Question 15: Mr. D, a 19-year-old college student has been brought to the emergency room by his roommate. Mr. D reports abdominal pain, polyuria, vomiting, and thirst. He appears flushed, and his lips and mucous membranes are dry and cracked. His skin turgor is greater than 3 seconds. He has deep, rapid respirations, and a fruity odor to his breath. He has a history of Type 1 diabetes. He states “I was cramming for finals and have missed a few doses of insulin”. He is alert but is having trouble focusing on the nurse’s questions. Mr. D’s vital signs and blood glucose are as follows: Blood glucose fingerstick level                       685 mg/dL Blood pressure                                                 100/60 mm/Hg Heart rate                                                          120 beats/min4 Respiratory Rate                                                32 breaths/min Temperature                                                       100.8o F (38.2o C) The arterial blood gas results for Mr. D are: pH                          7.25 PaO2                    97 mm/Hg PaCO2                 25 mm/Hg Bicarbonate      15 mEq/L The HCP ordered an insulin drip for Mr. D to begin at 0.1 units/kg/hr. Mr. D weigh 155 lbs. The pharmacy delivers a premixed bag of 100 units of regular insulin in 100 mL of normal saline. The nurse calculated the infusion pump setting as 10 mL/hr. (Round the weight calculation was to the nearest whole number). What should the charge nurse do to ensure safe administration of this medication?

Question 38: The nurse is assessing the lab values of a client with hyperosmolar hyperglycemia syndrome (HHS). Which values would the nurse confirm due to this condition? (Select all that apply)

Question:  13 Mr. D, a 19-year-old premed student has been brought to the emergency room by his roommate. Mr. D reports abdominal pain, polyuria, vomiting, and thirst. He appears flushed, and his lips and mucous membranes are dry and cracked. His skin turgor is greater than 3 seconds. He has deep, rapid respirations, and a fruity odor to his breath. He has a history of Type 1 diabetes. He states “I was cramming for finals and have missed a few doses of insulin”. He is alert but is having trouble focusing on the nurse’s questions. Mr. D’s vital signs and blood glucose are as follows: Blood glucose fingerstick level                       685 mg/dL Blood pressure                                                 100/60 mm/Hg Heart rate                                                          120 beats/min Respiratory Rate                                                32 breaths/minTemperature                                                       100.8o F (38.2o C) Which nursing concept is the priority in planning the initial emergency interventions for Mr. D?

Question 10: A 78-year-old patient with type 2 diabetes was admitted onto the nursing unit with a diagnosis of hyperosmolar hyperglycemia syndrome. She has a history of osteoporosis, breast cancer, and a recent urinary tract infection. She is nonverbal, but groans when turned and repositioned. Her most recent blood glucose was 650 mg/dL. A primary IV of normal saline is infusing as well as an insulin drip, which is titrated according to the facility’s insulin drip protocol.  Which IV fluid would the nurse expect to administer when the patient blood glucose level reached 250 mg/dL? 

Question 4: The nurse would assess the client with bacterial meningitis for which clinical manifestation? (Select all that apply)

Question 5: Which of the following represents a priority goal for the client during the acute phase of Guillain-Barre syndrome?

Question  43: Which nursing intervention is most important when caring for a client diagnosed with syndrome of inappropriate antidiuretic hormone?

Question 37: The client expresses concern about the possible exposure of family members to radioactive iodine and refuses to consent to the test. What would be the most appropriate action for the nurse to implement? 

Question 20: What information will the nurse teach a client who has been newly diagnosed with Graves disease?

Question 29: Which prescribed medication should the nurse expect will have rapid effects on a client admitted to the emergency department in thyroid crisis?