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Male fireflies emit light patterns to attract female fireflies for mating. A group of entomologists is studying the light patterns of closely related but distinct species of fireflies in Ohio. They are investigating what might happen when the ranges of these two species intersect. Which of the following outcomes might they see evidence for in their research? 

Mr. Lewis, a 69-year-old male arrives to the emergency department with his wife, who reports he suddenly became confused, had slurred speech, and appeared weak while sitting at the table approximately 30 minutes ago. History: • Type 2 Diabetes • Hypothyroidism • Hypertension • Hyperlipidemia • Coronary artery disease Initial Assessment Findings: • Slurred speech • Right-sided weakness • Confusion • Diaphoretic • Tremors • Pale appearance • Eyes open to voice • Inappropriate words • Withdraws from pain Admission Vital Signs: • Blood pressure: 185/90 • Heart rate: 108 • Respiratory rate: 22 • Temperature: 98.1 • Oxygen saturation: 96% on room air Laboratory Results: • Hemoglobin: 9.1 g/dL (12-16 g/dL) • Glucose: 48 mg/dL Using the provided image, what is Mr. Lewis’ Glasgow Coma Scale score?

Mr. Lewis, a 69-year-old male arrives to the emergency department with his wife, who reports he suddenly became confused, had slurred speech, and appeared weak while sitting at the table approximately 30 minutes ago. History: • Type 2 Diabetes • Hypothyroidism • Hypertension • Hyperlipidemia • Coronary artery disease Initial Assessment Findings: • Slurred speech • Right-sided weakness • Confusion • Diaphoretic • Tremors • Pale appearance • Eyes open to voice • Inappropriate words • Withdraws from pain Admission Vital Signs: • Blood pressure: 185/90 • Heart rate: 108 • Respiratory rate: 22 • Temperature: 98.1 • Oxygen saturation: 96% on room air Laboratory Results: • Hemoglobin: 9.1 g/dL (12-16 g/dL) • Glucose: 48 mg/dL After receiving IV dextrose, the patient becomes more alert. Updated history reveals a diagnosis of Vitamin B12 deficiency anemia. Which assessment finding should the nurse prioritize next?

A nurse is monitoring a client following a thyroidectomy for hyperthyroidism for the presence of hypoparathyroidism. Which of the following findings should the nurse expect?

Mr. Lewis, a 69-year-old male arrives to the emergency department with his wife, who reports he suddenly became confused, had slurred speech, and appeared weak while sitting at the table approximately 30 minutes ago. History: • Type 2 Diabetes • Hypothyroidism • Hypertension • Hyperlipidemia • Coronary artery disease Initial Assessment Findings: • Slurred speech • Right-sided weakness • Confusion • Diaphoretic • Tremors • Pale appearance • Eyes open to voice • Inappropriate words • Withdraws from pain Admission Vital Signs: • Blood pressure: 185/90 • Heart rate: 108 • Respiratory rate: 22 • Temperature: 98.1 • Oxygen saturation: 96% on room air Laboratory Results: • Hemoglobin: 9.1 g/dL (12-16 g/dL) • Glucose: 48 mg/dL What is the nurse’s priority action?

Mr. Lewis, a 69-year-old male arrives to the emergency department with his wife, who reports he suddenly became confused, had slurred speech, and appeared weak while sitting at the table approximately 30 minutes ago. History: • Type 2 Diabetes • Hypothyroidism • Hypertension • Hyperlipidemia • Coronary artery disease Initial Assessment Findings: • Slurred speech • Right-sided weakness • Confusion • Diaphoretic • Tremors • Pale appearance • Eyes open to voice • Inappropriate words • Withdraws from pain Admission Vital Signs: • Blood pressure: 185/90 • Heart rate: 108 • Respiratory rate: 22 • Temperature: 98.1 • Oxygen saturation: 96% on room air Laboratory Results: • Hemoglobin: 9.1 g/dL (12-16 g/dL) • Glucose: 48 mg/dL Which finding is most consistent with Vitamin B12 deficiency anemia?

Mr. Lewis, a 69-year-old male arrives to the emergency department with his wife, who reports he suddenly became confused, had slurred speech, and appeared weak while sitting at the table approximately 30 minutes ago. History: • Type 2 Diabetes • Hypothyroidism • Hypertension • Hyperlipidemia • Coronary artery disease Initial Assessment Findings: • Slurred speech • Right-sided weakness • Confusion • Diaphoretic • Tremors • Pale appearance • Eyes open to voice • Inappropriate words • Withdraws from pain Admission Vital Signs: • Blood pressure: 185/90 • Heart rate: 108 • Respiratory rate: 22 • Temperature: 98.1 • Oxygen saturation: 96% on room air Laboratory Results: • Hemoglobin: 9.1 g/dL (12-16 g/dL) • Glucose: 48 mg/dL Which finding requires the most immediate nursing action?

A patient with hyperthyroidism has a heart rate of 148 bpm and tremors. Which intervention is the priority?

Mr. Lewis, a 69-year-old male arrives to the emergency department with his wife, who reports he suddenly became confused, had slurred speech, and appeared weak while sitting at the table approximately 30 minutes ago. History: • Type 2 Diabetes • Hypothyroidism • Hypertension • Hyperlipidemia • Coronary artery disease Initial Assessment Findings: • Slurred speech • Right-sided weakness • Confusion • Diaphoretic • Tremors • Pale appearance • Eyes open to voice • Inappropriate words • Withdraws from pain Admission Vital Signs: • Blood pressure: 185/90 • Heart rate: 108 • Respiratory rate: 22 • Temperature: 98.1 • Oxygen saturation: 96% on room air Laboratory Results: • Hemoglobin: 9.1 g/dL (12-16 g/dL) • Glucose: 48 mg/dL The nurse is preparing the patient for discharge. Which teaching is most important to prevent future episodes?

A diabetic patient becomes confused, diaphoretic, and shaky. Which action is the priority?