1|Page
Endocrine & Respiratory NUR 445 Exam 1 Questions and
Answers with Complete Solutions UPDATED!!!
What test will be run before discharging DKA patient? -
ANSWER HbAc
What A1ACH is good for a diabetic patient? - ANSWER 7
What is HHS? - ANSWER Have some insulin but body might be
resistance causing blood glucose to be high for a long period of
time.
Who do you see commonly have HHS? - ANSWER Type 2 DM
What are four causes of HHS? (Hint: DIPN) - ANSWER - Not
enough insulin
- Delay in treatment
- Poor oral intake
- Impaired renal function
,2|Page
What are five signs and symptoms you would see in HHS? (Hint:
"BEN has a pHD") - ANSWER - Blood glucose > 600
- Neuro changes (alteration in LOC)
- pH greater than 7.4
- Dehydration
- Electrolyte imbalances
What are five interventions you would do for a client with HHS?
(Hint: FISHE) - ANSWER - IV insulin
- Fluids (0.9% NS)
- Hourly Glucose checks
- Strict I&O
- Educate patient on management and treatment adherence
What is the main electrolyte we are concerned with DKA or
HHS? - ANSWER K+
What is DKA? - ANSWER Deficiency of insulin leading to the use
of stored fats for energy. Leading to ketosis and acidosis state.
,3|Page
DKA: What patient would you commonly see this condition in? -
ANSWER Type 1 diabetic
What are three causes of DKA? - ANSWER - Infection
- Stress
- Skipped/ missed insulin
What are seven signs and symptoms of DKA? (Hint:
F.K.U.S.A.D.P) - ANSWER - Fruity breath
- Kussmaul breathing
- Urine/ serum ketones
- Serum glucose of >250
- Abdominal pain (n/v)
- Dehydration (increased HR / decreased BP)
- Positive anion gap
What is the anion gap formula? - ANSWER Na+ - (Cl- + HCO3-)
What are six interventions for DKA? (Hint: "Hungry Hippos
Munch Many Cheesy Nachos") - ANSWER - Hydration (0.9% NS)
, 4|Page
- Hourly glucose check (give IV insulin dip 10%)
- Monitor for ketones. (I&Os)
- Monitor more when patient is sick
- Notify provider if serum glucose is >250 & N/V >24 hrs
- Check K+
What should we educate patient on how to manage sick days at
home to prevent DKA? - ANSWER - Assess blood glucose more
often
- Check for ketones.
- Fluid replacement.
How will you know if the problem is DKA or HHS? - ANSWER
Check pH: DKA will have acidosis.
Which insulin do you give at night? - ANSWER Long-acting
insulin (insulin glargine/ Lantus)
What is the onset, peak, and duration of insulin glargine? -
ANSWER - Onset: 1 hr
Endocrine & Respiratory NUR 445 Exam 1 Questions and
Answers with Complete Solutions UPDATED!!!
What test will be run before discharging DKA patient? -
ANSWER HbAc
What A1ACH is good for a diabetic patient? - ANSWER 7
What is HHS? - ANSWER Have some insulin but body might be
resistance causing blood glucose to be high for a long period of
time.
Who do you see commonly have HHS? - ANSWER Type 2 DM
What are four causes of HHS? (Hint: DIPN) - ANSWER - Not
enough insulin
- Delay in treatment
- Poor oral intake
- Impaired renal function
,2|Page
What are five signs and symptoms you would see in HHS? (Hint:
"BEN has a pHD") - ANSWER - Blood glucose > 600
- Neuro changes (alteration in LOC)
- pH greater than 7.4
- Dehydration
- Electrolyte imbalances
What are five interventions you would do for a client with HHS?
(Hint: FISHE) - ANSWER - IV insulin
- Fluids (0.9% NS)
- Hourly Glucose checks
- Strict I&O
- Educate patient on management and treatment adherence
What is the main electrolyte we are concerned with DKA or
HHS? - ANSWER K+
What is DKA? - ANSWER Deficiency of insulin leading to the use
of stored fats for energy. Leading to ketosis and acidosis state.
,3|Page
DKA: What patient would you commonly see this condition in? -
ANSWER Type 1 diabetic
What are three causes of DKA? - ANSWER - Infection
- Stress
- Skipped/ missed insulin
What are seven signs and symptoms of DKA? (Hint:
F.K.U.S.A.D.P) - ANSWER - Fruity breath
- Kussmaul breathing
- Urine/ serum ketones
- Serum glucose of >250
- Abdominal pain (n/v)
- Dehydration (increased HR / decreased BP)
- Positive anion gap
What is the anion gap formula? - ANSWER Na+ - (Cl- + HCO3-)
What are six interventions for DKA? (Hint: "Hungry Hippos
Munch Many Cheesy Nachos") - ANSWER - Hydration (0.9% NS)
, 4|Page
- Hourly glucose check (give IV insulin dip 10%)
- Monitor for ketones. (I&Os)
- Monitor more when patient is sick
- Notify provider if serum glucose is >250 & N/V >24 hrs
- Check K+
What should we educate patient on how to manage sick days at
home to prevent DKA? - ANSWER - Assess blood glucose more
often
- Check for ketones.
- Fluid replacement.
How will you know if the problem is DKA or HHS? - ANSWER
Check pH: DKA will have acidosis.
Which insulin do you give at night? - ANSWER Long-acting
insulin (insulin glargine/ Lantus)
What is the onset, peak, and duration of insulin glargine? -
ANSWER - Onset: 1 hr
