a client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis dka which of the following interventions should the nurs
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Leadership and Management HESI

1. A client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). Which of the following interventions should the nurse implement first?

Correct answer: B

Rationale: The correct first intervention in the treatment of a client with diabetic ketoacidosis (DKA) is to start an intravenous line and infuse normal saline. This is essential for fluid resuscitation to restore intravascular volume and improve perfusion. Administering intravenous insulin can lead to further potassium depletion without first addressing dehydration and electrolyte imbalances. Monitoring serum potassium levels is important but should follow fluid resuscitation to avoid life-threatening hypokalemia. Obtaining an arterial blood gas (ABG) is necessary to assess the acid-base status but is not the initial priority when managing DKA.

2. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?

Correct answer: C

Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.

3. A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which of the following interventions should be the nurse's priority?

Correct answer: B

Rationale: The correct answer is to start an intravenous line and infuse normal saline. In diabetic ketoacidosis (DKA), the priority intervention is fluid resuscitation with normal saline to restore intravascular volume and improve perfusion. Administering insulin without first addressing dehydration and electrolyte imbalances can lead to further complications. Monitoring serum potassium levels and obtaining an arterial blood gas (ABG) are important aspects of DKA management but come after initial fluid resuscitation.

4. When teaching a male client diagnosed with type 1 diabetes mellitus how diet and exercise affect insulin requirements, Nurse Joy should include which guideline?

Correct answer: B

Rationale: When a person with type 1 diabetes exercises, it typically lowers blood glucose levels. As a result, insulin needs are reduced when exercise or food intake is decreased. Choice A is incorrect because more insulin is not typically needed when exercise or food intake is increased. Choice C is incorrect because increasing food intake would generally require more insulin to cover the additional glucose from the food. Choice D is incorrect as decreasing food intake usually leads to a lower need for insulin.

5. A client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN's teaching to the client?

Correct answer: C

Rationale: A DNR order is typically written after the healthcare provider has discussed the implications with the patient and their family. This ensures that the patient and family are fully informed before making such a critical decision. Choice A is incorrect because pronouncing clinical death is a medical determination, not directly related to DNR orders. Choice B is incorrect because while physicians commonly write DNR orders, the discussion with the patient and family is crucial. Choice D is incorrect because a DNR order does not require a court decision; it is a decision made in collaboration with the healthcare team and the patient or family.

Similar Questions

A client with type 1 DM is taught to take NPH and regular insulin every morning. The nurse should provide which instructions to the client?
A healthcare professional caring for a client who has been receiving intravenous diuretics suspects that the client is experiencing a deficient fluid volume. Which assessment finding would the healthcare professional note in a client with this condition?
A client newly diagnosed with DM asks a nurse why it is necessary to monitor blood glucose levels so often. The nurse's best response would be:
A client at risk for hypokalemia is being instructed by a nurse about foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:
The client with DM is being taught about foot care. The nurse instructs the client to:

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