GoodNurse free practice
NCLEX Question of the Day
Review the question, check the correct answer, and read the rationale before tomorrow's prompt arrives.
A nurse is caring for a client admitted with diabetic ketoacidosis (DKA). The client has received an initial bolus of 0.9% sodium chloride and is now receiving an insulin infusion. Current vital signs are BP 100/60 mmHg, HR 110/min, RR 24/min, Temp 99.0°F (37.2°C). Blood glucose is 350 mg/dL (19.4 mmol/L). Which finding requires the nurse's immediate attention?
-
Presence of moderate ketones in the urine
-
Correct answer Serum potassium level of 2.9 mEq/L (2.9 mmol/L)
-
Client reports feeling thirsty
-
Urine output of 50 mL over the past hour
Rationale
Rationale: Insulin therapy causes potassium to shift from the extracellular fluid back into the intracellular space. Combined with fluid resuscitation and osmotic diuresis from hyperglycemia, this can lead to rapid development of hypokalemia. A serum potassium level of 2.9 mEq/L (normal 3.5-5.0 mEq/L) is critically low and increases the risk of life-threatening cardiac dysrhythmias. This requires immediate intervention, typically potassium replacement. Urine output of 50 mL/hr is adequate. Moderate ketones are expected during DKA treatment and will resolve as insulin therapy continues. Thirst is a common symptom of hyperglycemia and dehydration seen in DKA and is expected to improve with treatment.
GoodNurse AI
Want to talk through why the other options are wrong? Sign up for GoodNurse to ask follow-up questions and get a guided explanation.
Free daily practice
Get the next question.
One NCLEX-style prompt, answer, and rationale in your inbox every morning. No account needed.
Free NCLEX practice. Unsubscribe anytime.