The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketonic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?

Correct Answer: D

Rationale: Hyperosmolar hyperglycemic nonketonic syndrome (HHNS) is characterized by extremely elevated blood glucose levels without significant ketosis. Unlike diabetic ketoacidosis (DKA), patients with HHNS usually do not have high levels of ketone bodies in their blood or urine. Therefore, the nurse should anticipate below-normal serum potassium levels in a client with HHNS, as hyperglycemia can lead to profound potassium losses through osmotic diuresis. Monitoring and treating electrolyte imbalances, including hypokalemia, are crucial in managing HHNS. It is important to correct these imbalances promptly to prevent further complications.

Correct Answer: B

Rationale: When caring for a client with hyperthyroidism, it is important to monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy. Treatment for hyperthyroidism often involves thyroid replacement therapy to restore the balance of thyroid hormones in the body. Monitoring for signs and symptoms of overmedication or undermedication is crucial to ensure the client's health and well-being. Restlessness, sweating, and weight loss can be indicators of an imbalance in thyroid hormone levels and may require adjustments in medication dosage. Regular monitoring and communication with healthcare providers are essential in managing the client's condition effectively.

Correct Answer: B

Rationale: The majority of lumbar disc herniations occur at the level of L4-L5. This is because the L4-L5 disc segment bears the highest amount of stress and load in the lumbar spine due to its location and mechanics. The intervertebral disc between the fourth (L4) and fifth (L5) lumbar vertebrae is subject to repetitive movements and mechanical stress, making it more susceptible to herniation compared to other levels in the lumbar spine. Additionally, the anatomy of the L4-L5 disc makes it more prone to degeneration and herniation, leading to a higher prevalence of herniated discs at this level.

Correct Answer: C

Rationale: The disease mentioned in the question is likely myasthenia gravis. Myasthenia gravis is an autoimmune disorder where the body's immune system attacks acetylcholine receptors at the neuromuscular junction. Acetylcholine is a neurotransmitter responsible for transmitting nerve impulses to muscles. In myasthenia gravis, the immune system destroys or blocks the acetylcholine receptor sites on muscle cells, leading to a decrease in the number of functioning receptor sites. This results in muscle weakness and fatigue because the communication between nerves and muscles is impaired. This is why the nurse would base the reply on the knowledge that there is a decreased number of functioning acetyl-choline receptor sites as the underlying cause of the disease.

Correct Answer: B

Rationale: When a client presents with right-sided weakness, it indicates that the underlying issue is likely located in the left hemisphere of the brain. This is due to the contralateral organization of the brain where the right side of the brain controls the left side of the body, and vice versa. Therefore, in Mr. Franco's case, the right-sided weakness suggests the affected lobe is the left lobe of his brain, not the right lobe as stated in option B.