A client with HHNS has an overall body deficit of potassium resulting from diuresis, which occurs secondary to the hyperosmolar, hyperglycemic state caused by the relative insulin deficiency.

Option A: An elevated serum acetone level is a symptom of diabetic ketoacidosis. Hepatic metabolism of free fatty acids as an alternative energy source results in accumulation of acidic intermediate and end metabolites (ie, ketones). Ketone bodies have generally included acetone, a true ketone.
Option B: Serum ketone bodies are characteristic of diabetic ketoacidosis. Ketone bodies are produced from acetyl coenzyme A mainly in the mitochondria within hepatocytes when carbohydrate utilization is impaired because of relative or absolute insulin deficiency, such that energy must be obtained from fatty acid metabolism.
Option C: Metabolic acidosis, not serum alkalosis, may occur in HHNS. A wide anion gap can be observed in patients with HHNS. The mild acidosis in HHNS is often multifactorial and results, in part, from the accumulation of minimal ketoacids in the absence of effective insulin activity.

Graves’ disease causes signs and symptoms of hypermetabolism, such as heat intolerance, diaphoresis, excessive thirst and appetite, and weight loss. To reduce heat intolerance and diaphoresis, the nurse should keep the client’s room temperature in the low-normal range.

Option A: To replace fluids lost via diaphoresis, the nurse should encourage, not restrict, intake of oral fluids.
Option B: Placing extra blankets on the bed of a client with heat intolerance would cause discomfort.
Option C: To provide needed energy and calories, the nurse should encourage the client to eat high-carbohydrate foods.

Colles’ fracture is a fracture of the distal radius, such as from a fall on an outstretched hand. It’s most common in women.

Option B: Colles’ fracture does not involve the olecranon. Most Colles fractures are secondary to a fall on an outstretched hand with a pronated forearm in dorsiflexion.
Option C: The humerus is not affected in Colles’ fracture. It is a complete fracture of the radius bone of the forearm close to the wrist resulting in an upward displacement of the radius and obvious deformity.
Option D: Colles’ fracture doesn’t refer to a fracture of the carpal scaphoid. A scaphoid fracture is a break in one of the small bones of the wrist.

In osteoporosis, bones lose calcium and phosphate salts, becoming porous, brittle, and abnormally vulnerable to fracture.

Option A: Sodium increases calcium excretion and higher calcium excretion is associated with lower bone mineral density, a predictor of osteoporotic fractures.
Option C: Potassium is not involved in osteoporosis. Potassium salts aid in bone health. A study, published in the journal Osteoporosis International, also revealed that high intake of potassium salts significantly reduces the excretion of calcium and acid in urine.
Option D: Sodium, in the form of sodium chloride, elevates urinary calcium excretion and, at prevailing calcium intakes, evokes compensatory responses that may lead to increased bone remodeling and bone loss. However, potassium was inversely associated with both urinary calcium excretion and intestinal calcium absorption, yielding no significant net change in calcium balance.

Severe hypoxia after smoke inhalation is typically related to ARDS.

Option B: Atelectasis is not associated with smoke inhalation. Inhaling harmful smoke can inflame the lungs and airway, causing them to swell and block oxygen. This can lead to acute respiratory distress syndrome and failure.
Option C: Bronchitis does not develop due to smoke inhalation. However, if the client already has bronchitis, inhalational injuries can worsen its condition.
Option D: Pneumonia isn’t typically associated with smoke inhalation and severe hypoxia.