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Extract:

The following scenario applies to the next 1 items
The emergency department (ED) nurse is caring for a 66-year-old male client
Item 1 of 1


History and Physical
2000: 66-year male arrives at the emergency department (ED) following a recommendation by his primary healthcare provider (PHCP). The client called his PHCP in the morning, reporting a headache, feeling unwell, fatigue, and thirst. He could not check his blood glucose because he reports being out of testing supplies for two weeks. He also reports being unable to take his prescribed antihypertensive and antidiabetic medications for one week because he lost his job. On exam, the client reports feeling fatigued and thirsty. He is alert and completely oriented. His physical exam was within normal limits except for a thready pulse with a rate of 119/minute.

The client has a medical history of type II diabetes mellitus, congestive heart failure (CHF), hypertension, and hyperlipidemia. He is prescribed atorvastatin, metformin, and lisinopril.

Vital Signs
Oral Temperature 98o F (36.7o C)
Pulse 119/minute
Respirations 19/minute
Blood pressure 98/52 mm Hg
Oxygen saturation 96% on room air

Physician Orders
Obtain intravenous (IV) access
Five units of regular insulin via intravenous push (IVP)
Infuse two liters of 0.9% saline over one hour
Obtain capillary blood glucose (CBG) every two hours
Potassium chloride 20 mEq by mouth x 1 dose
Implement seizure precautions


Question 1 of 5

The nurse reviews laboratory work ordered by the primary healthcare provider (PHCP). The nurse obtains physician orders for this client with hyperosmolar hyperglycemic state (HHS) . The nurse is preparing to implement the physician's orders. Which order should the nurse clarify with the physician?

Question Image

Correct Answer: A

Rationale: Infusing 2 liters of saline in one hour is too rapid for HHS, risking fluid overload. Slower infusion (e.g., 1 liter over 2-4 hours) is safer. Other orders align with HHS management.

Extract:


Question 2 of 5

Correct Answer:

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Question 3 of 5

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Question 4 of 5

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Question 5 of 5

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