Diabetes [DKA/HHS Final Exam Questions]
with Correct Answers 2026-2027
1. A patient with diabetes in the critical care unit is at risk for developing diabetic ketoacidosis
(DKA) secondary to
A. excess insulin administration.
B. inadequate food intake.
C. physiologic and psychologic stress.
D. increased release of antidiuretic hormone (ADH). - CORRECT ANSWER -
ANS C physiologic and psychologic stress.
Major neurologic and endocrine changes occur when an individual is confronted with physiolo
gic stress caused by any critical illness, sepsis, trauma, major surgery, or underlying cardiovasc
ular disease.
2. The hallmarkNof hyperglycemic hyperosmolar syndrome (HHS) is
A. hyperglycemia with low serum osmolality.
B. severe hyperglycemia with minimal or absent ketosis.
C. little or no ketosis in serum with rapidly escalating ketonuria.
D. hyperglycemia and ketosis. - CORRECT ANSWER -
ANS B severe hyperglycemia with minimal or absent ketosis.
The hallmarks of HHS are extremely high levels of plasma glucose with resulting elevations in s
erum hyperosmolality and osmotic diuresis. The disorder occurs mainly in patients with type II
diabetes.
3. The primary intervention for hyperglycemic hyperosmolar syndrome (HHS) is
A. rapid rehydration.
,B. monitoring vital signs.
C. high-dose intravenous (IV) insulin.
D. hourly urine sugar and acetone testing. - CORRECT ANSWER -ANS A rapid rehydration.
The goals of medical management are rapid rehydration, insulin replacement, and correction o
f electrolyte abnormalities, specifically potassium replacement. The underlying stimulus of HHS
must be discovered and treated. The same basic principles used to treat patients with diabetic
ketoacidosis are used for patients with HHS.
4. Characteristics of diabetes insipidus (DI) are
A. hyperglycemia and hyperosmolarity.
B. hyperglycemia and peripheral edema.
C. intense thirst and passage of excessively large quantities of dilute urine.
D. peripheral edema and pulmonary crackles. - CORRECT ANSWER -
ANS C intense thirst and passage of excessively large quantities of dilute urine.
The clinical diagnosis is made by the dramatic increase in dilute urine output in the absence of
diuretics, a fluid challenge, or hyperglycemia. Characteristics of DI are intense thirst and the p
assage of excessively large quantities of very dilute urine.
5. Patients with central DI are treated with
A. vasopressin.
B. insulin.
C. glucagon.
D. propylthiouracil. - CORRECT ANSWER -ANS A vasopressin.
Patients with central DI who are unable to synthesize antidiuretic hormone (ADH) require repla
cement ADH (vasopressin) or an ADH analog. The most commonly prescribed drug is the synth
, etic analog of ADH,desmopressin (DDAVP). DDAVP can be given intravenously, subcutaneously,
or as a nasal spray. A typical DDAVP dose is 1 to 2 mcg intravenously or subcutaneously every
12 hours.
6. In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiologic effect is
A. massive diuresis, leading to hemoconcentration.
B. dilutional hyponatremia, reducing sodium concentration to critically low levels.
C. hypokalemia from massive diuresis.
D. serum osmolality greater than 350 mOsm/kg. - CORRECT ANSWER -
ANS B dilutional hyponatremia, reducing sodium concentration to critically low levels.
Patients with SIADH have an excess of antidiuretic hormone secreted into the bloodstream, m
ore than the amount needed to maintain normal blood volume and serum osmolality. Excessiv
e water is resorbed at the kidney tubule, leading to dilutional hyponatremia.
7. Which of the following nursing interventions should be initiated on all patients with SIADH?
A. Placing the patient on an air mattress
B. Forcing fluids
C. Initiating seizure precautions
D. Applying soft restraints - CORRECT ANSWER -ANS C Initiating seizure precautions
The patient with SIADH has an excess of ADH secreted into the bloodstream, more than the a
mount needed to maintain normal blood volume and serum osmolality. Excessive water is reso
rbed at the kidney tubule, leading to dilutional hyponatremia. Symptoms of severe hyponatre
mia include an inability to concentrate, mental confusion, apprehension, seizures, a decreased
level of consciousness, coma, and death.
8. A patient has a 10-
year history of diabetes mellitus. The patient is admitted to the critical care unit with complain
with Correct Answers 2026-2027
1. A patient with diabetes in the critical care unit is at risk for developing diabetic ketoacidosis
(DKA) secondary to
A. excess insulin administration.
B. inadequate food intake.
C. physiologic and psychologic stress.
D. increased release of antidiuretic hormone (ADH). - CORRECT ANSWER -
ANS C physiologic and psychologic stress.
Major neurologic and endocrine changes occur when an individual is confronted with physiolo
gic stress caused by any critical illness, sepsis, trauma, major surgery, or underlying cardiovasc
ular disease.
2. The hallmarkNof hyperglycemic hyperosmolar syndrome (HHS) is
A. hyperglycemia with low serum osmolality.
B. severe hyperglycemia with minimal or absent ketosis.
C. little or no ketosis in serum with rapidly escalating ketonuria.
D. hyperglycemia and ketosis. - CORRECT ANSWER -
ANS B severe hyperglycemia with minimal or absent ketosis.
The hallmarks of HHS are extremely high levels of plasma glucose with resulting elevations in s
erum hyperosmolality and osmotic diuresis. The disorder occurs mainly in patients with type II
diabetes.
3. The primary intervention for hyperglycemic hyperosmolar syndrome (HHS) is
A. rapid rehydration.
,B. monitoring vital signs.
C. high-dose intravenous (IV) insulin.
D. hourly urine sugar and acetone testing. - CORRECT ANSWER -ANS A rapid rehydration.
The goals of medical management are rapid rehydration, insulin replacement, and correction o
f electrolyte abnormalities, specifically potassium replacement. The underlying stimulus of HHS
must be discovered and treated. The same basic principles used to treat patients with diabetic
ketoacidosis are used for patients with HHS.
4. Characteristics of diabetes insipidus (DI) are
A. hyperglycemia and hyperosmolarity.
B. hyperglycemia and peripheral edema.
C. intense thirst and passage of excessively large quantities of dilute urine.
D. peripheral edema and pulmonary crackles. - CORRECT ANSWER -
ANS C intense thirst and passage of excessively large quantities of dilute urine.
The clinical diagnosis is made by the dramatic increase in dilute urine output in the absence of
diuretics, a fluid challenge, or hyperglycemia. Characteristics of DI are intense thirst and the p
assage of excessively large quantities of very dilute urine.
5. Patients with central DI are treated with
A. vasopressin.
B. insulin.
C. glucagon.
D. propylthiouracil. - CORRECT ANSWER -ANS A vasopressin.
Patients with central DI who are unable to synthesize antidiuretic hormone (ADH) require repla
cement ADH (vasopressin) or an ADH analog. The most commonly prescribed drug is the synth
, etic analog of ADH,desmopressin (DDAVP). DDAVP can be given intravenously, subcutaneously,
or as a nasal spray. A typical DDAVP dose is 1 to 2 mcg intravenously or subcutaneously every
12 hours.
6. In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiologic effect is
A. massive diuresis, leading to hemoconcentration.
B. dilutional hyponatremia, reducing sodium concentration to critically low levels.
C. hypokalemia from massive diuresis.
D. serum osmolality greater than 350 mOsm/kg. - CORRECT ANSWER -
ANS B dilutional hyponatremia, reducing sodium concentration to critically low levels.
Patients with SIADH have an excess of antidiuretic hormone secreted into the bloodstream, m
ore than the amount needed to maintain normal blood volume and serum osmolality. Excessiv
e water is resorbed at the kidney tubule, leading to dilutional hyponatremia.
7. Which of the following nursing interventions should be initiated on all patients with SIADH?
A. Placing the patient on an air mattress
B. Forcing fluids
C. Initiating seizure precautions
D. Applying soft restraints - CORRECT ANSWER -ANS C Initiating seizure precautions
The patient with SIADH has an excess of ADH secreted into the bloodstream, more than the a
mount needed to maintain normal blood volume and serum osmolality. Excessive water is reso
rbed at the kidney tubule, leading to dilutional hyponatremia. Symptoms of severe hyponatre
mia include an inability to concentrate, mental confusion, apprehension, seizures, a decreased
level of consciousness, coma, and death.
8. A patient has a 10-
year history of diabetes mellitus. The patient is admitted to the critical care unit with complain
