Saunders NCLEX book
Study online at https://quizlet.com/_aesd84
1. 1. A client is brought 3. Intravenous infusion of normal saline
to the emergency de-
partment in an unre- Rationale: The primary goal of treatment in hyperosmolar hyperglycemic
sponsive state, and a syndrome (HHS) is to rehydrate the client to restore fluid volume and to
diagnosis of hyperos- correct electrolyte deficiency. Intravenous (IV) fluid replacement is similar
molar hyperglycemic to that administered in diabetic ketoacidosis (DKA) and begins with IV
syndrome is made. infusion of normal saline. Regular insulin, not NPH insulin, would be
The nurse would im- administered. The use of sodium bicarbonate to correct acidosis is avoided
mediately prepare to because it can precipitate a further drop in serum potassium levels. Intu-
initiate which antici- bation and mechanical ventilation are not required to treat HHS
pated primary health
Test-Taking Strategy: Focus on the subject, treatment of HHS, and note the
care provider's pre-
strategic word, immediately. If you can recall the treatment for DKA, you
scription?
will be able to answer this question easily. Treatment for HHS is similar to
1. Endotracheal intu- the treatment for DKA and begins with rehydration.
bation
2. 100 units of NPH in-
sulin
3. Intravenous infu-
sion of normal saline
4. Intravenous infu-
sion of sodium bicar-
bonate
2. 1. An external insulin 4. It administers a small continuous dose of short-duration insulin subcu-
pump is prescribed taneously. The client can self-administer an additional bolus dose from the
for a client with dia- pump before each meal.
betes mellitus. When
the client asks the Rationale: An insulin pump provides a small continuous dose of short-du-
nurse about the func- ration (rapid- or short-acting) insulin subcutaneously throughout the day
tioning of the pump, and night. The client can self-administer an additional bolus dose from the
the nurse bases the re- pump before each meal as needed. Short-duration insulin is used in an
, Saunders NCLEX book
Study online at https://quizlet.com/_aesd84
sponse on which in- insulin pump. An external pump is not attached surgically to the pancreas.
formation about the
pump? Test-Taking Strategy: Focus on the subject, use of an insulin pump. Re-
calling that short-duration insulin is used in an insulin pump will assist in
1. It is timed to release eliminating options 1 and 2. Noting the word external in the question will
programmed doses of assist in eliminating option 3.
either short-duration
or NPH insulin into the
bloodstream at specif-
ic intervals.
2. It continuously in-
fuses small amounts
of NPH insulin into
the bloodstream while
regularly monitoring
blood glucose levels.
3. It is surgically at-
tached to the pancreas
and infuses regular in-
sulin into the pan-
creas. This releases in-
sulin into the blood-
stream.
4. It administers a
small continuous dose
of short-duration in-
sulin subcutaneously.
The client can self-ad-
minister an addition-
al bolus dose from
the pump before each
meal.
, Saunders NCLEX book
Study online at https://quizlet.com/_aesd84
3. 1. A client with a 2. Comatose state
diagnosis of diabet- 3. Deep, rapid breathing
ic ketoacidosis (DKA) 5. Elevated blood glucose level
is being treated in
the emergency de- Rationale: Because of the profound deficiency of insulin associated with
partment. Which find- DKA, glucose cannot be used for energy and the body breaks down fat
ings support this diag-as a secondary source of energy. Ketones, which are acid by-products
nosis? Select all that of fat metabolism, build up, and the client experiences a metabolic ke-
apply. toacidosis. High serum glucose contributes to an osmotic diuresis and the
client becomes severely dehydrated. If untreated, the client will become
1. Increase in pH comatose due to severe dehydration, acidosis, and electrolyte imbalance.
2. Comatose state Kussmaul's respirations, the deep rapid breathing associated with DKA, is
3. Deep, rapid breath- a compensatory mechanism by the body. The body attempts to correct the
ing acidotic state by blowing off carbon dioxide (CO2), which is an acid. In the
4. Decreased urine absence of insulin, the client will experience severe hyperglycemia. Option
output 1 is incorrect, because in acidosis the pH would be low. Option 4 is incorrect
5. Elevated blood glu- because a high serum glucose will result in an osmotic diuresis and the
cose level client will experience polyuria.
Test-Taking Strategy: Focus on the subject, findings associated with DKA.
Recall that the pathophysiology of DKA is the breakdown of fats for energy.
The breakdown of fats leads to a state of acidosis. The high serum glucose
contributes to an osmotic diuresis. Knowing the pathophysiology of DKA
will aid in identification of the correct answers.
4. 1. The nurse teaches 2. Shakiness
a client with diabetes 3. Palpitations
mellitus about differ- 5. Lightheadedness
entiating between hy-
poglycemia and ke- Rationale: Shakiness, palpitations, and lightheadedness are signs/symp-
toacidosis. The client toms of hypoglycemia and would indicate the need for food or glucose.
Polyuria, blurred vision, and a fruity breath odor are manifestations of
Study online at https://quizlet.com/_aesd84
1. 1. A client is brought 3. Intravenous infusion of normal saline
to the emergency de-
partment in an unre- Rationale: The primary goal of treatment in hyperosmolar hyperglycemic
sponsive state, and a syndrome (HHS) is to rehydrate the client to restore fluid volume and to
diagnosis of hyperos- correct electrolyte deficiency. Intravenous (IV) fluid replacement is similar
molar hyperglycemic to that administered in diabetic ketoacidosis (DKA) and begins with IV
syndrome is made. infusion of normal saline. Regular insulin, not NPH insulin, would be
The nurse would im- administered. The use of sodium bicarbonate to correct acidosis is avoided
mediately prepare to because it can precipitate a further drop in serum potassium levels. Intu-
initiate which antici- bation and mechanical ventilation are not required to treat HHS
pated primary health
Test-Taking Strategy: Focus on the subject, treatment of HHS, and note the
care provider's pre-
strategic word, immediately. If you can recall the treatment for DKA, you
scription?
will be able to answer this question easily. Treatment for HHS is similar to
1. Endotracheal intu- the treatment for DKA and begins with rehydration.
bation
2. 100 units of NPH in-
sulin
3. Intravenous infu-
sion of normal saline
4. Intravenous infu-
sion of sodium bicar-
bonate
2. 1. An external insulin 4. It administers a small continuous dose of short-duration insulin subcu-
pump is prescribed taneously. The client can self-administer an additional bolus dose from the
for a client with dia- pump before each meal.
betes mellitus. When
the client asks the Rationale: An insulin pump provides a small continuous dose of short-du-
nurse about the func- ration (rapid- or short-acting) insulin subcutaneously throughout the day
tioning of the pump, and night. The client can self-administer an additional bolus dose from the
the nurse bases the re- pump before each meal as needed. Short-duration insulin is used in an
, Saunders NCLEX book
Study online at https://quizlet.com/_aesd84
sponse on which in- insulin pump. An external pump is not attached surgically to the pancreas.
formation about the
pump? Test-Taking Strategy: Focus on the subject, use of an insulin pump. Re-
calling that short-duration insulin is used in an insulin pump will assist in
1. It is timed to release eliminating options 1 and 2. Noting the word external in the question will
programmed doses of assist in eliminating option 3.
either short-duration
or NPH insulin into the
bloodstream at specif-
ic intervals.
2. It continuously in-
fuses small amounts
of NPH insulin into
the bloodstream while
regularly monitoring
blood glucose levels.
3. It is surgically at-
tached to the pancreas
and infuses regular in-
sulin into the pan-
creas. This releases in-
sulin into the blood-
stream.
4. It administers a
small continuous dose
of short-duration in-
sulin subcutaneously.
The client can self-ad-
minister an addition-
al bolus dose from
the pump before each
meal.
, Saunders NCLEX book
Study online at https://quizlet.com/_aesd84
3. 1. A client with a 2. Comatose state
diagnosis of diabet- 3. Deep, rapid breathing
ic ketoacidosis (DKA) 5. Elevated blood glucose level
is being treated in
the emergency de- Rationale: Because of the profound deficiency of insulin associated with
partment. Which find- DKA, glucose cannot be used for energy and the body breaks down fat
ings support this diag-as a secondary source of energy. Ketones, which are acid by-products
nosis? Select all that of fat metabolism, build up, and the client experiences a metabolic ke-
apply. toacidosis. High serum glucose contributes to an osmotic diuresis and the
client becomes severely dehydrated. If untreated, the client will become
1. Increase in pH comatose due to severe dehydration, acidosis, and electrolyte imbalance.
2. Comatose state Kussmaul's respirations, the deep rapid breathing associated with DKA, is
3. Deep, rapid breath- a compensatory mechanism by the body. The body attempts to correct the
ing acidotic state by blowing off carbon dioxide (CO2), which is an acid. In the
4. Decreased urine absence of insulin, the client will experience severe hyperglycemia. Option
output 1 is incorrect, because in acidosis the pH would be low. Option 4 is incorrect
5. Elevated blood glu- because a high serum glucose will result in an osmotic diuresis and the
cose level client will experience polyuria.
Test-Taking Strategy: Focus on the subject, findings associated with DKA.
Recall that the pathophysiology of DKA is the breakdown of fats for energy.
The breakdown of fats leads to a state of acidosis. The high serum glucose
contributes to an osmotic diuresis. Knowing the pathophysiology of DKA
will aid in identification of the correct answers.
4. 1. The nurse teaches 2. Shakiness
a client with diabetes 3. Palpitations
mellitus about differ- 5. Lightheadedness
entiating between hy-
poglycemia and ke- Rationale: Shakiness, palpitations, and lightheadedness are signs/symp-
toacidosis. The client toms of hypoglycemia and would indicate the need for food or glucose.
Polyuria, blurred vision, and a fruity breath odor are manifestations of
