Correct Answer: B

Rationale: The correct first intervention in a client with DKA is to start an intravenous line and infuse normal saline for fluid resuscitation. This is crucial to restore intravascular volume and improve perfusion, addressing the dehydration and electrolyte imbalances commonly seen in DKA. Administering insulin without addressing the dehydration can lead to further complications. Monitoring serum potassium levels is important but is not the first priority; potassium levels can shift with fluid resuscitation. Obtaining an arterial blood gas (ABG) is helpful in assessing acid-base status but is not the initial priority compared to fluid resuscitation.

Correct Answer: A

Rationale: When a client experiences secondary failure to an oral antidiabetic agent like glipizide, the next step is often to initiate insulin therapy. This is because secondary failure indicates that the current oral antidiabetic medication is no longer effective in managing blood glucose levels, and insulin therapy may be required to adequately control blood sugar. Switching to a different oral antidiabetic agent may not be effective if there is already resistance to the current agent. Adding another oral antidiabetic agent may not address the underlying issue of secondary failure. Restricting carbohydrate intake is important for diabetes management but is not the primary intervention indicated in this scenario of secondary failure to glipizide.

Correct Answer: B

Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.

Correct Answer: C

Rationale: In an Addisonian crisis, there is a lack of adrenal hormones leading to severe hypotension. Hypertension (choice A) is not a typical sign of Addisonian crisis but can occur in conditions like pheochromocytoma. Hyperglycemia (choice B) is not a characteristic sign of an Addisonian crisis. Tachycardia (choice D) may occur as a compensatory mechanism in response to hypotension, but severe bradycardia is more common in an Addisonian crisis.

Correct Answer: A

Rationale: The correct answer is A: Leukopenia. Propylthiouracil can lead to bone marrow suppression, resulting in leukopenia. Monitoring white blood cell counts is crucial to detect this potential side effect early. Choice B, hyperglycemia, is not typically associated with propylthiouracil use. Choice C, hypertension, is not a common side effect of propylthiouracil. Choice D, weight gain, is also not a typical side effect of propylthiouracil therapy.