Hondros NUR 205 Exam 3 – Actual Questions
with Complete Correct Answers & Rationales
(Diabetes, Acid-Base, Electrolytes, Med
Admin) Latest Update This Year
Section A: Diabetes & Glucose Regulation (1–25)
1. A fasting plasma glucose of 140 mg/dL on two separate occasions is most consistent
with:
A. Normal glucose regulation
B. Prediabetes
C. Diabetes mellitus
D. Hypoglycemia
Explanation: Fasting glucose ≥126 mg/dL on two separate tests is diagnostic for diabetes.
2. Classic symptoms of hyperglycemia include:
A. Weight gain, bradycardia, constipation
B. Polyuria, polydipsia, polyphagia
C. Cold intolerance, hair loss
D. Muscle twitching, tetany
Explanation: Excess glucose causes osmotic diuresis (polyuria), thirst (polydipsia), and
increased hunger (polyphagia).
3. A blood glucose of 48 mg/dL in a conscious patient is best managed first by:
A. Giving IV insulin
B. Providing 15 grams of fast-acting oral carbohydrate and rechecking in 15
, minutes
C. Restricting fluids
D. Administering a diuretic
Explanation: The “15/15” rule is used for mild/moderate hypoglycemia in conscious
patients.
4. Signs of hypoglycemia may include:
A. Dry skin, slow reflexes
B. Shakiness, sweating, confusion, irritability
C. Weight loss over months
D. Polyuria only
Explanation: Sympathetic activation produces tremors and sweating; CNS symptoms
include confusion.
5. A patient with type 1 diabetes forgets to take insulin and presents with Kussmaul
respirations and fruity breath. The nurse suspects:
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Lactic acidosis
Explanation: DKA features hyperglycemia, ketones, acidosis, Kussmaul respirations, and
fruity breath.
6. Priority nursing action in suspected DKA is to:
A. Restrict fluids
B. Begin IV fluids as ordered and monitor vital signs closely
C. Hold all insulin
D. Encourage oral intake only
,Explanation: Fluid resuscitation is an early priority to correct dehydration and support
perfusion.
7. Hyperosmolar hyperglycemic state (HHS) differs from DKA because HHS usually:
A. Occurs only in type 1
B. Has severe ketosis
C. Has very high glucose and dehydration but minimal or no ketones
D. Has low osmolality
Explanation: HHS has extreme hyperglycemia and dehydration with little ketosis; often in
type 2.
8. A patient with type 2 diabetes taking metformin must be taught to:
A. Stop metformin 2 days after contrast
B. Inform providers before IV contrast and sometimes hold metformin around
contrast administration
C. Increase dose before surgery
D. Take extra doses for fatigue
Explanation: Metformin may be held around contrast studies or major procedures to
reduce lactic acidosis risk.
9. When teaching a patient about sick-day management with diabetes, the nurse
should emphasize:
A. Stopping insulin when not eating
B. Continuing to monitor blood glucose more frequently and following the
sick-day plan
C. Avoiding fluids
D. Doubling oral agents
, Explanation: Illness can increase glucose; monitoring and following a sick-day plan is
essential.
10. For a patient using rapid-acting insulin (lispro), the nurse should instruct them to:
A. Take it 2 hours after meals
B. Take it within about 15 minutes of starting a meal
C. Take it at bedtime only
D. Skip it if fasting
Explanation: Rapid-acting insulin is dosed near meals to cover post-prandial glucose.
11. The best indicator of long-term glycemic control is:
A. Daily weight
B. Hemoglobin A1C
C. Fasting lipid panel
D. Serum sodium
Explanation: A1C reflects average glucose over approximately 2–3 months.
12. A patient on insulin therapy develops lipodystrophy at injection sites. The nurse
should:
A. Increase dose
B. Teach rotation of injection sites within one anatomical area
C. Stop insulin
D. Use the same spot daily
Explanation: Rotating sites reduces risk of lipodystrophy and absorption variability.
13. Diabetic neuropathy is most directly related to:
A. Low insulin doses
B. Chronic hyperglycemia causing nerve damage
with Complete Correct Answers & Rationales
(Diabetes, Acid-Base, Electrolytes, Med
Admin) Latest Update This Year
Section A: Diabetes & Glucose Regulation (1–25)
1. A fasting plasma glucose of 140 mg/dL on two separate occasions is most consistent
with:
A. Normal glucose regulation
B. Prediabetes
C. Diabetes mellitus
D. Hypoglycemia
Explanation: Fasting glucose ≥126 mg/dL on two separate tests is diagnostic for diabetes.
2. Classic symptoms of hyperglycemia include:
A. Weight gain, bradycardia, constipation
B. Polyuria, polydipsia, polyphagia
C. Cold intolerance, hair loss
D. Muscle twitching, tetany
Explanation: Excess glucose causes osmotic diuresis (polyuria), thirst (polydipsia), and
increased hunger (polyphagia).
3. A blood glucose of 48 mg/dL in a conscious patient is best managed first by:
A. Giving IV insulin
B. Providing 15 grams of fast-acting oral carbohydrate and rechecking in 15
, minutes
C. Restricting fluids
D. Administering a diuretic
Explanation: The “15/15” rule is used for mild/moderate hypoglycemia in conscious
patients.
4. Signs of hypoglycemia may include:
A. Dry skin, slow reflexes
B. Shakiness, sweating, confusion, irritability
C. Weight loss over months
D. Polyuria only
Explanation: Sympathetic activation produces tremors and sweating; CNS symptoms
include confusion.
5. A patient with type 1 diabetes forgets to take insulin and presents with Kussmaul
respirations and fruity breath. The nurse suspects:
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Lactic acidosis
Explanation: DKA features hyperglycemia, ketones, acidosis, Kussmaul respirations, and
fruity breath.
6. Priority nursing action in suspected DKA is to:
A. Restrict fluids
B. Begin IV fluids as ordered and monitor vital signs closely
C. Hold all insulin
D. Encourage oral intake only
,Explanation: Fluid resuscitation is an early priority to correct dehydration and support
perfusion.
7. Hyperosmolar hyperglycemic state (HHS) differs from DKA because HHS usually:
A. Occurs only in type 1
B. Has severe ketosis
C. Has very high glucose and dehydration but minimal or no ketones
D. Has low osmolality
Explanation: HHS has extreme hyperglycemia and dehydration with little ketosis; often in
type 2.
8. A patient with type 2 diabetes taking metformin must be taught to:
A. Stop metformin 2 days after contrast
B. Inform providers before IV contrast and sometimes hold metformin around
contrast administration
C. Increase dose before surgery
D. Take extra doses for fatigue
Explanation: Metformin may be held around contrast studies or major procedures to
reduce lactic acidosis risk.
9. When teaching a patient about sick-day management with diabetes, the nurse
should emphasize:
A. Stopping insulin when not eating
B. Continuing to monitor blood glucose more frequently and following the
sick-day plan
C. Avoiding fluids
D. Doubling oral agents
, Explanation: Illness can increase glucose; monitoring and following a sick-day plan is
essential.
10. For a patient using rapid-acting insulin (lispro), the nurse should instruct them to:
A. Take it 2 hours after meals
B. Take it within about 15 minutes of starting a meal
C. Take it at bedtime only
D. Skip it if fasting
Explanation: Rapid-acting insulin is dosed near meals to cover post-prandial glucose.
11. The best indicator of long-term glycemic control is:
A. Daily weight
B. Hemoglobin A1C
C. Fasting lipid panel
D. Serum sodium
Explanation: A1C reflects average glucose over approximately 2–3 months.
12. A patient on insulin therapy develops lipodystrophy at injection sites. The nurse
should:
A. Increase dose
B. Teach rotation of injection sites within one anatomical area
C. Stop insulin
D. Use the same spot daily
Explanation: Rotating sites reduces risk of lipodystrophy and absorption variability.
13. Diabetic neuropathy is most directly related to:
A. Low insulin doses
B. Chronic hyperglycemia causing nerve damage
