NURSl 5463/l NURS5463l Examl 2l (Newl
2026/l 2027l Update)l Adultl Gerontologyl
Acutel Carel Guide|l Questionsl &l Answersl
|l Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l UTA
QUESTION
Hyperglycemial froml Inflammation
Answer:
Elevationl in:
pro-inflammationl cytokines,l tumorl necrosisl factor-alpha,l interleukinl 1B,l 6,l 8,l lipidl
peroxidationl markers,l plasminogenl activatorl inhibitorsl 1l andl C-reactivel protein
QUESTION
Totall Dailyl Dosel (TDD)l ofl SubQl Insulin
Answer:
*0.4l tol 0.6l U/Kg/day*
-l Usel lowerl parameterl forl ptsl whol arel *not*l onl insulinl priorl tol admission
-l Usel higherl parameterl forl ptsl whol arel onl insulinl priorl tol admission,l obese,l orl onl
corticosteroids
QUESTION
TDDl ofl SubQl Insulinl forl Elderly/Renall Failure
Answer:
Canl startl asl lowl asl 0.3l U/Kg/day
,QUESTION
DKA
Answer:
Hallmark:l Anionl gapl metabolicl acidosis,l hyperglycemia,l elevatedl ketonesl inl urinel andl
blood
-l Beta-hydroxybutyratel (BHB)l isl bestl diagnosticl forl ketones
QUESTION
HHS
Answer:
Hallmark:l Littlel orl nol ketoacidl accumulation,l seruml BSl frequentlyl >l 1000l mg/dL,l
seruml osmolalityl >l 320l butl mayl reachl 380l osmol/kg,l neurologicl abnormalitiesl arel
frequentlyl presentl (comal inl 25l tol 50l percentl ofl cases)
Nol ketonel inl UA,l Elevatedl BUN/CRl froml volumel depletion
QUESTION
DKAl vs.l HHS
Answer:
DKA:
-l Anionl Gapl Metabolicl acidosis
-l Seruml Osmol isl lower
-l Mentall statusl changes
-l Abdominall painl canl bel present
-l Waterl deficitl @l 6l litersl
HHN:
-l Bloodl sugarsl >l 600l orl higher
-l Acidosisl isl notl present
-l Presentl withl Stuporl orl coma
,-l Seruml Osmolel isl >l 320l mOsm/kg
-l Waterl deficitl @l 9l liters
QUESTION
Freel Waterl Deficit
Answer:
*FWl deficit=l 0.6l xl Weightl inl KGl Xl ((currentl NA/140)l -1)*
%l totall bodyl waterl variablel tol consider:l 0.6l men,l 0.5l women/elderlyl men,l 0.45l elderlyl
woman
QUESTION
Correctedl Seruml Sodium
Answer:
*Correctedl NAl =l Seruml NAl +l [(Glucosel -100)/100]l xl 1.6*
Usel tol determinel fluidl resuscitation
-l Ifl Correctedl Sodiuml isl aroundl normall rangel >l 135l mEq/Ll usel ½l NS
-l Ifl Correctedl Sodiuml isl lessl thanl <135l (morel likel 129l )l thenl usel NSl (0.9%)
QUESTION
Adrenall Insufficiency:l Signsl andl Symptoms
Answer:
Hyperpigmentation,l vitiligo,l weakness,l fatigue,l poorl appetite,l weightl loss,l nausea,l
vomiting,l diarrhea,l myalgiasl asl resultl ofl hyperkalemia,l cravingl salt,l hypoglycemia
QUESTION
Adrenall Insufficiency:l Diagnosing
Answer:
ACTHl Stimulationl testl (cosyntropin)
, CMP
-l Hyponatremia
-l Hyperkalemia
-l Mildl non-gapl acidosis
-l Hypoglycemia
CBC
-l Lymphocytosis
-l Eosinophilia
TSH
-l Mayl bel increased
QUESTION
Adrenall Insufficiency:l Treatment
Answer:
Crisis:
Fluidl resuscitationl withl NSl orl D5NS
Stressl dosel steroidsl (hydrocortisone,l dexamethasone)
Determinel cause
Vasopressorsl ifl necessary
Insufficiency:l
Stressl dosel steroidsl (hydrocortisone,l prednisone)
QUESTION
Cushingl Diseasel vsl Cushingl Syndrome
Answer:
QUESTION
Cushingl Disorder:l Signsl &l Symptoms
Answer:
-l Moonl face,l buffalol hump,l centrall obesity
2026/l 2027l Update)l Adultl Gerontologyl
Acutel Carel Guide|l Questionsl &l Answersl
|l Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l UTA
QUESTION
Hyperglycemial froml Inflammation
Answer:
Elevationl in:
pro-inflammationl cytokines,l tumorl necrosisl factor-alpha,l interleukinl 1B,l 6,l 8,l lipidl
peroxidationl markers,l plasminogenl activatorl inhibitorsl 1l andl C-reactivel protein
QUESTION
Totall Dailyl Dosel (TDD)l ofl SubQl Insulin
Answer:
*0.4l tol 0.6l U/Kg/day*
-l Usel lowerl parameterl forl ptsl whol arel *not*l onl insulinl priorl tol admission
-l Usel higherl parameterl forl ptsl whol arel onl insulinl priorl tol admission,l obese,l orl onl
corticosteroids
QUESTION
TDDl ofl SubQl Insulinl forl Elderly/Renall Failure
Answer:
Canl startl asl lowl asl 0.3l U/Kg/day
,QUESTION
DKA
Answer:
Hallmark:l Anionl gapl metabolicl acidosis,l hyperglycemia,l elevatedl ketonesl inl urinel andl
blood
-l Beta-hydroxybutyratel (BHB)l isl bestl diagnosticl forl ketones
QUESTION
HHS
Answer:
Hallmark:l Littlel orl nol ketoacidl accumulation,l seruml BSl frequentlyl >l 1000l mg/dL,l
seruml osmolalityl >l 320l butl mayl reachl 380l osmol/kg,l neurologicl abnormalitiesl arel
frequentlyl presentl (comal inl 25l tol 50l percentl ofl cases)
Nol ketonel inl UA,l Elevatedl BUN/CRl froml volumel depletion
QUESTION
DKAl vs.l HHS
Answer:
DKA:
-l Anionl Gapl Metabolicl acidosis
-l Seruml Osmol isl lower
-l Mentall statusl changes
-l Abdominall painl canl bel present
-l Waterl deficitl @l 6l litersl
HHN:
-l Bloodl sugarsl >l 600l orl higher
-l Acidosisl isl notl present
-l Presentl withl Stuporl orl coma
,-l Seruml Osmolel isl >l 320l mOsm/kg
-l Waterl deficitl @l 9l liters
QUESTION
Freel Waterl Deficit
Answer:
*FWl deficit=l 0.6l xl Weightl inl KGl Xl ((currentl NA/140)l -1)*
%l totall bodyl waterl variablel tol consider:l 0.6l men,l 0.5l women/elderlyl men,l 0.45l elderlyl
woman
QUESTION
Correctedl Seruml Sodium
Answer:
*Correctedl NAl =l Seruml NAl +l [(Glucosel -100)/100]l xl 1.6*
Usel tol determinel fluidl resuscitation
-l Ifl Correctedl Sodiuml isl aroundl normall rangel >l 135l mEq/Ll usel ½l NS
-l Ifl Correctedl Sodiuml isl lessl thanl <135l (morel likel 129l )l thenl usel NSl (0.9%)
QUESTION
Adrenall Insufficiency:l Signsl andl Symptoms
Answer:
Hyperpigmentation,l vitiligo,l weakness,l fatigue,l poorl appetite,l weightl loss,l nausea,l
vomiting,l diarrhea,l myalgiasl asl resultl ofl hyperkalemia,l cravingl salt,l hypoglycemia
QUESTION
Adrenall Insufficiency:l Diagnosing
Answer:
ACTHl Stimulationl testl (cosyntropin)
, CMP
-l Hyponatremia
-l Hyperkalemia
-l Mildl non-gapl acidosis
-l Hypoglycemia
CBC
-l Lymphocytosis
-l Eosinophilia
TSH
-l Mayl bel increased
QUESTION
Adrenall Insufficiency:l Treatment
Answer:
Crisis:
Fluidl resuscitationl withl NSl orl D5NS
Stressl dosel steroidsl (hydrocortisone,l dexamethasone)
Determinel cause
Vasopressorsl ifl necessary
Insufficiency:l
Stressl dosel steroidsl (hydrocortisone,l prednisone)
QUESTION
Cushingl Diseasel vsl Cushingl Syndrome
Answer:
QUESTION
Cushingl Disorder:l Signsl &l Symptoms
Answer:
-l Moonl face,l buffalol hump,l centrall obesity