NURS 320 EXAM 2 – HEALTH AND ILLNESS
CONCEPTS I – (2026) ACTUAL QUESTIONS &
ANSWERS (DREXEL) 100% GUARANTEE PASS
Diabetes Mellitus & Acute Glycaemic Disorders
1. A patient with diabetic ketoacidosis has several laboratory abnormalities. Which finding
requires the nurse to recognize the presence of metabolic acidosis?
A. Arterial pH of 7.24
B. Serum sodium of 140 me/L
C. Pao₂ of 96 mm Hg
D. Haemoglobin of 14 g/dL
Answer: A. Arterial pH of 7.24
Rationale: DKA produces metabolic acidosis because insufficient insulin causes increased
lipolysis and ketone production. An arterial pH below 7.35 indicates acidemia. Sodium,
oxygenation, and haemoglobin values listed do not demonstrate the acid-base disturbance
characteristic of DKA.
2. Which assessment finding is most characteristic of diabetic ketoacidosis?
A. Bradycardia with shallow respirations
B. Fruity breath and deep, rapid respirations
C. Severe hypertension and pulmonary enema
D. Hypoglycaemia with diaphoresis only
Answer: B. Fruity breath and deep, rapid respirations
Rationale: DKA produces ketone accumulation and metabolic acidosis. Acetone creates a
fruity breath Odor, while Kussmaul respirations represent compensatory hyperventilation.
Hypoglycaemia is not characteristic of untreated DKA, and cardiovascular findings vary with
dehydration and severity.
3. A patient with type 1 diabetes has a blood glucose of 48 mg/dL and is awake and able to
swallow. What should the nurse provide first?
A. Regular insulin
B. A high-protein meal
,C. Approximately 15 g of rapid-acting carbohydrate
D. A normal-saline bolus
Answer: C. Approximately 15 g of rapid-acting carbohydrate
Rationale: Conscious patients experiencing symptomatic hypoglycaemia should receive
approximately 15 g of rapidly absorbed carbohydrate, followed by reassessment. Insulin
would worsen hypoglycaemia, protein acts more slowly, and IV fluid alone does not correct
the glucose deficit.
4. Which finding is more consistent with hyperosmolar hyperglycaemic state (HHS) than with
diabetic ketoacidosis?
A. Marked ketonemia
B. Fruity breath Odor
C. Significant metabolic acidosis
D. Profound hyperglycaemia with minimal ketosis
Answer: D. Profound hyperglycaemia with minimal ketosis
Rationale: HHS typically produces extremely elevated glucose and serum osmolality with
profound dehydration but little or no significant ketosis. DKA is more strongly associated
with ketone production and metabolic acidosis, whereas HHS commonly develops in type 2
diabetes.
5. During treatment of DKA, which laboratory value requires especially close monitoring
because insulin therapy can cause it to fall rapidly?
A. Potassium
B. Haemoglobin
C. Calcium
D. Albumin
Answer: A. Potassium
Rationale: Although serum potassium may initially appear normal or elevated during DKA,
total body potassium is depleted. Once insulin is administered, potassium shifts
intracellularly and serum potassium can fall rapidly, creating a potentially dangerous
dysrhythmia risk.
6. A patient receiving insulin becomes shaky, diaphoretic, confused, and tachycardic. Which
complication should the nurse suspect?
,A. Hypernatremia
B. Hypoglycaemia
C. Hypercalcemia
D. Metabolic alkalosis
Answer: B. Hypoglycaemia
Rationale: Adrenergic and neuroglycopenic manifestations of hypoglycaemia include
sweating, tremors, tachycardia, confusion, weakness, and behavioural changes. Prompt
recognition and treatment are important because prolonged severe hypoglycaemia can
result in seizures, coma, or neurologic injury.
7. Which statement demonstrates correct understanding of insulin administration?
A. “I should inject all insulin into the exact same spot.”
B. “I can massage the injection site vigorously afterward.”
C. “I should rotate injection sites within an appropriate anatomical region.”
D. “I should stop insulin whenever my glucose improves.”
Answer: C. “I should rotate injection sites within an appropriate anatomical region.”
Rationale: Rotating insulin injection sites helps prevent lip hypertrophy and unpredictable
absorption. Patients should avoid repeatedly using one exact location and should follow
prescribed insulin schedules even when glucose readings improve unless the clinician
changes therapy.
8. A patient with diabetes has a fasting glucose of 38 mg/dL and is unconscious. Which
intervention is most appropriate?
A. Give oral juice
B. Administer scheduled insulin
C. Encourage ambulation
D. Administer IV dextrose according to emergency protocol
Answer: D. Administer IV dextrose according to emergency protocol
Rationale: An unconscious patient cannot safely swallow because aspiration is possible.
Severe symptomatic hypoglycaemia requires rapid parenteral glucose when IV access is
available; glucagon may be used when IV access is unavailable according to protocol.
9. Which assessment finding would most strongly support diabetic peripheral neuropathy?
, A. Loss of protective sensation in the feet
B. Bounding pedal pulses
C. Increased visual acuity
D. Warm, moist skin
Answer: A. Loss of protective sensation in the feet
Rationale: Peripheral neuropathy can impair sensation, particularly in the distal lower
extremities. Reduced protective sensation increases the risk of unnoticed trauma, burns,
pressure injuries, and infection, making routine foot inspection and appropriate footwear
especially important.
10. A patient with diabetes asks why foot inspection is necessary every day. Which response
is best?
A. “It prevents all diabetic complications.”
B. “Reduced sensation may allow injuries to go unnoticed.”
C. “It eliminates the need for glucose monitoring.”
D. “It guarantees that infection will not occur.”
Answer: B. “Reduced sensation may allow injuries to go unnoticed.”
Rationale: Diabetes can cause peripheral neuropathy and vascular impairment, increasing
the risk of unnoticed injury and delayed healing. Daily inspection allows early identification
of blisters, cuts, redness, drainage, or other changes requiring intervention.
11. Which laboratory result most directly reflects average glycaemic control over
approximately the previous 2–3 months?
A. Random glucose
B. Fasting glucose
C. Haemoglobin A1C
D. Urine ketones
Answer: C. Haemoglobin A1C
Rationale: Haemoglobin A1C reflects the proportion of glycated haemoglobin and provides
an estimate of average blood glucose over roughly the preceding two to three months. It is
useful for evaluating longer-term glycaemic control rather than immediate glucose changes.
12. A patient taking metformin is scheduled for a procedure involving iodinated contrast.
Which action is appropriate?
CONCEPTS I – (2026) ACTUAL QUESTIONS &
ANSWERS (DREXEL) 100% GUARANTEE PASS
Diabetes Mellitus & Acute Glycaemic Disorders
1. A patient with diabetic ketoacidosis has several laboratory abnormalities. Which finding
requires the nurse to recognize the presence of metabolic acidosis?
A. Arterial pH of 7.24
B. Serum sodium of 140 me/L
C. Pao₂ of 96 mm Hg
D. Haemoglobin of 14 g/dL
Answer: A. Arterial pH of 7.24
Rationale: DKA produces metabolic acidosis because insufficient insulin causes increased
lipolysis and ketone production. An arterial pH below 7.35 indicates acidemia. Sodium,
oxygenation, and haemoglobin values listed do not demonstrate the acid-base disturbance
characteristic of DKA.
2. Which assessment finding is most characteristic of diabetic ketoacidosis?
A. Bradycardia with shallow respirations
B. Fruity breath and deep, rapid respirations
C. Severe hypertension and pulmonary enema
D. Hypoglycaemia with diaphoresis only
Answer: B. Fruity breath and deep, rapid respirations
Rationale: DKA produces ketone accumulation and metabolic acidosis. Acetone creates a
fruity breath Odor, while Kussmaul respirations represent compensatory hyperventilation.
Hypoglycaemia is not characteristic of untreated DKA, and cardiovascular findings vary with
dehydration and severity.
3. A patient with type 1 diabetes has a blood glucose of 48 mg/dL and is awake and able to
swallow. What should the nurse provide first?
A. Regular insulin
B. A high-protein meal
,C. Approximately 15 g of rapid-acting carbohydrate
D. A normal-saline bolus
Answer: C. Approximately 15 g of rapid-acting carbohydrate
Rationale: Conscious patients experiencing symptomatic hypoglycaemia should receive
approximately 15 g of rapidly absorbed carbohydrate, followed by reassessment. Insulin
would worsen hypoglycaemia, protein acts more slowly, and IV fluid alone does not correct
the glucose deficit.
4. Which finding is more consistent with hyperosmolar hyperglycaemic state (HHS) than with
diabetic ketoacidosis?
A. Marked ketonemia
B. Fruity breath Odor
C. Significant metabolic acidosis
D. Profound hyperglycaemia with minimal ketosis
Answer: D. Profound hyperglycaemia with minimal ketosis
Rationale: HHS typically produces extremely elevated glucose and serum osmolality with
profound dehydration but little or no significant ketosis. DKA is more strongly associated
with ketone production and metabolic acidosis, whereas HHS commonly develops in type 2
diabetes.
5. During treatment of DKA, which laboratory value requires especially close monitoring
because insulin therapy can cause it to fall rapidly?
A. Potassium
B. Haemoglobin
C. Calcium
D. Albumin
Answer: A. Potassium
Rationale: Although serum potassium may initially appear normal or elevated during DKA,
total body potassium is depleted. Once insulin is administered, potassium shifts
intracellularly and serum potassium can fall rapidly, creating a potentially dangerous
dysrhythmia risk.
6. A patient receiving insulin becomes shaky, diaphoretic, confused, and tachycardic. Which
complication should the nurse suspect?
,A. Hypernatremia
B. Hypoglycaemia
C. Hypercalcemia
D. Metabolic alkalosis
Answer: B. Hypoglycaemia
Rationale: Adrenergic and neuroglycopenic manifestations of hypoglycaemia include
sweating, tremors, tachycardia, confusion, weakness, and behavioural changes. Prompt
recognition and treatment are important because prolonged severe hypoglycaemia can
result in seizures, coma, or neurologic injury.
7. Which statement demonstrates correct understanding of insulin administration?
A. “I should inject all insulin into the exact same spot.”
B. “I can massage the injection site vigorously afterward.”
C. “I should rotate injection sites within an appropriate anatomical region.”
D. “I should stop insulin whenever my glucose improves.”
Answer: C. “I should rotate injection sites within an appropriate anatomical region.”
Rationale: Rotating insulin injection sites helps prevent lip hypertrophy and unpredictable
absorption. Patients should avoid repeatedly using one exact location and should follow
prescribed insulin schedules even when glucose readings improve unless the clinician
changes therapy.
8. A patient with diabetes has a fasting glucose of 38 mg/dL and is unconscious. Which
intervention is most appropriate?
A. Give oral juice
B. Administer scheduled insulin
C. Encourage ambulation
D. Administer IV dextrose according to emergency protocol
Answer: D. Administer IV dextrose according to emergency protocol
Rationale: An unconscious patient cannot safely swallow because aspiration is possible.
Severe symptomatic hypoglycaemia requires rapid parenteral glucose when IV access is
available; glucagon may be used when IV access is unavailable according to protocol.
9. Which assessment finding would most strongly support diabetic peripheral neuropathy?
, A. Loss of protective sensation in the feet
B. Bounding pedal pulses
C. Increased visual acuity
D. Warm, moist skin
Answer: A. Loss of protective sensation in the feet
Rationale: Peripheral neuropathy can impair sensation, particularly in the distal lower
extremities. Reduced protective sensation increases the risk of unnoticed trauma, burns,
pressure injuries, and infection, making routine foot inspection and appropriate footwear
especially important.
10. A patient with diabetes asks why foot inspection is necessary every day. Which response
is best?
A. “It prevents all diabetic complications.”
B. “Reduced sensation may allow injuries to go unnoticed.”
C. “It eliminates the need for glucose monitoring.”
D. “It guarantees that infection will not occur.”
Answer: B. “Reduced sensation may allow injuries to go unnoticed.”
Rationale: Diabetes can cause peripheral neuropathy and vascular impairment, increasing
the risk of unnoticed injury and delayed healing. Daily inspection allows early identification
of blisters, cuts, redness, drainage, or other changes requiring intervention.
11. Which laboratory result most directly reflects average glycaemic control over
approximately the previous 2–3 months?
A. Random glucose
B. Fasting glucose
C. Haemoglobin A1C
D. Urine ketones
Answer: C. Haemoglobin A1C
Rationale: Haemoglobin A1C reflects the proportion of glycated haemoglobin and provides
an estimate of average blood glucose over roughly the preceding two to three months. It is
useful for evaluating longer-term glycaemic control rather than immediate glucose changes.
12. A patient taking metformin is scheduled for a procedure involving iodinated contrast.
Which action is appropriate?
