a client with type 2 diabetes is admitted with hyperglycemic hyperosmolar syndrome hhs which laboratory value is most concerning
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Nursing Elites

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HESI 799 RN Exit Exam Quizlet

1. A client with type 2 diabetes is admitted with hyperglycemic hyperosmolar syndrome (HHS). Which laboratory value is most concerning?

Correct answer: C

Rationale: In a client with hyperglycemic hyperosmolar syndrome (HHS), a serum osmolarity of 320 mOsm/kg is the most concerning laboratory value. This high osmolarity indicates severe dehydration, which can lead to serious complications. Elevated serum glucose levels (choice A) are expected in HHS but do not directly reflect dehydration. Blood pressure (choice B) and serum pH (choice D) are important parameters to monitor but are not the most concerning values in HHS compared to serum osmolarity.

2. A client with heart failure is prescribed furosemide (Lasix). Which assessment finding requires immediate intervention?

Correct answer: C

Rationale: The correct answer is C. Crackles in the lungs indicate fluid overload, a common issue in heart failure patients. Immediate intervention is necessary to prevent worsening heart failure symptoms and potential complications. A heart rate of 60 beats per minute and a blood pressure of 100/60 mmHg are within normal ranges for many individuals and do not typically require immediate intervention in this context. The presence of a new murmur may be important to monitor but is not the priority when crackles in the lungs suggest fluid overload.

3. An adult male who fell from a roof and fractured his left femur is admitted for surgical stabilization after having a soft cast applied in the emergency department. Which assessment finding warrants immediate intervention by the nurse?

Correct answer: A

Rationale: In a patient with a fractured femur, weak palpable distal pulses can indicate compromised circulation to the lower extremity. This finding suggests a potential vascular compromise that requires immediate intervention to prevent further complications like compartment syndrome or ischemia. Pain at the fracture site, mild swelling of the leg, and bruising around the fracture site are expected following such an injury and surgical stabilization, and while they should be monitored, they do not require immediate intervention like addressing compromised circulation.

4. The nurse is teaching a male client with multiple sclerosis how to empty his bladder using the Crede Method. When performing a return demonstration, the client applies pressure to the umbilical areas of his abdomen. What instruction should the nurse provide?

Correct answer: D

Rationale: The client is applying pressure in the wrong region (umbilical area) and should be instructed to apply pressure at the suprapubic area. Applying downward manual pressure at the suprapubic region helps in emptying the bladder effectively by assisting in pushing the urine out through the urethra. Choices A, B, and C are incorrect because they do not address the specific issue of applying pressure to help empty the bladder using the Crede Method.

5. Which breakfast selection indicates that the client understands the nurse's instructions about the dietary management of osteoporosis?

Correct answer: D

Rationale: The correct answer is D, 'Bagel with jelly and skim milk.' This choice includes skim milk, a good source of calcium, which is important for osteoporosis management. It also avoids foods that inhibit calcium absorption. Osteoporosis dietary management emphasizes increased calcium intake and reducing foods that hinder calcium absorption. Choice A only provides proteins but lacks calcium. Choice B offers fruits and a bran muffin, but it lacks a good source of calcium. Choice C has granola but misses a significant source of calcium.

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