CCRN PRACTICE QUESTIONS – ENDOCRINE
VERIFIED CORRECT ANSWERS 2025/2026
GRADED A+.
Which of the following would be inappropriate for a patient with diabetic
ketoacidosis?
a. Rapid infusion of normal saline (NS)
b. Regular insulin intravenous injection followed by infusion
c. Potassium replacement
d. 50 mL of 50% dextrose in water (D50W) if blood glucose falls to less than
250 mg/dL - correct answer>>Correct answer: d
Rationale: Dextrose should be added to the NS or ½NS (depending on serum
osmolality) when the blood glucose decreases to less than 250 mg/dL, but only in
a concentration of 5% (D5W). D50W would be too much and would cause more
hyperglycemia.
-Taking Strategy: None
A friend brings a 22-year-old woman to the emergency department. She says
that the patient is a diabetic and takes insulin. She reports that they were out
exercising and the patient became agitated and argumentative and then lost
consciousness. The friend called an ambulance. When you measure the
serum glucose, it is 25 mg/dL. What should you do? a. Administer 25 g of
glucose intravenously.
b. Administer 12.5 g of glucose intravenously.
c. Administer 10 g of glucose by mouth.
d. Administer glucagon intramuscularly. - correct answer>>Correct answer: a
Rationale: She is unconscious, so 25 g should be given. Because she cannot
take anything by mouth, it should be given intravenously. D50W is 50%
dextrose, which has 50 g/100 mL. An ampule is 50 mL, so it supplies 25 g of
, dextrose. Glucagon is a hormone that causes the body to mobilize glucose.
Glucagon is an indirect way to increase the serum glucose and will take longer
than giving the glucose directly.
Test-Taking Strategy: None
A 75-year-old woman is admitted with pneumonia. She is started on enteral
feedings. Over the last several hours, her urine output has been increasing.
Which laboratory test is most important at this time? a.
Arterial blood gases b.
Serum potassium c.
Serum glucose
d. Serum sodium - correct answer>>Correct answer: c
Rationale: An older patient with infection receiving high-glucose enteral feedings
is at risk of developing glucose intolerance and hyperglycemic hyperosmolar state
(HHS). Close monitoring of serum glucose and appropriate insulin administration
by sliding scale will prevent the development of HHS and the life-threatening
dehydration that occurs. Test Taking Strategy: None
Which of the following accurately describes a difference between diabetic
ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS)?
a. Patients with DKA have higher serum glucose levels than patients with HHS.
b. Patients with DKA have a greater fluid deficit than patients with HHS.
c. Patients with HHS require more insulin than patients with DKA.
d. Patients with HHS have a greater potassium deficit than patients with
DKA. - correct answer>>Correct answer: d
Rationale: Patients with HHS generally have higher serum glucose levels but
require less insulin than patients with DKA. The insulin deficit is considered
relative in HHS and absolute in DKA. The fluid deficit generally is greater in HHS
(higher serum glucose, therefore, more osmotic diuresis), and potassium is
excreted in the osmotic diuresis. The potassium deficit, therefore, is greater in
HHS.
, Test-Taking Strategy: None
Your patient had a craniotomy yesterday. Which of the following findings would
be consistent with the occurrence of diabetes insipidus? a. Serum osmolality 260
mOsm/L
b. Urine output less than 600 mL/24 hr
c. Specific gravity of urine 1.025
d. Serum sodium 165 mEq/L - correct answer>>Correct answer: d
Rationale: Diabetes insipidus is characterized by diuresis of hypotonic urine. Urine
output increases, specific gravity of urine decreases, serum osmolality increases,
and serum sodium increases.
Test-Taking Strategy: None
A 55-year-old man has been prescribed acarbose (Precose) to control his type 2
diabetes mellitus. When you teach him about the drug, which of the following
would you tell him to use for hypoglycemia? a. Orange juice b. Fresh fruit
c. Cheese and crackers
d. Glucose tablets - correct answer>>Correct answer: d
Rationale: Acarbose (Precose) is an alpha-glucosidase inhibitor. It delays digestion
of ingested carbohydrates, resulting in a smaller rise in serum glucose after meals.
Simple sugar must be given for hypoglycemia. The patient should be instructed to
carry glucose tablets and to use them for indications of hypoglycemia.
Test-Taking Strategy: None
Which of the following is the appropriate first intervention for someone with
symptoms of hypoglycemia? a. Immediately replace fluids. b. Assess the
patient's glucose level.
c. Assess and adjust the patient's insulin level.
d. Administer three glucose tablets. - correct answer>>Correct answer: b
Rationale: First confirm that there is hypoglycemia before initiating treatment.
Test-Taking Strategy: None
VERIFIED CORRECT ANSWERS 2025/2026
GRADED A+.
Which of the following would be inappropriate for a patient with diabetic
ketoacidosis?
a. Rapid infusion of normal saline (NS)
b. Regular insulin intravenous injection followed by infusion
c. Potassium replacement
d. 50 mL of 50% dextrose in water (D50W) if blood glucose falls to less than
250 mg/dL - correct answer>>Correct answer: d
Rationale: Dextrose should be added to the NS or ½NS (depending on serum
osmolality) when the blood glucose decreases to less than 250 mg/dL, but only in
a concentration of 5% (D5W). D50W would be too much and would cause more
hyperglycemia.
-Taking Strategy: None
A friend brings a 22-year-old woman to the emergency department. She says
that the patient is a diabetic and takes insulin. She reports that they were out
exercising and the patient became agitated and argumentative and then lost
consciousness. The friend called an ambulance. When you measure the
serum glucose, it is 25 mg/dL. What should you do? a. Administer 25 g of
glucose intravenously.
b. Administer 12.5 g of glucose intravenously.
c. Administer 10 g of glucose by mouth.
d. Administer glucagon intramuscularly. - correct answer>>Correct answer: a
Rationale: She is unconscious, so 25 g should be given. Because she cannot
take anything by mouth, it should be given intravenously. D50W is 50%
dextrose, which has 50 g/100 mL. An ampule is 50 mL, so it supplies 25 g of
, dextrose. Glucagon is a hormone that causes the body to mobilize glucose.
Glucagon is an indirect way to increase the serum glucose and will take longer
than giving the glucose directly.
Test-Taking Strategy: None
A 75-year-old woman is admitted with pneumonia. She is started on enteral
feedings. Over the last several hours, her urine output has been increasing.
Which laboratory test is most important at this time? a.
Arterial blood gases b.
Serum potassium c.
Serum glucose
d. Serum sodium - correct answer>>Correct answer: c
Rationale: An older patient with infection receiving high-glucose enteral feedings
is at risk of developing glucose intolerance and hyperglycemic hyperosmolar state
(HHS). Close monitoring of serum glucose and appropriate insulin administration
by sliding scale will prevent the development of HHS and the life-threatening
dehydration that occurs. Test Taking Strategy: None
Which of the following accurately describes a difference between diabetic
ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS)?
a. Patients with DKA have higher serum glucose levels than patients with HHS.
b. Patients with DKA have a greater fluid deficit than patients with HHS.
c. Patients with HHS require more insulin than patients with DKA.
d. Patients with HHS have a greater potassium deficit than patients with
DKA. - correct answer>>Correct answer: d
Rationale: Patients with HHS generally have higher serum glucose levels but
require less insulin than patients with DKA. The insulin deficit is considered
relative in HHS and absolute in DKA. The fluid deficit generally is greater in HHS
(higher serum glucose, therefore, more osmotic diuresis), and potassium is
excreted in the osmotic diuresis. The potassium deficit, therefore, is greater in
HHS.
, Test-Taking Strategy: None
Your patient had a craniotomy yesterday. Which of the following findings would
be consistent with the occurrence of diabetes insipidus? a. Serum osmolality 260
mOsm/L
b. Urine output less than 600 mL/24 hr
c. Specific gravity of urine 1.025
d. Serum sodium 165 mEq/L - correct answer>>Correct answer: d
Rationale: Diabetes insipidus is characterized by diuresis of hypotonic urine. Urine
output increases, specific gravity of urine decreases, serum osmolality increases,
and serum sodium increases.
Test-Taking Strategy: None
A 55-year-old man has been prescribed acarbose (Precose) to control his type 2
diabetes mellitus. When you teach him about the drug, which of the following
would you tell him to use for hypoglycemia? a. Orange juice b. Fresh fruit
c. Cheese and crackers
d. Glucose tablets - correct answer>>Correct answer: d
Rationale: Acarbose (Precose) is an alpha-glucosidase inhibitor. It delays digestion
of ingested carbohydrates, resulting in a smaller rise in serum glucose after meals.
Simple sugar must be given for hypoglycemia. The patient should be instructed to
carry glucose tablets and to use them for indications of hypoglycemia.
Test-Taking Strategy: None
Which of the following is the appropriate first intervention for someone with
symptoms of hypoglycemia? a. Immediately replace fluids. b. Assess the
patient's glucose level.
c. Assess and adjust the patient's insulin level.
d. Administer three glucose tablets. - correct answer>>Correct answer: b
Rationale: First confirm that there is hypoglycemia before initiating treatment.
Test-Taking Strategy: None
