Final answer:
In a hyperglycemic-hyperosmolar state, a nurse would expect to see increased urine output due to the body's attempt to excrete excess glucose, which leads to dehydration and increased serum osmolality.
Step-by-step explanation:
A nurse caring for a client experiencing a hyperglycemic-hyperosmolar state, which is a complication of diabetes mellitus, would expect to see increased urine output (option c). This condition is characterized by extremely high blood glucose levels leading to increased osmolality, which pulls fluids into the bloodstream and subsequently leads to a diuretic effect. Therefore, the kidneys excrete more urine to eliminate the excess glucose. As a result, both dehydration and an increase in serum osmolality occur, not a decrease, hence ruling out option d). Options a) hypoglycemia and b) Kussmaul respirations are associated with other states, such as insulin overtreatment or diabetic ketoacidosis, respectively.