A patient with diabetes mellitus (DM) developed a serum glucose of 900 and an elevated serum osmolality. The patient then became unconscious. What pathological process most likely caused the altered neurologic status?
The brain cells became edematous because of a blood to tissue shift of fluid.
Hyperinsulinemia caused hypoglycemia and a tonic clonic seizure.
The brain cells became dehydrated because of fluid shirting out of the cells.
Fluid volume overload caused higher pressure in the brain tissue
The Correct Answer is C
A. The brain cells became edematous because of a blood to tissue shift of fluid: This describes cerebral edema, which is not typically caused by hyperglycemia.
B. Hyperinsulinemia caused hypoglycemia and a tonic-clonic seizure: The scenario describes hyperglycemia, not hypoglycemia.
C. The brain cells became dehydrated because of fluid shifting out of the cells:. In hyperglycemic hyperosmolar syndrome (HHS), extremely high blood glucose leads to increased serum osmolality, causing water to move out of brain cells, leading to dehydration and altered consciousness.
D. Fluid volume overload caused higher pressure in the brain tissue: Fluid volume overload is not the primary issue in this scenario; rather, dehydration is the concern due to hyperglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. High unconjugated, low direct: In liver disease, both conjugated (direct) and unconjugated bilirubin levels are typically elevated.
B. High conjugated, high direct: In cirrhosis and alcoholic liver disease, the liver's ability to process bilirubin is impaired, leading to elevated levels of both conjugated (direct) and unconjugated bilirubin, causing jaundice.
C. High direct, high unconjugated: Both direct (conjugated) and unconjugated bilirubin levels are elevated, but this does not clarify the direct relationship with jaundice.
D. Low indirect, normal unconjugated: In liver disease, bilirubin levels are elevated, not low or normal.
Correct Answer is A
Explanation
A. Positive Brudzinski's sign: A positive Brudzinski's sign, which involves involuntary flexion of the hips and knees when the neck is flexed, is a common finding in meningitis (both viral and bacterial).
B. Dysarthria and double vision: These symptoms are not typical of viral meningitis; they are more often associated with neurological disorders such as multiple sclerosis.
C. Petechiae and purpura: These are more commonly associated with bacterial meningitis, particularly meningococcal meningitis, rather than viral meningitis.
D. Positive Babinski's reflex: A positive Babinski’s reflex indicates an upper motor neuron lesion and is not specific to meningitis.
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