Key Concepts
Introduction
Scenario setup A client with DKA has BG 480 mg/dL, pH 7.18, K+ 5.6 mEq/L on admission. RR 32, HR 124, dry mucosa, fruity breath. Insulin infusion per protocol is starting. DKA management is fluid resuscitation, insulin therapy, electrolyte monitoring, and watching for complications (hypokalemia as insulin drives K intracellularly). RN priorities: strict monitoring, accurate I/O, timely labs, communication. Traps: giving insulin without addressing K, missing frequent glucose checks, or ignoring fluid balance. This case-study format is intentional: boards reward trajectory thinking—what changed, what is unstable, and what you do next for the role named in the stem. For NCLEX-RN (United States), read the assignment line before you eliminate answers. Slow read: re-scan the stem for vitals trends, oxygen settings, allergies, and time since onset—case items often hide the decisive clue in a single line. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing...