BSN 366 VCBC GEORGE HAMILTON DKA CASE STUDY |
COMPLETE ASSESSMENT, GLUCOSE REGULATION, ABG
ANALYSIS & NURSING MANAGEMENT | 2026 UPDATE -
NIGHTINGALE COLLEGE.
79 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN 366 VCBC GEORGE HAMILTON DKA CASE STUDY | COMPLETE ASSESSMENT, GLUCOSE
REGULATION, ABG ANALYSIS & NURSING MANAGEMENT | 2026 UPDATE - NIGHTINGALE COLLEGE.. It
contains 79 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 79 Questions
Foundations - Application - BSN 366 VCBC George Hamilton DKA CASE Study Complete Assessment
Glucose Regulation ABG Analysis & Nursing Management 2026 Update - Nightingale College Nursing
Diabetic Ketoacidosis Management Undergraduate YEAR 3 BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Diabetes Mellitus 1-14 Insulin, Potassium, Initial, Appropriate, Fluid
Pathophysiology AND Types
Diabetic Ketoacidosis DKA 15-28 Insulin, Infusion, Treatment, Potassium, Nursing
Clinical Manifestations AND
Diagnosis
Glucose Regulation AND 29-42 Initial, Insulin, Potassium, Ketoacidosis, Paco2
Insulin Therapy
Fluid AND Electrolyte 43-56 Insulin, Serum, Anion GAP, Infusion, Glucose
Balance IN DKA
Arterial Blood GAS ABG 57-70 Insulin, Infusion, Receiving, Serum, Appropriate
Analysis AND Acid-base
Balance
Nursing Assessment AND 71-79 Insulin, Nursing, Finding, Infusion, Appropriate
Monitoring
TOTAL 79 All questions include answers and detailed rationales
,Section A - Diabetes Mellitus Pathophysiology AND Types
Q1.
In DKA, which pathophysiological mechanism directly leads to the development of
metabolic acidosis despite adequate renal function?
A. Increased hepatic ketone production B. Renal failure causing retention of sulfuric
outpacing peripheral utilization acid
C. Lactic acidosis from tissue hypoperfusion D. Loss of bicarbonate via diarrhea
Correct: A - Increased hepatic ketone production outpacing peripheral utilization
Rationale:In DKA, insulin deficiency leads to uncontrolled lipolysis and hepatic ketogenesis,
producing beta-hydroxybutyrate and acetoacetate. These strong organic acids overwhelm the
buffering system, causing high anion gap metabolic acidosis. Renal function may be
adequate but cannot excrete ketones fast enough.
Why the other answers are wrong:
B. DKA doesn't involve primary renal retention of sulfuric acid; ketones are the source.
C. Lactic acidosis can occur but is not the primary driver of the metabolic acidosis in DKA.
D. Bicarbonate loss via diarrhea is not a typical feature of DKA.
Reference: McCance, K.L. & Huether, S.E. (2026). Pathophysiology: The Biologic Basis for Disease in
Adults and Children, 9th ed., Ch. 32.
Q2.
A patient with DKA has an initial potassium level of 5.8 mEq/L. Which intervention is the
priority?
A. Administer IV potassium immediately to B. Hold potassium and monitor ECG for tall
prevent hypokalemia T waves
C. Administer insulin to shift potassium D. Initiate continuous renal replacement
intracellularly therapy
Correct: B - Hold potassium and monitor ECG for tall T waves
Rationale:Initial hyperkalemia in DKA is due to extracellular shift from acidosis and insulin
deficiency. While total body potassium is depleted, giving IV potassium immediately can
cause dangerous hyperkalemia. Hold potassium, monitor ECG for peaked T waves, and
recheck levels after insulin and fluid therapy.
Why the other answers are wrong:
A. Administering potassium while serum K+ is high risks cardiac arrhythmias.
C. Insulin will lower potassium but is not the immediate priority over monitoring and safety.
D. CRRT is not indicated for DKA unless severe renal failure exists.
Page 3
, Section A - Diabetes Mellitus Pathophysiology AND Types
Reference: American Diabetes Association. (2026). Standards of Medical Care in Diabetes - Diabetes Care, 49(Suppl 1).
Q3.
Which of the following ABG findings is most consistent with the initial presentation of
DKA?
A. pH 7.32, PaCO2 50 mmHg, HCO3 24 B. pH 7.28, PaCO2 30 mmHg, HCO3 12
mEq/L mEq/L
C. pH 7.45, PaCO2 30 mmHg, HCO3 20 D. pH 7.25, PaCO2 60 mmHg, HCO3 26
mEq/L mEq/L
Correct: B - pH 7.28, PaCO2 30 mmHg, HCO3 12 mEq/L
Rationale:DKA causes metabolic acidosis with compensatory respiratory alkalosis. Low pH,
low HCO3, and low PaCO2 (due to Kussmaul respirations) are classic. Option B shows
metabolic acidosis with respiratory compensation.
Why the other answers are wrong:
A. High PaCO2 suggests respiratory acidosis, not compensation for metabolic acidosis.
C. Alkalosis is not typical; HCO3 is low but pH is high, inconsistent.
D. High PaCO2 with normal HCO3 indicates respiratory acidosis, not DKA.
Reference: Moser, D.K. & Riegel, B. (2026). Handbook of Clinical Nursing Research, ABG interpretation.
Q4.
A patient with DKA is receiving IV fluids and insulin. Which finding indicates a potential
complication of overly rapid fluid correction?
A. Serum sodium decreasing from 132 to B. Serum osmolality dropping faster than 3
128 mEq/L mOsm/kg/hr
C. Urine output increasing to 80 mL/hr D. Blood glucose falling 50 mg/dL/hr
Correct: B - Serum osmolality dropping faster than 3 mOsm/kg/hr
Rationale:Overly rapid correction of hyperosmolality can precipitate cerebral edema,
especially in children but also in adults. A safe rate is to reduce serum osmolality by 1-2
mOsm/kg/hr. Faster drops are dangerous.
Why the other answers are wrong:
A. Mild sodium decrease can occur with fluid shift but is not the main risk indicator.
C. Increased urine output is expected with rehydration.
D. Glucose falling 50 mg/dL/hr is within acceptable range (50-75 mg/dL/hr).
Reference: Khardori, R. (2026). Diabetic Ketoacidosis Treatment & Management, Medscape.
Page 4
COMPLETE ASSESSMENT, GLUCOSE REGULATION, ABG
ANALYSIS & NURSING MANAGEMENT | 2026 UPDATE -
NIGHTINGALE COLLEGE.
79 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN 366 VCBC GEORGE HAMILTON DKA CASE STUDY | COMPLETE ASSESSMENT, GLUCOSE
REGULATION, ABG ANALYSIS & NURSING MANAGEMENT | 2026 UPDATE - NIGHTINGALE COLLEGE.. It
contains 79 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 79 Questions
Foundations - Application - BSN 366 VCBC George Hamilton DKA CASE Study Complete Assessment
Glucose Regulation ABG Analysis & Nursing Management 2026 Update - Nightingale College Nursing
Diabetic Ketoacidosis Management Undergraduate YEAR 3 BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Diabetes Mellitus 1-14 Insulin, Potassium, Initial, Appropriate, Fluid
Pathophysiology AND Types
Diabetic Ketoacidosis DKA 15-28 Insulin, Infusion, Treatment, Potassium, Nursing
Clinical Manifestations AND
Diagnosis
Glucose Regulation AND 29-42 Initial, Insulin, Potassium, Ketoacidosis, Paco2
Insulin Therapy
Fluid AND Electrolyte 43-56 Insulin, Serum, Anion GAP, Infusion, Glucose
Balance IN DKA
Arterial Blood GAS ABG 57-70 Insulin, Infusion, Receiving, Serum, Appropriate
Analysis AND Acid-base
Balance
Nursing Assessment AND 71-79 Insulin, Nursing, Finding, Infusion, Appropriate
Monitoring
TOTAL 79 All questions include answers and detailed rationales
,Section A - Diabetes Mellitus Pathophysiology AND Types
Q1.
In DKA, which pathophysiological mechanism directly leads to the development of
metabolic acidosis despite adequate renal function?
A. Increased hepatic ketone production B. Renal failure causing retention of sulfuric
outpacing peripheral utilization acid
C. Lactic acidosis from tissue hypoperfusion D. Loss of bicarbonate via diarrhea
Correct: A - Increased hepatic ketone production outpacing peripheral utilization
Rationale:In DKA, insulin deficiency leads to uncontrolled lipolysis and hepatic ketogenesis,
producing beta-hydroxybutyrate and acetoacetate. These strong organic acids overwhelm the
buffering system, causing high anion gap metabolic acidosis. Renal function may be
adequate but cannot excrete ketones fast enough.
Why the other answers are wrong:
B. DKA doesn't involve primary renal retention of sulfuric acid; ketones are the source.
C. Lactic acidosis can occur but is not the primary driver of the metabolic acidosis in DKA.
D. Bicarbonate loss via diarrhea is not a typical feature of DKA.
Reference: McCance, K.L. & Huether, S.E. (2026). Pathophysiology: The Biologic Basis for Disease in
Adults and Children, 9th ed., Ch. 32.
Q2.
A patient with DKA has an initial potassium level of 5.8 mEq/L. Which intervention is the
priority?
A. Administer IV potassium immediately to B. Hold potassium and monitor ECG for tall
prevent hypokalemia T waves
C. Administer insulin to shift potassium D. Initiate continuous renal replacement
intracellularly therapy
Correct: B - Hold potassium and monitor ECG for tall T waves
Rationale:Initial hyperkalemia in DKA is due to extracellular shift from acidosis and insulin
deficiency. While total body potassium is depleted, giving IV potassium immediately can
cause dangerous hyperkalemia. Hold potassium, monitor ECG for peaked T waves, and
recheck levels after insulin and fluid therapy.
Why the other answers are wrong:
A. Administering potassium while serum K+ is high risks cardiac arrhythmias.
C. Insulin will lower potassium but is not the immediate priority over monitoring and safety.
D. CRRT is not indicated for DKA unless severe renal failure exists.
Page 3
, Section A - Diabetes Mellitus Pathophysiology AND Types
Reference: American Diabetes Association. (2026). Standards of Medical Care in Diabetes - Diabetes Care, 49(Suppl 1).
Q3.
Which of the following ABG findings is most consistent with the initial presentation of
DKA?
A. pH 7.32, PaCO2 50 mmHg, HCO3 24 B. pH 7.28, PaCO2 30 mmHg, HCO3 12
mEq/L mEq/L
C. pH 7.45, PaCO2 30 mmHg, HCO3 20 D. pH 7.25, PaCO2 60 mmHg, HCO3 26
mEq/L mEq/L
Correct: B - pH 7.28, PaCO2 30 mmHg, HCO3 12 mEq/L
Rationale:DKA causes metabolic acidosis with compensatory respiratory alkalosis. Low pH,
low HCO3, and low PaCO2 (due to Kussmaul respirations) are classic. Option B shows
metabolic acidosis with respiratory compensation.
Why the other answers are wrong:
A. High PaCO2 suggests respiratory acidosis, not compensation for metabolic acidosis.
C. Alkalosis is not typical; HCO3 is low but pH is high, inconsistent.
D. High PaCO2 with normal HCO3 indicates respiratory acidosis, not DKA.
Reference: Moser, D.K. & Riegel, B. (2026). Handbook of Clinical Nursing Research, ABG interpretation.
Q4.
A patient with DKA is receiving IV fluids and insulin. Which finding indicates a potential
complication of overly rapid fluid correction?
A. Serum sodium decreasing from 132 to B. Serum osmolality dropping faster than 3
128 mEq/L mOsm/kg/hr
C. Urine output increasing to 80 mL/hr D. Blood glucose falling 50 mg/dL/hr
Correct: B - Serum osmolality dropping faster than 3 mOsm/kg/hr
Rationale:Overly rapid correction of hyperosmolality can precipitate cerebral edema,
especially in children but also in adults. A safe rate is to reduce serum osmolality by 1-2
mOsm/kg/hr. Faster drops are dangerous.
Why the other answers are wrong:
A. Mild sodium decrease can occur with fluid shift but is not the main risk indicator.
C. Increased urine output is expected with rehydration.
D. Glucose falling 50 mg/dL/hr is within acceptable range (50-75 mg/dL/hr).
Reference: Khardori, R. (2026). Diabetic Ketoacidosis Treatment & Management, Medscape.
Page 4
