NUR 255 Contemporary Nursing Practice II -
Midlands Technical College, TEST 2 Exam
Review | Complete Study Guide with
Complete Verified Exam Questions and
Detailed Answers – Already Graded A+
Question 1
A patient with hyperosmolar hyperglycemic syndrome whose blood glucose level
approaches 250 mg/dL should receive which intervention?
A. Administering 0.9% NaCl
B. Administering 0.1 unit/kg/hr of insulin
C. Administering IM glucagon
D. Administering IV fluids containing glucose
Answer: D
Rationale: IV fluids containing glucose should be administered when blood glucose
approaches 250 mg/dL to prevent hypoglycemia. 0.9% NaCl is given initially for fluid
replacement, insulin corrects hyperglycemia, and glucagon is for hypoglycemic
emergencies.
Question 2
Which condition may be observed because of incorrect fluid replacement with hypotonic
fluids in patients with diabetic ketoacidosis?
A. Polyuria
B. Hypokalemia
C. Cerebral edema
D. Metabolic acidosis
Answer: C
Rationale: Rapid administration of hypotonic fluids can cause a sudden drop in serum
sodium, resulting in cerebral edema. Polyuria and metabolic acidosis are manifestations
of DKA, not complications of treatment.
pg. 1
,Question 3
What is the correct order of the events leading to ketoacidosis?
1. Decreased glucose utilization
2. Insulin deficiency
3. Ketones accumulate
4. Breakdown of fat stores
A. 1,3,4,2
B. 2,1,4,3
C. 1,4,2,3
D. 4,1,3,2
Answer: B
Rationale: Ketoacidosis begins with insulin deficiency (2), leading to decreased
glucose utilization (1). Fat stores are broken down for energy (4), resulting in ketone
accumulation (3).
Question 4
A patient who is in diabetic ketoacidosis (DKA) is on a continuous short-acting insulin
infusion and is receiving a continuous infusion of normal saline solution. Which
assessment is the highest priority for this patient?
A. Urine output
B. Temperature
C. Respiratory rate
D. Cardiac monitoring
Answer: D
Rationale: Cardiac monitoring is the highest priority because insulin infusion causes
potassium to shift intracellularly, decreasing serum potassium and potentially causing
cardiac dysrhythmias.
Question 5
When assessing for signs of ketoacidosis in a patient with diabetes, which respiratory
pattern would the nurse expect to find?
A. Central apnea
B. Hypoventilation
C. Kussmaul respirations
D. Cheyne-Stokes respirations
pg. 2
,Answer: C
Rationale: Kussmaul respirations (deep, unlabored breathing) occur as the lungs
compensate for metabolic acidosis by blowing off acids and carbon dioxide.
Question 6
While caring for a patient with diabetic ketoacidosis, the nurse finds that the patient is
experiencing rapid, deep breathing because of dyspnea. Which physiologic cause does
the nurse suspect?
A. Metabolic acidosis
B. Dry mucous membranes
C. Increased serum osmolality
D. Increased endogenous insulin secretion
Answer: A
Rationale: Rapid, deep breathing (Kussmaul respirations) is a compensatory response
to metabolic acidosis.
Question 7
Which condition may lead to a coma in patients with diabetic ketoacidosis if left
untreated? Select all that apply.
1. Dehydration
2. Hypoglycemia
3. Cerebral edema
4. Metabolic acidosis
5. Electrolyte imbalance
A. 1,2,5
B. 2,3,5
C. 1,4,5
D. 1,2,3,4
E. All of them
F. None
Answer: C
Rationale: Dehydration (1), metabolic acidosis (4), and electrolyte imbalance (5) may
lead to coma if untreated. Hypoglycemia and cerebral edema are not directly associated
with DKA coma.
pg. 3
, Question 8
Which clinical manifestation would be assessed in a patient who is in diabetic
ketoacidosis (DKA)? Select all that apply.
1. Tachycardia
2. Kussmaul respirations
3. Orthostatic hypotension
4. Hypovolemic shock state
5. Reduced bowel movements
6. Manifestations that mimic alcohol intoxication state
A. 1,2,3,4
B. 2,3,5
C. 1,4,5,6
D. 1,2,5,6
E. All of them
F. None
Answer: A
Rationale: DKA is characterized by tachycardia (1), Kussmaul respirations (2),
orthostatic hypotension (3), and hypovolemic shock state (4). Reduced bowel
movements and alcohol intoxication symptoms are not associated with DKA.
Question 9
A patient with type 1 diabetes reports severe dehydration, dry mouth, fever associated
with chills, and a fruity odor of the breath. Which interprofessional treatment would be
included in the plan of care? Select all that apply.
1. Monitor serum calcium levels
2. Administer potassium to correct hypokalemia
3. Administer sodium bicarbonate if severe acidosis is present
4. Administer 0.9% sodium chloride (NaCl) to correct fluid imbalance
5. Administer 5% to 10% dextrose when the glucose levels are below 100 mg/dL
A. 1,2,3,4
B. 2,3,4
C. 1,4,5
pg. 4
Midlands Technical College, TEST 2 Exam
Review | Complete Study Guide with
Complete Verified Exam Questions and
Detailed Answers – Already Graded A+
Question 1
A patient with hyperosmolar hyperglycemic syndrome whose blood glucose level
approaches 250 mg/dL should receive which intervention?
A. Administering 0.9% NaCl
B. Administering 0.1 unit/kg/hr of insulin
C. Administering IM glucagon
D. Administering IV fluids containing glucose
Answer: D
Rationale: IV fluids containing glucose should be administered when blood glucose
approaches 250 mg/dL to prevent hypoglycemia. 0.9% NaCl is given initially for fluid
replacement, insulin corrects hyperglycemia, and glucagon is for hypoglycemic
emergencies.
Question 2
Which condition may be observed because of incorrect fluid replacement with hypotonic
fluids in patients with diabetic ketoacidosis?
A. Polyuria
B. Hypokalemia
C. Cerebral edema
D. Metabolic acidosis
Answer: C
Rationale: Rapid administration of hypotonic fluids can cause a sudden drop in serum
sodium, resulting in cerebral edema. Polyuria and metabolic acidosis are manifestations
of DKA, not complications of treatment.
pg. 1
,Question 3
What is the correct order of the events leading to ketoacidosis?
1. Decreased glucose utilization
2. Insulin deficiency
3. Ketones accumulate
4. Breakdown of fat stores
A. 1,3,4,2
B. 2,1,4,3
C. 1,4,2,3
D. 4,1,3,2
Answer: B
Rationale: Ketoacidosis begins with insulin deficiency (2), leading to decreased
glucose utilization (1). Fat stores are broken down for energy (4), resulting in ketone
accumulation (3).
Question 4
A patient who is in diabetic ketoacidosis (DKA) is on a continuous short-acting insulin
infusion and is receiving a continuous infusion of normal saline solution. Which
assessment is the highest priority for this patient?
A. Urine output
B. Temperature
C. Respiratory rate
D. Cardiac monitoring
Answer: D
Rationale: Cardiac monitoring is the highest priority because insulin infusion causes
potassium to shift intracellularly, decreasing serum potassium and potentially causing
cardiac dysrhythmias.
Question 5
When assessing for signs of ketoacidosis in a patient with diabetes, which respiratory
pattern would the nurse expect to find?
A. Central apnea
B. Hypoventilation
C. Kussmaul respirations
D. Cheyne-Stokes respirations
pg. 2
,Answer: C
Rationale: Kussmaul respirations (deep, unlabored breathing) occur as the lungs
compensate for metabolic acidosis by blowing off acids and carbon dioxide.
Question 6
While caring for a patient with diabetic ketoacidosis, the nurse finds that the patient is
experiencing rapid, deep breathing because of dyspnea. Which physiologic cause does
the nurse suspect?
A. Metabolic acidosis
B. Dry mucous membranes
C. Increased serum osmolality
D. Increased endogenous insulin secretion
Answer: A
Rationale: Rapid, deep breathing (Kussmaul respirations) is a compensatory response
to metabolic acidosis.
Question 7
Which condition may lead to a coma in patients with diabetic ketoacidosis if left
untreated? Select all that apply.
1. Dehydration
2. Hypoglycemia
3. Cerebral edema
4. Metabolic acidosis
5. Electrolyte imbalance
A. 1,2,5
B. 2,3,5
C. 1,4,5
D. 1,2,3,4
E. All of them
F. None
Answer: C
Rationale: Dehydration (1), metabolic acidosis (4), and electrolyte imbalance (5) may
lead to coma if untreated. Hypoglycemia and cerebral edema are not directly associated
with DKA coma.
pg. 3
, Question 8
Which clinical manifestation would be assessed in a patient who is in diabetic
ketoacidosis (DKA)? Select all that apply.
1. Tachycardia
2. Kussmaul respirations
3. Orthostatic hypotension
4. Hypovolemic shock state
5. Reduced bowel movements
6. Manifestations that mimic alcohol intoxication state
A. 1,2,3,4
B. 2,3,5
C. 1,4,5,6
D. 1,2,5,6
E. All of them
F. None
Answer: A
Rationale: DKA is characterized by tachycardia (1), Kussmaul respirations (2),
orthostatic hypotension (3), and hypovolemic shock state (4). Reduced bowel
movements and alcohol intoxication symptoms are not associated with DKA.
Question 9
A patient with type 1 diabetes reports severe dehydration, dry mouth, fever associated
with chills, and a fruity odor of the breath. Which interprofessional treatment would be
included in the plan of care? Select all that apply.
1. Monitor serum calcium levels
2. Administer potassium to correct hypokalemia
3. Administer sodium bicarbonate if severe acidosis is present
4. Administer 0.9% sodium chloride (NaCl) to correct fluid imbalance
5. Administer 5% to 10% dextrose when the glucose levels are below 100 mg/dL
A. 1,2,3,4
B. 2,3,4
C. 1,4,5
pg. 4
