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1. A patient with type 1 diabetes mellitus presents with fruity breath, Kussmaul
respirations, and blood glucose of 520 mg/dL. What condition is most likely occurring?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
D. Insulin resistance syndrome
Answer: B
Rationale: The presence of hyperglycemia, ketone-associated fruity breath, and deep
Kussmaul respirations is classic for diabetic ketoacidosis (DKA), a life-threatening
complication of type 1 diabetes caused by absolute insulin deficiency and fat breakdown
producing ketones.
2. Which laboratory value is most indicative of diabetic ketoacidosis (DKA)?
A. Serum bicarbonate of 24 mEq/L
B. Blood pH of 7.38
C. Serum ketones present
D. Potassium of 3.5 mEq/L
Answer: C
Rationale: Elevated serum ketones confirm fat metabolism due to insulin deficiency, a
hallmark of DKA. In DKA, bicarbonate is low and pH is acidic.
3. What is the priority nursing intervention for a patient in DKA?
A. Administer long-acting insulin
,B. Begin IV fluid replacement
C. Provide oral glucose
D. Restrict fluids
Answer: B
Rationale: Fluid resuscitation with isotonic saline is the first priority to restore circulating
volume and improve perfusion before insulin administration.
4. Which sign is most consistent with hypoglycemia?
A. Dry skin and thirst
B. Shallow respirations
C. Diaphoresis and tremors
D. Bradycardia and hypertension
Answer: C
Rationale: Hypoglycemia activates the sympathetic nervous system, causing sweating,
tremors, anxiety, and tachycardia.
5. A patient with hyperthyroidism is most likely to exhibit which symptom?
A. Weight gain
B. Bradycardia
C. Heat intolerance
D. Cold intolerance
Answer: C
Rationale: Excess thyroid hormone increases metabolism, leading to heat intolerance,
weight loss, and tachycardia.
6. What condition is associated with severe hypothyroidism and hypothermia,
bradycardia, and altered mental status?
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
, D. SIADH
Answer: B
Rationale: Myxedema coma is a life-threatening complication of severe hypothyroidism
characterized by decreased metabolism and neurologic decline.
7. Which medication is commonly used to treat hypothyroidism?
A. Methimazole
B. Levothyroxine
C. Propylthiouracil
D. Insulin glargine
Answer: B
Rationale: Levothyroxine is synthetic T4 used to replace deficient thyroid hormone in
hypothyroidism.
8. What is the hallmark symptom of Addison’s disease?
A. Moon face
B. Hyperglycemia
C. Hyperpigmentation
D. Exophthalmos
Answer: C
Rationale: Addison’s disease causes adrenal insufficiency, leading to increased ACTH
and resulting hyperpigmentation.
9. Which electrolyte imbalance is most associated with Addison’s disease?
A. Hypernatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypochloremia
Answer: B