A client who was diagnosed with type I diabetes mellitus 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?

Correct Answer: B

Rationale: A blood glucose level of 470 mg/dl indicates severe hyperglycemia in a client with type I diabetes mellitus. Arm and leg trembling, known as tremors, is a common symptom associated with high blood glucose levels. Tremors are often a result of the body's stress response to the extreme levels of glucose in the blood. Other common symptoms of hyperglycemia include increased thirst, frequent urination, blurred vision, and fatigue. Cool, moist skin, rapid, thready pulse, and slow, shallow respirations are not typically associated with hyperglycemia and are more indicative of other conditions or clinical situations.

Correct Answer: D

Rationale: These milestones are typically achieved around 9 months of age.

Correct Answer: C

Rationale: When a neurologist asks a patient to smile, they are testing the function of the facial nerve, Cranial Nerve VII (CN VII). CN VII controls the muscles of facial expression, including the muscles required for smiling. If there is weakness or paralysis on one side of the face when the patient tries to smile, it may indicate a problem with CN VII function, such as Bell's palsy or a lesion affecting the facial nerve.

Correct Answer: A

Rationale: Statement A is incorrect because hepatitis A is not caused by an RNA virus of the enterovirus family. Instead, hepatitis A is caused by the hepatitis A virus (HAV), which belongs to the Picornaviridae family. Hepatitis A is primarily spread through the fecal-oral route, usually through the ingestion of contaminated food or water. Additionally, hepatitis A can be transmitted through close personal contact and sexual contact. While hepatitis A occurs worldwide, it is more prevalent in areas with poor sanitation and overcrowding.

Correct Answer: B

Rationale: Following laryngectomy surgery, the larynx (voice box) is removed, making it impossible for the patient to produce sound for speech. The options listed are alternative communication methods for patients post-surgery, except for using a picture board. Placing a finger over the stoma can help redirect air for speech, using a special valve can help divert air for speech as well, and learning esophageal speech involves speaking by swallowing air into the esophagus and then releasing it to create sound. Picture boards are not a common method of communication for patients following laryngectomy surgery.