Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia.

The presence of hypovolemic shock related to osmotic diuresis.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia.

Fluid overload resulting from aggressive ﬂuid replacement.

Answer and Explanation

The Correct Answer is A

Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia are the main reasons for initiating cardiac monitoring in patients with diabetic ketoacidosis. In diabetic ketoacidosis, insulin deficiency causes the body to break down fat for energy, leading to the production of ketones and resulting in metabolic acidosis. In addition, glucose and potassium are lost in the urine due to osmotic diuresis. Hypokalemia can cause ECG changes and dysrhythmias, which can be life-threatening.

Hypokalemia is a common complication of DKA and can lead to ECG changes such as ST-segment depression, T-wave inversion, and U waves².

Hypovolemic shock related to osmotic diuresis is an important consideration in the management of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

Cardiovascular collapse resulting from the eﬀects of hyperglycemia is not a common complication of diabetic ketoacidosis, and it is not the primary reason for initiating cardiac monitoring.

Fluid overload resulting from aggressive ﬂuid replacement is a potential complication of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.

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Correct Answer is B

Explanation

Abdominal discomfort an hour after a meal is a common symptom of a gastric ulcer because the stomach is where food is initially processed, and stomach acid is most concentrated. In contrast, duodenal ulcers typically cause pain 2-3 hours after meals, as food moves out of the stomach and into the duodenum, where it encounters duodenal acid.

A positive stool occult blood test is a non-specific finding that can be caused by many gastrointestinal conditions, including peptic ulcers. It does not indicate the location of the ulcer.

The number of ulcers the client has had in the past does not indicate the location of the current ulcer.

Normal hemoglobin and hematocrit levels do not provide information about the location of the ulcer.

A. The patient has a urine output of 800 ml/hr. B. The patient is confused and lethargic. C. The patient's urine specific gravity is 1.003. D. The patient had a recent head injury.

Correct Answer is B

Explanation

Diabetes insipidus is a condition where the body is not able to regulate water balance properly, leading to excessive urine output and dehydration. The patient's urine output of 800 ml/hr (option A) and low urine specific gravity of 1.003 (option C) is consistent with diabetes insipidus and requires monitoring, but they are not as immediately concerning as the patient's confusion and lethargy.

Confusion and lethargy may indicate severe dehydration, electrolyte imbalances, or even brain swelling (if the patient had a recent head injury, as mentioned in option D). These symptoms require immediate attention to prevent further complications and ensure the patient's safety.

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Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with diagnosis of peptic ulcer disease. Which assessment finding indicates to the nurse that the client most likely has an ulcer in the stomach rather than the duodenum?

Correct Answer is B

Explanation

Which of the information below obtained when caring for a patient who has been admited for evaluation of diabetes insipidus will be of greatest concern to the nurse?

Correct Answer is B

Explanation

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