Pccn practice
A nurse in the emergency department assesses a patient with a hand laceration and
notices that the patient smells strongly of alcohol. The patient is diabetic, irritable, and
pale and reports headache. The nurse is waiting for laboratory results. What serum
glucose level might the nurse expect to find?
a. 50 to 60 mg/dL
b. <50 mg/dL
c. >1000 mg/dL
d. 80 to 110 mg/dL - answer b. <50mg/dL
Following a chest infection, a patient with type 1 diabetes reports fatigue and nausea.
Assessment reveals a blood glucose level of 450 mg/dL. Which of the following
pharmacologic interventions are priorities for patient care?
a. Administer intravenous (IV) fluids at the prescribed rate to correct sodium levels.
b. Administer intravenous (IV) fluids based on corrected sodium levels.
c. Administer prescribed insulin via IV bolus, then continuous drip.
d. "Administer intravenous (IV) fluids based on corrected sodium levels" and "Administer
prescribed insulin via IV bolus, then continuous drip". - answer d. "Administer
intravenous (IV) fluids based on corrected sodium levels" and "Administer prescribed
insulin via IV bolus, then continuous drip".
Which of the following are possible complications from diabetic ketoacidosis?
a. Hyponitremia
b. Metabolic acidosis
c. Hyperkalemia
d. Metabolic alkalosis - answer b. Metabolic acidosis
MA- caused by ketosis resulting from insulin deficiency and stress hormone excess.
Hyperkalemia is caused by higher than normal levels of potassium, usually through
impaired renal function. Hyponatremia is a low level of nitrogen in the blood associated
with protein malnutrition or overhydration. Metabolic alkalosis is an acid-base
imbalance, like metabolic acidosis, but is caused by an increase in serum bicarbonate
(HCO3) concentration.
An unconscious patient with hypoglycemia is being treated with IV glucose (50 mL of
50% dextrose IV bolus) to correct serum glucose levels of 40 mg/dL. Which of the
following is a possible complication of administering hypertonic dextrose?
a. Myocardial infarction
b. Cardiac arrest
c. Hypokalemia
d. Phlebitis - answer c. phlebitis
