NUR445 Critical Care Exam 1 UPDATED ACTUAL Questions and CORRECT
Answers
What should a fasting blood glucose be? 70-100mg/dL
What should a postprandial blood glucose It should not exceed 180mg/dL
be?
Glycated Hemoglobin A1C measures blood It checks the blood glucose for the past 3-4 months (120 days)
glucose for how many months?
What is a normal A1C for a non-diabetic? < 5.4-5.6%
What is a normal A1C for a diabetic? < 6.5%
A calculator of the difference between c. Anion Gap
measurable extracellular plasma cations A calculator of the difference between measurable extracellular plasma cations (Na+
(Na+ & K+) and the measurable anions (Cl- & K+) and the measurable anions (Cl- & HCO3-) is the anion gap
& HCO3-) is called?
a. the Ketotic cycle
b. Hyperosmotic filtration
c. Anion Gap
d. Nephrogenic filtration
What does the anion gap represent? b. represents the unmeasurable ions present in ht extracellular fluid
a. represents the measurable amount of
ions present in the extracellular fluid
b. represents the unmeasurable ions
present in ht extracellular fluid
c. represents the measurable of ions
present in the intracellular fluid
d. represents the unmeasurable of ions
present in the intracellular fluid
What is a normal anion gap range? 8-16 mEq/L
, > 18 is high
What is a High Anion Gap? What does this
It indicates metabolic acidosis. It effects over production or decreased exertion of
represent?
acid products
What is a Low Anion Gap? What does this < 8 is low
represent? It indicates Metabolic Alkalosis
Islets of Langerhans is groups of pancreatic Alpha Cells
cells secreting insulin and glucagon from Beta Cells
the pancreas. What are the names of the Delta Cells
cells? PP Cells
Which organ is involved in Glucose d. pancreas
metabolism? The pancreas is involved in Glucose Metabolism
a. stomach
b. liver
c. intestines
d. pancreas
What do alpha cells excrete? c. glucagon
a. pancreatic polypeptide Glucagon (released when sugar levels are low, released from the liver to raise blood
b. insulin glucose levels). This is done through Gluconeogenesis from non-carbohydrates
c. glucagon (proteins & fat
d. somatostatin
What do beta cells secrete? b. insulin
a. pancreatic polypeptide Insulin (responsible for storage of carbohydrates, protein, fat, helps transport
b. insulin potassium into cells too, helps lower blood glucose).
c. glucagon
d. somatostatin
What do delta cells secrete? d. somatostatin
a. pancreatic polypeptide Somatostatin (decrease glucagon & insulin)
b. insulin
c. glucagon
d. somatostatin
What do PP cells secrete? a. pancreatic polypeptide
a. pancreatic polypeptide
b. insulin
c. glucagon
d. somatostatin
Diabetic Ketacidosis (DKA) is more often c. Type 1 Diabetes
seen in: These patients are insulin dependent - they don't produce insulin
a. Type 2 Diabetes
b. Cushing's Syndrome
c. Type 1 Diabetes
d. Myxedema
What diagnostic criteria is needed to c. hyperglycemia
consider someone having DKA?
a. hypoglycemia
b. extremely high levels of plasma glucose
w/ resulting elevations of serum osmolality
causing osmostic diuresis
c. hyperglycemia
d. extremely low levels of plasma glucose
w/ resulting dip of serum osmolality
causing osmostic retention
, d. DKA
Diabetic Ketoacidosis (DKA): Type I Diabetes (Insulin Dependent-does not produce
The patient presents to the hospital with a
Insulin)
blood glucose level of 400, their pH is 7.1,
Dx Criteria→ Hyperglycemia
HCO3 is 17. They have moderate-severe
BGL: >250mg/dL (alone, is not a definitive diagnosis)
ketonemia & ketonuria. Their plasma
pH: <7.3
osmolality is 300. What is do you suspect is
HCO3: <18mEq/L (severe metabolic acidosis)
wrong with this patient?
Moderate-Severe Ketonemia or Ketonuria
a. HHS
Hyperglycemia plasma osmolality- 275-295 (greater than 295)
b. SIADH
Increased Osmolality: increased hemoconcentration, dehydration "hypertonic"
c. DI
Decreased Osmolality: decreased, hemodilution, volume overload "hypotonic"
d. DKA
Chemistry panel-potassium can be normal or abnormal, low sodium (hyponatremia
from N/V) which can cause Cerebral Edema.
A patient walks into the ER. They have d. DKA
abdominal pain, Kussmaul respirations, an These are classic s/s of DKA
altered LOC, polydipsia, polyphagia,
polyuria, vomiting, thready pulse, acetone
breath, and their pulse is thready and
tachycardic. What do you suspect they
have?
a. HHS
b. SIADH
c. DI
d. DKA
A patient walks into the ER. They have a. reverse dehydration
abdominal pain, Kussmaul respirations, an b. replace electrolytes
altered LOC, polydipsia, polyphagia, c. replace insulin
polyuria, vomiting, thready pulse, acetone The patient has DKA. They have lost 5-10% of fluid body weight. They should be kept
breath, and their pulse is thready and NPO. We want their blood sugar to drop to a level of 50-70 mg/dL/hr.
tachycardic. What is a priority action take
when you realize what is happening? SATA
a. reverse dehydration
b. replace electrolytes
c. replace insulin
d. give insulin
e. give a diuretic
What type of fluids should be given to a c. isotonic 0.9% sodium chloride
patient who has DKA? This is to reverse the dehydration. They may need 6-9L of fluid. Once their blood
a. hypertonic 3% glucose level falls to 200mg/dL - then switch to Dextrose 5% (D5W) with 0.45%
b. hypotonic 0.45 NS Hypotonic NS. Then start to transition the pt to SQ insulin.
c. isotonic 0.9% sodium chloride
d. isotonic D5W
Keytones in the urine indicate what? c. hyperglycemia
a. dehydration Ketones in the urine could indicate hyperglycemia & poorly controlled diabetes.
b. infection Glucose can't be transported into the cells because of lack of insulin. Fats are broken
c. hyperglycemia down and used for energy. Ketones are a by-product of fat breakdown. Ketones leak
d. renal damage into the urine.
Answers
What should a fasting blood glucose be? 70-100mg/dL
What should a postprandial blood glucose It should not exceed 180mg/dL
be?
Glycated Hemoglobin A1C measures blood It checks the blood glucose for the past 3-4 months (120 days)
glucose for how many months?
What is a normal A1C for a non-diabetic? < 5.4-5.6%
What is a normal A1C for a diabetic? < 6.5%
A calculator of the difference between c. Anion Gap
measurable extracellular plasma cations A calculator of the difference between measurable extracellular plasma cations (Na+
(Na+ & K+) and the measurable anions (Cl- & K+) and the measurable anions (Cl- & HCO3-) is the anion gap
& HCO3-) is called?
a. the Ketotic cycle
b. Hyperosmotic filtration
c. Anion Gap
d. Nephrogenic filtration
What does the anion gap represent? b. represents the unmeasurable ions present in ht extracellular fluid
a. represents the measurable amount of
ions present in the extracellular fluid
b. represents the unmeasurable ions
present in ht extracellular fluid
c. represents the measurable of ions
present in the intracellular fluid
d. represents the unmeasurable of ions
present in the intracellular fluid
What is a normal anion gap range? 8-16 mEq/L
, > 18 is high
What is a High Anion Gap? What does this
It indicates metabolic acidosis. It effects over production or decreased exertion of
represent?
acid products
What is a Low Anion Gap? What does this < 8 is low
represent? It indicates Metabolic Alkalosis
Islets of Langerhans is groups of pancreatic Alpha Cells
cells secreting insulin and glucagon from Beta Cells
the pancreas. What are the names of the Delta Cells
cells? PP Cells
Which organ is involved in Glucose d. pancreas
metabolism? The pancreas is involved in Glucose Metabolism
a. stomach
b. liver
c. intestines
d. pancreas
What do alpha cells excrete? c. glucagon
a. pancreatic polypeptide Glucagon (released when sugar levels are low, released from the liver to raise blood
b. insulin glucose levels). This is done through Gluconeogenesis from non-carbohydrates
c. glucagon (proteins & fat
d. somatostatin
What do beta cells secrete? b. insulin
a. pancreatic polypeptide Insulin (responsible for storage of carbohydrates, protein, fat, helps transport
b. insulin potassium into cells too, helps lower blood glucose).
c. glucagon
d. somatostatin
What do delta cells secrete? d. somatostatin
a. pancreatic polypeptide Somatostatin (decrease glucagon & insulin)
b. insulin
c. glucagon
d. somatostatin
What do PP cells secrete? a. pancreatic polypeptide
a. pancreatic polypeptide
b. insulin
c. glucagon
d. somatostatin
Diabetic Ketacidosis (DKA) is more often c. Type 1 Diabetes
seen in: These patients are insulin dependent - they don't produce insulin
a. Type 2 Diabetes
b. Cushing's Syndrome
c. Type 1 Diabetes
d. Myxedema
What diagnostic criteria is needed to c. hyperglycemia
consider someone having DKA?
a. hypoglycemia
b. extremely high levels of plasma glucose
w/ resulting elevations of serum osmolality
causing osmostic diuresis
c. hyperglycemia
d. extremely low levels of plasma glucose
w/ resulting dip of serum osmolality
causing osmostic retention
, d. DKA
Diabetic Ketoacidosis (DKA): Type I Diabetes (Insulin Dependent-does not produce
The patient presents to the hospital with a
Insulin)
blood glucose level of 400, their pH is 7.1,
Dx Criteria→ Hyperglycemia
HCO3 is 17. They have moderate-severe
BGL: >250mg/dL (alone, is not a definitive diagnosis)
ketonemia & ketonuria. Their plasma
pH: <7.3
osmolality is 300. What is do you suspect is
HCO3: <18mEq/L (severe metabolic acidosis)
wrong with this patient?
Moderate-Severe Ketonemia or Ketonuria
a. HHS
Hyperglycemia plasma osmolality- 275-295 (greater than 295)
b. SIADH
Increased Osmolality: increased hemoconcentration, dehydration "hypertonic"
c. DI
Decreased Osmolality: decreased, hemodilution, volume overload "hypotonic"
d. DKA
Chemistry panel-potassium can be normal or abnormal, low sodium (hyponatremia
from N/V) which can cause Cerebral Edema.
A patient walks into the ER. They have d. DKA
abdominal pain, Kussmaul respirations, an These are classic s/s of DKA
altered LOC, polydipsia, polyphagia,
polyuria, vomiting, thready pulse, acetone
breath, and their pulse is thready and
tachycardic. What do you suspect they
have?
a. HHS
b. SIADH
c. DI
d. DKA
A patient walks into the ER. They have a. reverse dehydration
abdominal pain, Kussmaul respirations, an b. replace electrolytes
altered LOC, polydipsia, polyphagia, c. replace insulin
polyuria, vomiting, thready pulse, acetone The patient has DKA. They have lost 5-10% of fluid body weight. They should be kept
breath, and their pulse is thready and NPO. We want their blood sugar to drop to a level of 50-70 mg/dL/hr.
tachycardic. What is a priority action take
when you realize what is happening? SATA
a. reverse dehydration
b. replace electrolytes
c. replace insulin
d. give insulin
e. give a diuretic
What type of fluids should be given to a c. isotonic 0.9% sodium chloride
patient who has DKA? This is to reverse the dehydration. They may need 6-9L of fluid. Once their blood
a. hypertonic 3% glucose level falls to 200mg/dL - then switch to Dextrose 5% (D5W) with 0.45%
b. hypotonic 0.45 NS Hypotonic NS. Then start to transition the pt to SQ insulin.
c. isotonic 0.9% sodium chloride
d. isotonic D5W
Keytones in the urine indicate what? c. hyperglycemia
a. dehydration Ketones in the urine could indicate hyperglycemia & poorly controlled diabetes.
b. infection Glucose can't be transported into the cells because of lack of insulin. Fats are broken
c. hyperglycemia down and used for energy. Ketones are a by-product of fat breakdown. Ketones leak
d. renal damage into the urine.
