,NURS 6550 Final exam Advanced Practice Acute Care I Questions
And Answers 2026/2027 Walden University
Course: NURS 6550
University: Walden University
Assessment: Final Exam
Area: Advanced Practice Care of Adults in Acute Care Settings I
Question Count: 100
1.
A patient with diabetes presents with polyuria, polydipsia, abdominal pain,
vomiting, and deep rapid respirations. Which condition should be suspected?
A) Diabetic ketoacidosis
B) Hyperosmolar hyperglycemic state
C) Hypoglycemia
D) Diabetes insipidus
Answer: A) Diabetic ketoacidosis
Rationale: DKA is characterized by hyperglycemia, ketosis, metabolic
acidosis, dehydration, and often gastrointestinal symptoms and Kussmaul
respirations.
2.
Which laboratory finding is most characteristic of diabetic ketoacidosis?
A) Elevated serum ketones
B) Low serum glucose
C) Respiratory alkalosis
D) Hypercalcemia
Answer: A) Elevated serum ketones
Rationale: Ketone production from insulin deficiency is a defining feature of
DKA.
3.
A patient with DKA has a serum potassium of 3.0 mEq/L before insulin
therapy is initiated. What is the priority?
A) Correct the significant hypokalemia before starting insulin
B) Start insulin immediately regardless of potassium
,C) Administer sodium bicarbonate to all patients
D) Restrict IV fluids
Answer: A) Correct the significant hypokalemia before starting
insulin
Rationale: Insulin shifts potassium intracellularly and can worsen significant
hypokalemia. Potassium must be appropriately addressed before insulin in
markedly hypokalemic patients.
4.
Which treatment is the foundation of initial DKA management?
A) Isotonic IV fluid replacement
B) Immediate bicarbonate administration in every patient
C) Oral glucose
D) Fluid restriction
Answer: A) Isotonic IV fluid replacement
Rationale: Severe dehydration is a major component of DKA, so appropriate
IV fluid resuscitation is central to treatment.
5.
Which feature more strongly favors hyperosmolar hyperglycemic state over
DKA?
A) Marked hyperosmolarity with minimal or absent significant ketosis
B) Prominent ketoacidosis
C) Kussmaul respirations from severe acidosis
D) Large serum ketone burden
Answer: A) Marked hyperosmolarity with minimal or absent
significant ketosis
Rationale: HHS is characterized by profound hyperglycemia and
hyperosmolality with little or no substantial ketoacidosis.
6.
An older adult with diabetes presents with profound dehydration, altered
mental status, and extremely high serum glucose without significant
ketones. Which diagnosis is most likely?
A) Hyperosmolar hyperglycemic state
B) DKA
, C) Addisonian crisis
D) Myxedema coma
Answer: A) Hyperosmolar hyperglycemic state
Rationale: HHS commonly occurs in older adults with type 2 diabetes and
can produce profound dehydration and neurologic abnormalities.
7.
A patient with untreated hyperthyroidism develops fever, severe tachycardia,
agitation, vomiting, and heart failure. Which condition should be suspected?
A) Thyroid storm
B) Myxedema coma
C) Adrenal crisis
D) DKA
Answer: A) Thyroid storm
Rationale: Thyroid storm is a life-threatening decompensation of
thyrotoxicosis involving marked systemic and cardiovascular manifestations.
8.
Which medication class is commonly used to reduce peripheral adrenergic
manifestations during thyroid storm when appropriate?
A) Beta-blocker
B) Loop diuretic
C) Proton-pump inhibitor
D) Anticoagulant
Answer: A) Beta-blocker
Rationale: Beta-blockade can reduce tachycardia, tremor, and other
adrenergic manifestations when not contraindicated.
9.
Which condition is most strongly associated with severe hypothyroidism and
altered mental status?
A) Myxedema coma
B) Thyroid storm
C) DKA
D) Pheochromocytoma
Answer: A) Myxedema coma
And Answers 2026/2027 Walden University
Course: NURS 6550
University: Walden University
Assessment: Final Exam
Area: Advanced Practice Care of Adults in Acute Care Settings I
Question Count: 100
1.
A patient with diabetes presents with polyuria, polydipsia, abdominal pain,
vomiting, and deep rapid respirations. Which condition should be suspected?
A) Diabetic ketoacidosis
B) Hyperosmolar hyperglycemic state
C) Hypoglycemia
D) Diabetes insipidus
Answer: A) Diabetic ketoacidosis
Rationale: DKA is characterized by hyperglycemia, ketosis, metabolic
acidosis, dehydration, and often gastrointestinal symptoms and Kussmaul
respirations.
2.
Which laboratory finding is most characteristic of diabetic ketoacidosis?
A) Elevated serum ketones
B) Low serum glucose
C) Respiratory alkalosis
D) Hypercalcemia
Answer: A) Elevated serum ketones
Rationale: Ketone production from insulin deficiency is a defining feature of
DKA.
3.
A patient with DKA has a serum potassium of 3.0 mEq/L before insulin
therapy is initiated. What is the priority?
A) Correct the significant hypokalemia before starting insulin
B) Start insulin immediately regardless of potassium
,C) Administer sodium bicarbonate to all patients
D) Restrict IV fluids
Answer: A) Correct the significant hypokalemia before starting
insulin
Rationale: Insulin shifts potassium intracellularly and can worsen significant
hypokalemia. Potassium must be appropriately addressed before insulin in
markedly hypokalemic patients.
4.
Which treatment is the foundation of initial DKA management?
A) Isotonic IV fluid replacement
B) Immediate bicarbonate administration in every patient
C) Oral glucose
D) Fluid restriction
Answer: A) Isotonic IV fluid replacement
Rationale: Severe dehydration is a major component of DKA, so appropriate
IV fluid resuscitation is central to treatment.
5.
Which feature more strongly favors hyperosmolar hyperglycemic state over
DKA?
A) Marked hyperosmolarity with minimal or absent significant ketosis
B) Prominent ketoacidosis
C) Kussmaul respirations from severe acidosis
D) Large serum ketone burden
Answer: A) Marked hyperosmolarity with minimal or absent
significant ketosis
Rationale: HHS is characterized by profound hyperglycemia and
hyperosmolality with little or no substantial ketoacidosis.
6.
An older adult with diabetes presents with profound dehydration, altered
mental status, and extremely high serum glucose without significant
ketones. Which diagnosis is most likely?
A) Hyperosmolar hyperglycemic state
B) DKA
, C) Addisonian crisis
D) Myxedema coma
Answer: A) Hyperosmolar hyperglycemic state
Rationale: HHS commonly occurs in older adults with type 2 diabetes and
can produce profound dehydration and neurologic abnormalities.
7.
A patient with untreated hyperthyroidism develops fever, severe tachycardia,
agitation, vomiting, and heart failure. Which condition should be suspected?
A) Thyroid storm
B) Myxedema coma
C) Adrenal crisis
D) DKA
Answer: A) Thyroid storm
Rationale: Thyroid storm is a life-threatening decompensation of
thyrotoxicosis involving marked systemic and cardiovascular manifestations.
8.
Which medication class is commonly used to reduce peripheral adrenergic
manifestations during thyroid storm when appropriate?
A) Beta-blocker
B) Loop diuretic
C) Proton-pump inhibitor
D) Anticoagulant
Answer: A) Beta-blocker
Rationale: Beta-blockade can reduce tachycardia, tremor, and other
adrenergic manifestations when not contraindicated.
9.
Which condition is most strongly associated with severe hypothyroidism and
altered mental status?
A) Myxedema coma
B) Thyroid storm
C) DKA
D) Pheochromocytoma
Answer: A) Myxedema coma
