A nurse is caring for a client who has diabetic ketoacidosis. which of the following laboratory

In patients suspected of having diabetic ketoacidosis, serum electrolytes, blood urea nitrogen (BUN) and creatinine, glucose, ketones, and osmolarity should be measured. Urine should be tested for ketones. Patients who appear significantly ill and those with positive ketones should have arterial blood gas measurement.

Symptoms and signs of a triggering illness should be pursued with appropriate studies (eg, cultures, imaging studies). Adults should have an ECG to screen for acute myocardial infarction and to help determine the significance of abnormalities in serum potassium.

Other laboratory abnormalities include hyponatremia, elevated serum creatinine, and elevated plasma osmolality. Hyperglycemia may cause dilutional hyponatremia, so measured serum sodium is corrected by adding 1.6 mEq/L (1.6 mmol/L) for each 100 mg/dL (5.6 mmol/L) elevation of serum glucose over 100 mg/dL (5.6 mmol/L). To illustrate, for a patient with serum sodium of 124 mEq/L (124 mmol/L) and glucose of 600 mg/dL (33.3 mmol/L), add 1.6 ([600 −100]/100) = 8 mEq/L (8 mmol/L) to 124 for a corrected serum sodium of 132 mEq/L (132 mmol/L). As acidosis is corrected, serum potassium drops. An initial potassium level < 4.5 mEq/L (< 4.5 mmol/L) indicates marked potassium depletion and requires immediate potassium supplementation.

This quiz on DKA (Diabetic Ketoacidosis NCLEX Questions) will test you on how to care for the diabetic patient who is experiencing this condition. As the nurse, you must know typical signs and symptoms of DKA, patient teaching, and expected medical treatments.

Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) are both complication of diabetes mellitus, but there are differences between the two complications that you must know as a nurse.

This endocrine teaching series will test your knowledge on how to differentiate between the two conditions, along with a video lecture.

This DKA quiz will test you on the following for the NCLEX exam:

Signs and Symptoms of Diabetic Ketoacidosis
Causes of Diabetic Ketoacidosis
Patient education for DKA
Treatments of Diabetic Ketoacidosis
DKA vs HHNS

NCLEX Review Nursing Lecture on DKA

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1. Which of the following is not a sign or symptom of Diabetic Ketoacidosis?

A. Positive Ketones in the urine

B. Oliguria

C. Polydipsia

D. Abdominal Pain

2. A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient’s labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next?

A. Start the IV fluids and administer the insulin bolus and drip as ordered

B. Hold the insulin and notify the doctor of the potassium level of 2.5

C. Hold IV fluids and administer insulin as ordered

D. Recheck the glucose level

3. Which patient is MOST likely to develop Diabetic Ketoacidosis?

A. A 25 year old female newly diagnosed with Cushing’s Disease taking glucocorticoids.

B. A 36 year old male with diabetes mellitus who has been unable to eat the past 2 days due to a gastrointestinal illness and has not been taking insulin.

C. A 35 year old female newly diagnosed with Type 2 diabetes.

D. None of the options are correct.

4. Which of the following statements are INCORRECT about Diabetic Ketoacidoisis?

A. Extreme Hyperglycemia that presents with blood glucose >600 mg/dL

B. Ketones are present in the urine.

C. Metabolic acidosis is present with Kussmaul breathing.

D. Potassium levels should be at least 3.3 or higher during treatment of DKA with insulin therapy.

5. True or False: When priming the tubing for an Insulin infusion it is best practice to waste 50cc to 100cc of insulin prior to starting the infusion because insulin absorbs into the plastic lining of the tubing.

6. You are providing care to a patient experiencing diabetic ketoacidosis. The patient is on an insulin drip and their current glucose level is 300. In addition to this, the patient also has 5% Dextroxe 0.45% NS infusing in the right antecubital vein. Which of the following patient signs/symptoms causes concern?

A. Patient has a potassium level of 2.3

B. Patient complains of thirst.

c. Patient is nauseous.

D. Patient’s skin and mucous membranes are dry.

7. What type of insulin do you expect the doctor to order for treatment of DKA?

A. IV NPH

B. IV Novolog

C. IV Levemir

D. IV Regular Insulin

8. A patient diagnosed with diabetes mellitus is being discharged home and you are teaching them about preventing DKA. What statement by the patient demonstrates they understood your teaching about this condition?

A. “I will hold off taking my insulin while I’m sick.”

B. “It is normal for my blood sugar to be 250-350 mg/dL while I’m sick.”

C. “It is important I check my blood glucose every 3-4 hours when I’m sick and consume liquids.”

D. “I should not be alarmed if ketones are present in my urine because this is expected during illness.”

Answer Key:

1. B 2. B 3. B 4. A 5. True 6. A 7. D 8. C

More NCLEX Endocrine Quizzes

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ATI AA nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the followinglaboratory findings should the nurse expect?Negative urine ketones – INCORRECToA client who has DKA experiences ketosis, which results in ketones in the urineand blood.BUN 32 mg/dL – CORRECToDKA results in osmotic diuresis and subsequent dehydration. The nurse shouldexpect a client who has DKA to have elevated BUN, creatinine, and specificgravity levels resulting from the excess glucose present in the urine.pH 7.43 – INCORRECToThe nurse should expect a client who has DKA to have a pH level less than 7.35due to the increased production of ketones, which results in metabolic acidosis.The client might exhibit Kussmaul respirations, which are deep and rapidrespirations that compensate for the decreased pH. Sodium bicarbonate isadministered for severe acidosis when the client's pH level is less than 7.OHCO3 23 mEq/L – INCORRECToThe nurse should expect a client who has DKA to have an HCO3 less than 15mEq/L. This decreased value is due to an increased production of ketones,resulting in metabolic acidosis.