NURSING TEST EXAM DIABETES MELLITUS NCLEX QUIZ 1 25 Q&A’S WITH RATIONALES (GUARANTEED PASS) | RATED A+

NURSING TEST EXAM DIABETES MELLITUS NCLEX QUIZ 1 25 Q&A’S WITH RATIONALES (GUARANTEED PASS) | RATED A+
1. A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings
include fasting blood glucose of 120mg/dl, temperature of 101ºF, pulse of 88 bpm, respirations
of 22 bpm, and a BP of 140/84 mmHg. Which finding would be of most concern to the nurse?
ï‚· A. Pulse
ï‚· B. Blood pressure
ï‚· C. Respiration
ï‚· D. Temperature
Correct Answer: D. Temperature
An elevated temperature may indicate infection. Infection is a leading cause of hyperglycemic
hyperosmolar nonketotic syndrome or diabetic ketoacidosis. Due to the possibility of an
infectious trigger for DKA, the patient may be febrile or hypothermic. If there is a superimposed
infection that triggered the episode of DKA, the patient may have other infectious symptoms like
fever, cough, or other urinary symptoms.
ï‚· Option A: The pulse rate of 88 bpm is normal. On examination, vital signs
typically reveal tachycardia and tachypnea. Supraventricular tachycardia (SVT)
can occur as a complication of diabetic ketoacidosis in the absence of underlying
heart disease, and the risk is increased by the electrolyte, acid-base, and fluid
balance disturbances, as in the previous case reports.
ï‚· Option B: A blood pressure of 140/84 mmHg is hypertensive. Blood pressure
may also vary, though hypotension is possible and indicative of a more severe
disease process. Insulin is known to decrease the catecholamine-induced
production of these 2 potent vasodilators. Severe insulin deficiency as seen in
DKA thus leads to increased production of PGI2 and PGE2, which leads to
vasodilation and hypotension.
ï‚· Option C: Respirations of 22 bpm are normal. Kussmaul’s breathing, which is
labored, deep, and tachypneic, may occur in clients with DKA. Some providers
may appreciate a fruity scent to the patient’s breath, indicative of the presence of
acetone.

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