CCRN PRACTICE QUESTIONS – ENDOCRINE
VERIFIED CORRECT ANSWERS 2025 GRADED
A+.
Which of the following is true regarding the difference between diabetic
ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS)? a.
There is less dehydration in HHS than there is in DKA.
b. DKA occurs in type 1 diabetes mellitus (DM), and HHS occurs in type 2
DM.
c. Less insulin usually is needed in HHS than is needed in DKA.
d. Potassium is low in DKA and normal or high in HHS. - correct
answer>>Correct answer: b
Rationale: Patients with HHS have more dehydration and azotemia than
patients with DKA. Although patients with HHS have higher serum glucose
levels, it takes less insulin to normalize their glucose metabolism. Patients
with DKA have elevated potassium levels because they are acidotic. Patients
with HHS are not acidotic, and their potassium levels are not skewed by
acidosis. Therefore they have a normal or low (because of loss in diuresis)
potassium. Patients with type 1 DM develop DKA, but patients with type 2
DM develop HHS.
Test-Taking Strategy: Always be logical. Remember that insulin need is
absolute in type 1 DM and that the hyperglycemia that occurs in DKA is
accompanied by acidosis because gluconeogenesis occurs with liberation
and incomplete breakdown of free fatty acids. The insulin deficiency in type
2 DM is relative. In the hyperglycemia that occurs in HHS, there is enough
insulin to prevent gluconeogenesis and therefore acidosis. Choose option b
as the correct answer.
,Patients with hyperglycemic hyperosmolar state (HHS) are susceptible to
thrombosis and pulmonary embolism because: a. they are dehydrated.
b. they are hyperglycemic.
c. they have vascular changes.
d. they are immobile - correct answer>>Correct answer: a
Rationale: Patients with HHS are extremely dehydrated, which makes them
hypercoagulable.
Test-Taking Strategy: Imagine the diuresis that would be caused by a serum
glucose of 1100 mg/dL (and this is average in HHS; some patients have even
higher serum glucose levels). This causes a tremendous osmotic diuresis and
dehydration. Dehydration causes hypercoagulability and predisposes the
patient to thrombosis and pulmonary embolism. Remember that
hypercoagulability is one component of Virchow's triad. Choose option a.
A newly diagnosed diabetic patient who is on insulin complains of feeling
nervous and afraid that she is going to faint. She is diaphoretic and has a
tremor. Nursing actions might include all of the following except: a.
giving her a glass of juice to drink.
b. administering 50% dextrose in water (D50W) if she cannot drink.
c. administering potassium.
d. checking her serum glucose. - correct answer>>Correct answer: c
Rationale: Although her clinical signs and symptoms indicate that she is
hypoglycemic, a serum glucose level would confirm hypoglycemia. She
should be given 10 to 15 g of carbohydrates. If she is unconscious, she
should be given one ampule of D50W. Potassium should be checked,
especially if you have given her dextrose intravenously, because
potassium moves into the cell with insulin and dextrose. Dextrose should
not be given without knowledge of the potassium level.
Test-Taking Strategy: Because her clinical symptoms indicate that she is
hypoglycemic, any action with glucose in it probably would be appropriate.
This is an except question, so the answer is except option c.
, Hypoglycemia should be suspected when the diabetic patient complains of
or manifests:
a. decreased skin turgor, abdominal pain, and tachypnea.
b. flushed skin, tachycardia, and Kussmaul's breathing.
c. thirst, hypotension, and fruity odor to breath.
d. weakness, headache, and diaphoresis. - correct answer>>Correct answer:
d
Rationale: The easiest way to remember the initial symptoms of
hypoglycemia is to think about the effects on the sympathetic nervous
system. Initially the effects are tachycardia; tachypnea; irritability; cool,
clammy skin; and weakness. Eventually headache also occurs as the glucose
in the brain decreases.
Test-Taking Strategy: Go with what you know. Eliminate option b because
you know that Kussmaul's respirations go with diabetic ketoacidosis.
Eliminate option c because you know that fruity or acetone breath goes with
diabetic ketoacidosis. Eliminate option a because decreased skin turgor is
associated with the dehydration of diabetic ketoacidosis and abdominal pain
is associated with the metabolic acidosis of diabetic ketoacidosis. Weakness,
headache, and diaphoresis are symptoms of hypoglycemia. Choose option d
A patient develops diabetes insipidus after a craniotomy. Which group of
findings would be most characteristic of diabetes insipidus?
a. Oliguria, low serum osmolality, hyponatremia, and high urine specific
gravity
b. Polyuria, high serum osmolality, hypernatremia, and low urine specific
gravity
c. Oliguria, high serum osmolality, hypernatremia, and low urine specific
gravity
d. Polyuria, low serum osmolality, hyponatremia, and high urine specific
gravity - correct answer>>Correct answer: b
VERIFIED CORRECT ANSWERS 2025 GRADED
A+.
Which of the following is true regarding the difference between diabetic
ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS)? a.
There is less dehydration in HHS than there is in DKA.
b. DKA occurs in type 1 diabetes mellitus (DM), and HHS occurs in type 2
DM.
c. Less insulin usually is needed in HHS than is needed in DKA.
d. Potassium is low in DKA and normal or high in HHS. - correct
answer>>Correct answer: b
Rationale: Patients with HHS have more dehydration and azotemia than
patients with DKA. Although patients with HHS have higher serum glucose
levels, it takes less insulin to normalize their glucose metabolism. Patients
with DKA have elevated potassium levels because they are acidotic. Patients
with HHS are not acidotic, and their potassium levels are not skewed by
acidosis. Therefore they have a normal or low (because of loss in diuresis)
potassium. Patients with type 1 DM develop DKA, but patients with type 2
DM develop HHS.
Test-Taking Strategy: Always be logical. Remember that insulin need is
absolute in type 1 DM and that the hyperglycemia that occurs in DKA is
accompanied by acidosis because gluconeogenesis occurs with liberation
and incomplete breakdown of free fatty acids. The insulin deficiency in type
2 DM is relative. In the hyperglycemia that occurs in HHS, there is enough
insulin to prevent gluconeogenesis and therefore acidosis. Choose option b
as the correct answer.
,Patients with hyperglycemic hyperosmolar state (HHS) are susceptible to
thrombosis and pulmonary embolism because: a. they are dehydrated.
b. they are hyperglycemic.
c. they have vascular changes.
d. they are immobile - correct answer>>Correct answer: a
Rationale: Patients with HHS are extremely dehydrated, which makes them
hypercoagulable.
Test-Taking Strategy: Imagine the diuresis that would be caused by a serum
glucose of 1100 mg/dL (and this is average in HHS; some patients have even
higher serum glucose levels). This causes a tremendous osmotic diuresis and
dehydration. Dehydration causes hypercoagulability and predisposes the
patient to thrombosis and pulmonary embolism. Remember that
hypercoagulability is one component of Virchow's triad. Choose option a.
A newly diagnosed diabetic patient who is on insulin complains of feeling
nervous and afraid that she is going to faint. She is diaphoretic and has a
tremor. Nursing actions might include all of the following except: a.
giving her a glass of juice to drink.
b. administering 50% dextrose in water (D50W) if she cannot drink.
c. administering potassium.
d. checking her serum glucose. - correct answer>>Correct answer: c
Rationale: Although her clinical signs and symptoms indicate that she is
hypoglycemic, a serum glucose level would confirm hypoglycemia. She
should be given 10 to 15 g of carbohydrates. If she is unconscious, she
should be given one ampule of D50W. Potassium should be checked,
especially if you have given her dextrose intravenously, because
potassium moves into the cell with insulin and dextrose. Dextrose should
not be given without knowledge of the potassium level.
Test-Taking Strategy: Because her clinical symptoms indicate that she is
hypoglycemic, any action with glucose in it probably would be appropriate.
This is an except question, so the answer is except option c.
, Hypoglycemia should be suspected when the diabetic patient complains of
or manifests:
a. decreased skin turgor, abdominal pain, and tachypnea.
b. flushed skin, tachycardia, and Kussmaul's breathing.
c. thirst, hypotension, and fruity odor to breath.
d. weakness, headache, and diaphoresis. - correct answer>>Correct answer:
d
Rationale: The easiest way to remember the initial symptoms of
hypoglycemia is to think about the effects on the sympathetic nervous
system. Initially the effects are tachycardia; tachypnea; irritability; cool,
clammy skin; and weakness. Eventually headache also occurs as the glucose
in the brain decreases.
Test-Taking Strategy: Go with what you know. Eliminate option b because
you know that Kussmaul's respirations go with diabetic ketoacidosis.
Eliminate option c because you know that fruity or acetone breath goes with
diabetic ketoacidosis. Eliminate option a because decreased skin turgor is
associated with the dehydration of diabetic ketoacidosis and abdominal pain
is associated with the metabolic acidosis of diabetic ketoacidosis. Weakness,
headache, and diaphoresis are symptoms of hypoglycemia. Choose option d
A patient develops diabetes insipidus after a craniotomy. Which group of
findings would be most characteristic of diabetes insipidus?
a. Oliguria, low serum osmolality, hyponatremia, and high urine specific
gravity
b. Polyuria, high serum osmolality, hypernatremia, and low urine specific
gravity
c. Oliguria, high serum osmolality, hypernatremia, and low urine specific
gravity
d. Polyuria, low serum osmolality, hyponatremia, and high urine specific
gravity - correct answer>>Correct answer: b
