@nclex.review1: NCLEX Sample Question A client has glucose 920 mg/dL, minimal ketones, and severe dehydration. What complication is most concerning? A. Cerebral edema B. Severe neurologic changes C. Metabolic alkalosis D. Hypoglycemia Correct answer: B. Severe neurologic changes Rationale: This client has HHS, characterized by extreme hyperglycemia, profound dehydration, and hyperosmolarity. Severe hyperosmolarity can cause confusion, seizures, decreased level of consciousness, and coma. * A. Cerebral edema: More strongly associated with DKA, particularly in children. * C. Metabolic alkalosis: HHS does not typically cause this. * D. Hypoglycemia: The glucose is extremely elevated, not low. Tip: HHS → extreme glucose + severe dehydration + altered mental status.