PCCN CERTIFICATION EXAM|VERIFIED QUESTIONS AND CORRECT DETAILED
ANSWERS|RATED AND GRADED A+ NEW UPDATE| 2026/2027
Diabetes Insipidus (Sip) - ANSWER✔ antidiuretic hormone is not secreted adequately, or the kidney is
resistant to its effect
Diabetes insipidus labs - ANSWER✔ 1. hypernatremia
2. elevated BUN/Cr
3. increased serum osmo >295
4. decreased urine osmo < 200
5. decreased urine specific gravity < 1.005
6. Decreased ADH
7. Polydipsia
diabetes insipidus treatment - ANSWER✔ Desmopressin (vasopressin);
hydrochlorothiazide, hypotonic sol.
syndrome of inappropriate (increased) ADH (SIADH) - ANSWER✔ excessive secretion of antidiuretic
hormone producing water retention in the body
SIADH Labs - ANSWER✔ Urine chemistry: Think CONCENTRATED.
● Increased urine sodium
●Increased urine osmolarity
●Increased Urine Specific Gravity > 1.030
● As urine volume decreases, urine osmolarity increases. (decreased UOP)
Blood chemistry: Think DILUTE.
● Decreased serum sodium (dilutional hyponatremia)
● Decreased serum osmolarity (less than 270 mEq/L)
, ● As serum volume increases, serum osmolarity decreases.
- Increased ADH
SIADH Treatment - ANSWER✔ Fluid restriction, IV hypertonic saline, Loop Diuretics, , na correction.
Diabetes Ketoacidosis Pathophysiology - ANSWER✔ - Too much glucose & too little insulin.
- Body compensates w/ osmotic diuresis
- Leads the the 3Ps (Polyuria, polydipsia, polyphagia) & glycourisa, dehydration & electrolyte imbalance.
- Leads to fat burning metabolism - ketone release - kussmaul breathing
diabetes ketoacidosis s/s - ANSWER✔ Neuro: Lethargic, confused, decreased DTR, n/v
Cardio: Tachycardia & Hypotension
Pulmonary: Fruity breath & kussmaul breathing
3Ps (Polyuria, polyphagia, polydipsia
diabetes ketoacidosis labs - ANSWER✔ PH (acidotic - Increased ketones)
Urine Glucose
Blood Glucose 300 - 800
Decrease HCO3
Decrease Na
Elevated K
Increased Anion Gap
Diabetes Ketoacidosis Treatment - ANSWER✔ -Hospitalization
-Correction of fluid (isotonic sol/hypotonic) and electrolyte balances
-Administer insulin
ANSWERS|RATED AND GRADED A+ NEW UPDATE| 2026/2027
Diabetes Insipidus (Sip) - ANSWER✔ antidiuretic hormone is not secreted adequately, or the kidney is
resistant to its effect
Diabetes insipidus labs - ANSWER✔ 1. hypernatremia
2. elevated BUN/Cr
3. increased serum osmo >295
4. decreased urine osmo < 200
5. decreased urine specific gravity < 1.005
6. Decreased ADH
7. Polydipsia
diabetes insipidus treatment - ANSWER✔ Desmopressin (vasopressin);
hydrochlorothiazide, hypotonic sol.
syndrome of inappropriate (increased) ADH (SIADH) - ANSWER✔ excessive secretion of antidiuretic
hormone producing water retention in the body
SIADH Labs - ANSWER✔ Urine chemistry: Think CONCENTRATED.
● Increased urine sodium
●Increased urine osmolarity
●Increased Urine Specific Gravity > 1.030
● As urine volume decreases, urine osmolarity increases. (decreased UOP)
Blood chemistry: Think DILUTE.
● Decreased serum sodium (dilutional hyponatremia)
● Decreased serum osmolarity (less than 270 mEq/L)
, ● As serum volume increases, serum osmolarity decreases.
- Increased ADH
SIADH Treatment - ANSWER✔ Fluid restriction, IV hypertonic saline, Loop Diuretics, , na correction.
Diabetes Ketoacidosis Pathophysiology - ANSWER✔ - Too much glucose & too little insulin.
- Body compensates w/ osmotic diuresis
- Leads the the 3Ps (Polyuria, polydipsia, polyphagia) & glycourisa, dehydration & electrolyte imbalance.
- Leads to fat burning metabolism - ketone release - kussmaul breathing
diabetes ketoacidosis s/s - ANSWER✔ Neuro: Lethargic, confused, decreased DTR, n/v
Cardio: Tachycardia & Hypotension
Pulmonary: Fruity breath & kussmaul breathing
3Ps (Polyuria, polyphagia, polydipsia
diabetes ketoacidosis labs - ANSWER✔ PH (acidotic - Increased ketones)
Urine Glucose
Blood Glucose 300 - 800
Decrease HCO3
Decrease Na
Elevated K
Increased Anion Gap
Diabetes Ketoacidosis Treatment - ANSWER✔ -Hospitalization
-Correction of fluid (isotonic sol/hypotonic) and electrolyte balances
-Administer insulin
