneration typically experience a loss of central vision first, which can severely impact activities such as reading, driving, and recognizing faces.

B) "Straining during a bowel movement can increase the progression of the disease.": This statement is not supported by evidence related to macular degeneration. While general health and avoiding strain are important, there is no specific connection between straining during bowel movements and the progression of macular degeneration.

C) "Plan to include high doses of Vitamin E in your diet.": Although antioxidants like Vitamin E can be beneficial for eye health, especially in the context of a balanced diet including other vitamins and minerals, there is no specific recommendation for high doses of Vitamin E alone to manage macular degeneration. The AREDS (Age-Related Eye Disease Study) formulation includes a combination of vitamins and minerals.

D) "Remove glasses before performing the Amsler grid test at home.": When using the Amsler grid test to monitor for changes in vision due to macular degeneration, clients should wear their glasses or contact lenses to ensure they are viewing the grid with their usual visual correction. This helps in accurately detecting any distortions or changes in vision.

A. Hematuria B. Insomnia C. Arthralgia D. Hypoglycemia

Correct Answer is B

Explanation

A) Hematuria:
While hematuria is a concerning symptom, it is not a commonly recognized adverse effect of buspirone. Hematuria might indicate other underlying conditions that need evaluation but is not typically linked to the use of buspirone.

B) Insomnia:
Insomnia is a potential adverse effect of buspirone. It can significantly impact the client’s quality of life and overall well-being. Reporting insomnia to the healthcare provider is important as it may necessitate adjustments in medication or additional interventions to help manage sleep disturbances.

C) Arthralgia:
Arthralgia, or joint pain, is not commonly associated with buspirone use. If the client experiences joint pain, it is more likely to be related to other causes rather than the medication. However, all symptoms should still be discussed with a healthcare provider.

D) Hypoglycemia:
Hypoglycemia is not a known adverse effect of buspirone. This medication does not typically influence blood glucose levels. If the client experiences symptoms of low blood sugar, other factors or conditions should be considered as potential causes.

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A nurse working in an emergency department is reviewing laboratory results of a client who is unconscious and has fruity odor to his breath. The nurse suspects diabetic ketoacidosis. Which of the following results should the nurse expect for this acid-base imbalance?

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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has vision impairment related to macular degeneration. Which of the following statements should the nurse include?

Correct Answer is A

Explanation

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Correct Answer is B

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