Grade A+ Nclex- Saunders questions Diabetes with rationales 2025
A client is brought to the emergency department in an unrespon-
sive state, and a diagnosis of hyperglycemic hyperosmolar state
(HHS) is made. The nurse would immediately prepare to initiate 3. Intravenous solution of normal saline.
which anticipated health care provider's prescription? Rationale:
1. The primary goal of treatment in hyperglycemic hyperosmolar
Endotracheal intubation state (HHS) is to rehydrate the client to restore fluid volume and
to correct electrolyte deficiency. Intravenous fluid replacement is
2. similar to that administered in diabetic ketoacidosis (DKA) and
100 units of NPH insulin begins with IV infusion of normal saline. Regular insulin, not NPH
insulin, would be administered. The use of sodium bicarbonate
3. to correct acidosis is avoided because it can precipitate a further
Intravenous infusion of normal saline drop in serum potassium levels. Intubation and mechanical venti-
lation are not required to treat HHS.
4.
Intravenous infusion of sodium bicarbonate
An external insulin pump is prescribed for a client with diabetes
mellitus and the client asks the nurse about the functioning of the
pump. The nurse bases the response on which information about
the pump?
1.
Is timed to release programmed doses of short-duration or NPH 4..Gives a small continuous dose of short-duration insulin sub-
insulin into the bloodstream at specific intervals cutaneously, and the client can self-administer a bolus with an
additional dose from the pump before each meal
2.
Continuously infuses small amounts of NPH insulin into the blood- Rationale:
stream while regularly monitoring blood glucose levels An insulin pump provides a small continuous dose of short-du-
ration (rapid or short-acting) insulin subcutaneously throughout
3. the day and night, and the client can self-administer a bolus with
Is surgically attached to the pancreas and infuses regular insulin an additional dose from the pump before each meal as needed.
into the pancreas, which in turn releases the insulin into the Short-duration insulin is used in an insulin pump. An external pump
bloodstream is not attached surgically to the pancreas.
4.
Gives a small continuous dose of short-duration insulin sub-
cutaneously, and the client can self-administer a bolus with an
additional dose from the pump before each meal
A client with a diagnosis of diabetic ketoacidosis (DKA) is being
treated in the emergency department. Which findings would the
nurse expect to note as confirming this diagnosis? Select all that
apply.
1.
Increase in pH 3, 5 & 6
2. Rationale:
Comatose state In DKA, the arterial pH is lower than 7.35, plasma bicarbonate
is lower than 15 mEq/L, the blood glucose level is higher than
3. 250 mg/dL, and ketones are present in the blood and urine. The
Deep, rapid breathing client would be experiencing polyuria, and Kussmaul's respira-
tions (deep and rapid breathing pattern) would be present. A
4. comatose state may occur if DKA is not treated, but coma would
Decreased urine output not confirm the diagnosis.
5.
Elevated blood glucose level
6.
Low plasma bicarbonate level
The nurse teaches a client with diabetes mellitus about differenti-
ating between hypoglycemia and ketoacidosis. The client demon-
strates an understanding of the teaching by stating that a form of
glucose should be taken if which symptoms develop? Select all
,Grade A+ Nclex- Saunders questions Diabetes with rationales 2025
that apply.
1.
Polyuria
2.
Shakiness
2,3 & 5
3.
Rationale:
Palpitations
Shakiness, palpitations, and lightheadedness are signs of hypo-
glycemia and would indicate the need for food or glucose. Polyuria,
4.
blurred vision, and a fruity breath odor are signs of hyperglycemia.
Blurred vision
5.
Lightheadedness
6.
Fruity breath odor
The nurse provides instructions to a client newly diagnosed with
type 1 diabetes mellitus. The nurse recognizes accurate under-
standing of measures to prevent diabetic ketoacidosis when the
client makes which statement?
1. 4
"I will stop taking my insulin if I'm too sick to eat."
During illness, the client should monitor blood glucose levels and
2. should notify the HCP if the level is higher than 250 mg/dL. Insulin
"I will decrease my insulin dose during times of illness." should never be stopped. In fact, insulin may need to be increased
during times of illness. Doses should not be adjusted without the
3. HCP's advice and are usually adjusted on the basis of blood
"I will adjust my insulin dose according to the level of glucose in glucose levels, not urinary glucose readings.
my urine."
4.
"I will notify my health care provider (HCP) if my blood glucose
level is higher than 250 mg/dL."
A client is admitted to a hospital with a diagnosis of diabetic ke-
toacidosis (DKA). The initial blood glucose level was 950 mg/dL. A
continuous intravenous infusion of short-acting insulin is initiated,
along with intravenous rehydration with normal saline. The serum
glucose level is now 240 mg/dL. The nurse would next prepare to
3
administer which item?
During management of DKA, when the blood glucose level falls
1.
to 250 to 300 mg/dL, the infusion rate is reduced and a dextrose
Ampule of 50% dextrose
solution is added to maintain a blood glucose level of about 250
mg/dL, or until the client recovers from ketosis. Fifty percent dex-
2.
trose is used to treat hypoglycemia. NPH insulin is not used to
NPH insulin subcutaneously
treat DKA. Phenytoin (Dilantin) is not a usual treatment measure
for DKA.
3.
Intravenous fluids containing dextrose
4.
Phenytoin (Dilantin) for the prevention of seizures
he nurse is monitoring a client newly diagnosed with diabetes
mellitus for signs of complications. Which sign, if exhibited in the
client, would indicate hyperglycemia? 1
1.
Polyuria
A client is brought to the emergency department in an unrespon-
sive state, and a diagnosis of hyperglycemic hyperosmolar state
(HHS) is made. The nurse would immediately prepare to initiate 3. Intravenous solution of normal saline.
which anticipated health care provider's prescription? Rationale:
1. The primary goal of treatment in hyperglycemic hyperosmolar
Endotracheal intubation state (HHS) is to rehydrate the client to restore fluid volume and
to correct electrolyte deficiency. Intravenous fluid replacement is
2. similar to that administered in diabetic ketoacidosis (DKA) and
100 units of NPH insulin begins with IV infusion of normal saline. Regular insulin, not NPH
insulin, would be administered. The use of sodium bicarbonate
3. to correct acidosis is avoided because it can precipitate a further
Intravenous infusion of normal saline drop in serum potassium levels. Intubation and mechanical venti-
lation are not required to treat HHS.
4.
Intravenous infusion of sodium bicarbonate
An external insulin pump is prescribed for a client with diabetes
mellitus and the client asks the nurse about the functioning of the
pump. The nurse bases the response on which information about
the pump?
1.
Is timed to release programmed doses of short-duration or NPH 4..Gives a small continuous dose of short-duration insulin sub-
insulin into the bloodstream at specific intervals cutaneously, and the client can self-administer a bolus with an
additional dose from the pump before each meal
2.
Continuously infuses small amounts of NPH insulin into the blood- Rationale:
stream while regularly monitoring blood glucose levels An insulin pump provides a small continuous dose of short-du-
ration (rapid or short-acting) insulin subcutaneously throughout
3. the day and night, and the client can self-administer a bolus with
Is surgically attached to the pancreas and infuses regular insulin an additional dose from the pump before each meal as needed.
into the pancreas, which in turn releases the insulin into the Short-duration insulin is used in an insulin pump. An external pump
bloodstream is not attached surgically to the pancreas.
4.
Gives a small continuous dose of short-duration insulin sub-
cutaneously, and the client can self-administer a bolus with an
additional dose from the pump before each meal
A client with a diagnosis of diabetic ketoacidosis (DKA) is being
treated in the emergency department. Which findings would the
nurse expect to note as confirming this diagnosis? Select all that
apply.
1.
Increase in pH 3, 5 & 6
2. Rationale:
Comatose state In DKA, the arterial pH is lower than 7.35, plasma bicarbonate
is lower than 15 mEq/L, the blood glucose level is higher than
3. 250 mg/dL, and ketones are present in the blood and urine. The
Deep, rapid breathing client would be experiencing polyuria, and Kussmaul's respira-
tions (deep and rapid breathing pattern) would be present. A
4. comatose state may occur if DKA is not treated, but coma would
Decreased urine output not confirm the diagnosis.
5.
Elevated blood glucose level
6.
Low plasma bicarbonate level
The nurse teaches a client with diabetes mellitus about differenti-
ating between hypoglycemia and ketoacidosis. The client demon-
strates an understanding of the teaching by stating that a form of
glucose should be taken if which symptoms develop? Select all
,Grade A+ Nclex- Saunders questions Diabetes with rationales 2025
that apply.
1.
Polyuria
2.
Shakiness
2,3 & 5
3.
Rationale:
Palpitations
Shakiness, palpitations, and lightheadedness are signs of hypo-
glycemia and would indicate the need for food or glucose. Polyuria,
4.
blurred vision, and a fruity breath odor are signs of hyperglycemia.
Blurred vision
5.
Lightheadedness
6.
Fruity breath odor
The nurse provides instructions to a client newly diagnosed with
type 1 diabetes mellitus. The nurse recognizes accurate under-
standing of measures to prevent diabetic ketoacidosis when the
client makes which statement?
1. 4
"I will stop taking my insulin if I'm too sick to eat."
During illness, the client should monitor blood glucose levels and
2. should notify the HCP if the level is higher than 250 mg/dL. Insulin
"I will decrease my insulin dose during times of illness." should never be stopped. In fact, insulin may need to be increased
during times of illness. Doses should not be adjusted without the
3. HCP's advice and are usually adjusted on the basis of blood
"I will adjust my insulin dose according to the level of glucose in glucose levels, not urinary glucose readings.
my urine."
4.
"I will notify my health care provider (HCP) if my blood glucose
level is higher than 250 mg/dL."
A client is admitted to a hospital with a diagnosis of diabetic ke-
toacidosis (DKA). The initial blood glucose level was 950 mg/dL. A
continuous intravenous infusion of short-acting insulin is initiated,
along with intravenous rehydration with normal saline. The serum
glucose level is now 240 mg/dL. The nurse would next prepare to
3
administer which item?
During management of DKA, when the blood glucose level falls
1.
to 250 to 300 mg/dL, the infusion rate is reduced and a dextrose
Ampule of 50% dextrose
solution is added to maintain a blood glucose level of about 250
mg/dL, or until the client recovers from ketosis. Fifty percent dex-
2.
trose is used to treat hypoglycemia. NPH insulin is not used to
NPH insulin subcutaneously
treat DKA. Phenytoin (Dilantin) is not a usual treatment measure
for DKA.
3.
Intravenous fluids containing dextrose
4.
Phenytoin (Dilantin) for the prevention of seizures
he nurse is monitoring a client newly diagnosed with diabetes
mellitus for signs of complications. Which sign, if exhibited in the
client, would indicate hyperglycemia? 1
1.
Polyuria
