A patient with diabetic ketoacidosis (DKA) has been receiving insulin for 6 hours. Laboratory finding are Na+ 131, K+ 3.7, CL- 102, HCO3 22, and glucose 170. Which action should the nurse take?

Give potassium intravenously.

Administer D5 NS with the insulin drip.

Administer 3% NS at 200ml/hr

Expect the insulin drip to be discontinued.

Answer and Explanation

The Correct Answer is B

A. Give potassium intravenously. – The potassium level is 3.7 (within normal range 3.5–5.0), so potassium is not needed yet.

B. Administer D5 NS with the insulin drip. – Correct Answer. Once glucose drops to ≤200 mg/dL, dextrose is added to prevent hypoglycemia while continuing insulin to correct ketoacidosis.

C. Administer 3% NS at 200 mL/hr. – Hypertonic saline is used for severe hyponatremia, which is not the case here.

D. Expect the insulin drip to be discontinued. – The insulin drip is not discontinued until ketoacidosis has fully resolved (when HCO3 > 18, pH > 7.3, and anion gap normalizes).

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Correct Answer is D

Explanation

A. Bring fresh-cut flowers to cheer the patient up. – Incorrect. Fresh flowers should be avoided due to the risk of fungal or bacterial infections in immunocompromised patients.

B. Take the patient to the cafeteria for meals. – Incorrect. Bone marrow transplant patients are at high risk for infection, and leaving the room increases exposure to pathogens.

C. A cover gown is not necessary when entering the patient’s room. – Incorrect. Depending on the hospital’s isolation precautions, visitors may be required to wear gowns and masks to protect the patient.

D. Do not visit if you have had a recent infection. – Correct Answer. Even mild infections can be life-threatening to patients undergoing a bone marrow transplant, so visitors should stay away if they are unwell.

A. 8 hr B. 6 hr C. 4 hr D. 2 hr

Correct Answer is C

Explanation

A. 8 hr – Incorrect. RBC transfusions must not exceed 4 hours due to the risk of bacterial growth and hemolysis.

B. 6 hr – Incorrect. Blood products should be infused within a maximum of 4 hours to prevent complications.

C. 4 hr – Correct Answer. The maximum infusion time for packed RBCs is 4 hours to reduce the risk of bacterial contamination and infection.

D. 2 hr – Incorrect. While blood is often infused within 2 hours, the maximum safe limit is 4 hours.

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A patient with diabetic ketoacidosis (DKA) has been receiving insulin for 6 hours. Laboratory finding are Na+ 131, K+ 3.7, CL- 102, HCO3 22, and glucose 170. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What information will the nurse provide to the visitors of a patient who is to receive a bone marrow transplant?

Correct Answer is D

Explanation

A nurse is planning care for a patient who is to receive packed RBCs. The nurse should plan for the total infusion time to not exceed which of the following?

Correct Answer is C

Explanation

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