NSG 123 Exam 4: Diabetes Complications, Pediatrics, Acid-Base, Cancer Care,
Respiratory Disorders | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Medical-Surgical Nursing – Diabetes Mellitus (DKA, HHS, Insulin Types, Metformin, Acarbose,
Glyburide); Pediatric Respiratory (RDS, Bronchiolitis, RSV, Croup, Otitis Media); Pediatric GI
(Dehydration, Rotavirus, Salmonella, E. coli, Enterobius vermicularis); Acid-Base Imbalances (Metabolic
Acidosis/Alkalosis, Respiratory Acidosis/Alkalosis, ABG Interpretation); Cancer Care (Chemotherapy,
Neutropenic Precautions, Brachytherapy, Mucositis, Stomatitis, Cancer Screening); Thyroid Disorders;
Geriatrics
Source: NSG 123 Exam 4 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. A nurse is reviewing the health history of a client who has DM type 2. Which of the following are risk factors for
HHS? (SATA)
A. evidence of recent myocardial infarction
B. BUN 35
C. takes calcium channel blocker
D. age 77 years
E. daily insulin injections
Correct Answer: A, B, C, D (recent MI, BUN 35, calcium channel blocker, age 77 years).
1. HHS risk factors: older age, infection, MI, stroke, CKD, medications (thiazides, CCBs, beta-blockers).
2. HHS presents with extreme hyperglycemia (>600) without ketosis.
2. A nurse is assessing a client who has DKA & ketones in the urine. The nurse should suspect which of the following
findings? (SATA)
A. weight gain
B. fruity odor of breath
C. abdominal pain
D. Kussmaul respirations
E. metabolic acidosis
Correct Answer: B, C, D, E (fruity odor, abdominal pain, Kussmaul respirations, metabolic acidosis).
1. DKA triad: hyperglycemia, ketosis, metabolic acidosis.
2. Kussmaul respirations are deep, rapid breathing compensating for acidosis.
, 3. The nurse is reviewing lab results of a client who has HHS. Which of the following findings should the nurse expect?
A. blood pH 7.2
B. blood osmolarity 350
C. blood K 3.8
D. blood Cr 0.8
Correct Answer: B. blood osmolarity 350.
1. HHS hallmark: serum osmolality >320 mOsm/kg.
2. pH is normal or slightly low (no significant acidosis).
4. A nurse is reviewing the medical record for a client who is to begin therapy for DKA. Which of the following
prescriptions should the nurse expect?
A. administer IV infusion of regular insulin at 0.3 unit/kg/hr
B. administer slow IV infusion of 3% sodium chloride
C. rapidly administer IV infusion of 0.9% sodium chloride
D. add glucose to the IV infusion when blood glucose is 350
Correct Answer: C. rapidly administer IV infusion of 0.9% sodium chloride.
1. Fluid resuscitation is priority in DKA (dehydration).
2. Add dextrose when blood glucose reaches ~250 mg/dL.
5. A nurse is providing discharge teaching to a client who had DKA. Which of the following info should the nurse
include about preventing DKA? (SATA)
A. drink 2 L fluids daily
B. monitor blood glucose every 4 hr when ill
C. administer insulin as prescribed when ill
D. notify provider when blood glucose is 200
E. report ketones in the urine after 24 hr of illness
Correct Answer: A, B, C, E (drink fluids, monitor BG q4hr when ill, take insulin when ill, report
ketones after 24 hr).
1. Never omit insulin during illness (risk of DKA).
2. SICK day management: sugar, insulin, carbs, ketones.
6. A nurse is teaching clients about the use of insulin to treat type 1 DM. For which type of insulin should the nurse tell
the clients to expect a peak effect 1-5 hr after administration?
A. insulin glargine
B. NPH insulin
C. regular insulin
D. insulin lispro
Correct Answer: C. regular insulin.
1. Regular insulin: onset 30-60 min, peak 2-5 hours, duration 5-8 hours.
2. Lispro: onset 10-30 min, peak 30-90 min; Glargine: no peak.
Respiratory Disorders | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Medical-Surgical Nursing – Diabetes Mellitus (DKA, HHS, Insulin Types, Metformin, Acarbose,
Glyburide); Pediatric Respiratory (RDS, Bronchiolitis, RSV, Croup, Otitis Media); Pediatric GI
(Dehydration, Rotavirus, Salmonella, E. coli, Enterobius vermicularis); Acid-Base Imbalances (Metabolic
Acidosis/Alkalosis, Respiratory Acidosis/Alkalosis, ABG Interpretation); Cancer Care (Chemotherapy,
Neutropenic Precautions, Brachytherapy, Mucositis, Stomatitis, Cancer Screening); Thyroid Disorders;
Geriatrics
Source: NSG 123 Exam 4 Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. A nurse is reviewing the health history of a client who has DM type 2. Which of the following are risk factors for
HHS? (SATA)
A. evidence of recent myocardial infarction
B. BUN 35
C. takes calcium channel blocker
D. age 77 years
E. daily insulin injections
Correct Answer: A, B, C, D (recent MI, BUN 35, calcium channel blocker, age 77 years).
1. HHS risk factors: older age, infection, MI, stroke, CKD, medications (thiazides, CCBs, beta-blockers).
2. HHS presents with extreme hyperglycemia (>600) without ketosis.
2. A nurse is assessing a client who has DKA & ketones in the urine. The nurse should suspect which of the following
findings? (SATA)
A. weight gain
B. fruity odor of breath
C. abdominal pain
D. Kussmaul respirations
E. metabolic acidosis
Correct Answer: B, C, D, E (fruity odor, abdominal pain, Kussmaul respirations, metabolic acidosis).
1. DKA triad: hyperglycemia, ketosis, metabolic acidosis.
2. Kussmaul respirations are deep, rapid breathing compensating for acidosis.
, 3. The nurse is reviewing lab results of a client who has HHS. Which of the following findings should the nurse expect?
A. blood pH 7.2
B. blood osmolarity 350
C. blood K 3.8
D. blood Cr 0.8
Correct Answer: B. blood osmolarity 350.
1. HHS hallmark: serum osmolality >320 mOsm/kg.
2. pH is normal or slightly low (no significant acidosis).
4. A nurse is reviewing the medical record for a client who is to begin therapy for DKA. Which of the following
prescriptions should the nurse expect?
A. administer IV infusion of regular insulin at 0.3 unit/kg/hr
B. administer slow IV infusion of 3% sodium chloride
C. rapidly administer IV infusion of 0.9% sodium chloride
D. add glucose to the IV infusion when blood glucose is 350
Correct Answer: C. rapidly administer IV infusion of 0.9% sodium chloride.
1. Fluid resuscitation is priority in DKA (dehydration).
2. Add dextrose when blood glucose reaches ~250 mg/dL.
5. A nurse is providing discharge teaching to a client who had DKA. Which of the following info should the nurse
include about preventing DKA? (SATA)
A. drink 2 L fluids daily
B. monitor blood glucose every 4 hr when ill
C. administer insulin as prescribed when ill
D. notify provider when blood glucose is 200
E. report ketones in the urine after 24 hr of illness
Correct Answer: A, B, C, E (drink fluids, monitor BG q4hr when ill, take insulin when ill, report
ketones after 24 hr).
1. Never omit insulin during illness (risk of DKA).
2. SICK day management: sugar, insulin, carbs, ketones.
6. A nurse is teaching clients about the use of insulin to treat type 1 DM. For which type of insulin should the nurse tell
the clients to expect a peak effect 1-5 hr after administration?
A. insulin glargine
B. NPH insulin
C. regular insulin
D. insulin lispro
Correct Answer: C. regular insulin.
1. Regular insulin: onset 30-60 min, peak 2-5 hours, duration 5-8 hours.
2. Lispro: onset 10-30 min, peak 30-90 min; Glargine: no peak.
