The nurse is teaching a patient with diabetes mellitus how to differentiate between hypoglycemia and ketoacidosis. The patient demonstrates understanding of hypoglycemia by stating they will check their blood glucose when experiencing which of the following symptoms?

Fruity-smelling breath

Sweating and nervousness

Nausea and vomiting

Increased thirst and urination

Answer and Explanation

The Correct Answer is B

Choice A reason: Fruity-smelling breath is a symptom of ketoacidosis, not hypoglycemia. Ketoacidosis occurs when the body produces high levels of ketones due to a lack of insulin, leading to metabolic acidosis.

Choice B reason: Sweating and nervousness are common symptoms of hypoglycemia. Low blood glucose levels trigger the release of adrenaline, which causes these symptoms. Patients should check their blood glucose when experiencing these signs to prevent severe hypoglycemia.

Choice C reason: Nausea and vomiting are more associated with ketoacidosis. High blood glucose levels and the presence of ketones can cause gastrointestinal upset.

Choice D reason: Increased thirst and urination are also symptoms of hyperglycemia and ketoacidosis. These symptoms result from the body's attempt to eliminate excess glucose and ketones through urine.

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Correct Answer is D

Explanation

Choice A reason: While a post-operative patient preparing for discharge is important, they are stable enough to be considered for discharge and do not require immediate assessment.

Choice B reason: A patient with Cushing's disease after insertion of a nasogastric tube may need monitoring, but this is not as urgent as a patient with potential respiratory distress.

Choice C reason: A patient scheduled for a chest radiograph who is anxious about their treatment does not require immediate intervention compared to a patient experiencing respiratory issues.

Choice D reason: A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift may be experiencing respiratory distress and requires immediate assessment and intervention to prevent further complications.

A. Administer phosphate binders with meals. B. Encourage the patient to increase potassium-rich foods. C. Monitor calcium levels for signs of hypocalcaemia. D. Increase fluid intake to 3 litters per day.

Correct Answer is A

Explanation

Choice A reason: Administering phosphate binders with meals is an essential intervention for managing renal osteodystrophy in patients with chronic kidney disease (CKD). Renal osteodystrophy results from an imbalance of calcium and phosphate in the body due to impaired kidney function. Phosphate binders help reduce the absorption of phosphate from the diet, thereby lowering serum phosphate levels and preventing complications such as secondary hyperparathyroidism and bone disorders. This intervention helps maintain the proper balance of minerals, improving bone health and reducing the risk of fractures and other skeletal complications in CKD patients.

Choice B reason: Encouraging the patient to increase potassium-rich foods is not appropriate for managing renal osteodystrophy. Patients with CKD often need to limit their potassium intake because impaired kidney function can lead to hyperkalaemia (elevated potassium levels), which is potentially life-threatening. Instead of promoting potassium-rich foods, the focus should be on controlling phosphate and maintaining calcium levels.

Choice C reason: Monitoring calcium levels for signs of hypocalcaemia is important in CKD management, but it is not the primary intervention for renal osteodystrophy. While hypocalcaemia can occur in CKD due to disrupted vitamin D metabolism, addressing phosphate levels through the use of phosphate binders is a more targeted approach to managing renal osteodystrophy and preventing secondary hyperparathyroidism.

Choice D reason: Increasing fluid intake to 3 litters per day is generally not recommended for CKD patients, especially those with reduced urine output or fluid retention issues. Excessive fluid intake can lead to fluid overload, hypertension, and heart failure in CKD patients. The intervention should focus on phosphate control rather than fluid intake adjustments.

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The nurse is teaching a patient with diabetes mellitus how to differentiate between hypoglycemia and ketoacidosis. The patient demonstrates understanding of hypoglycemia by stating they will check their blood glucose when experiencing which of the following symptoms?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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