NURS 2207 Endocrine Prep Exam Questions With Solved Solutions.
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Course
NURS 2207
Institution
NURS 2207
The nurse adds 20 mEq of potassium chloride to the intravenous solution of a client with diabetic ketoacidosis. Which purpose would this medication serve?
1. Treats hyperpnea
2. Prevents flaccid paralysis
3. Prevents hypokalemia
4. Treats cardiac dysrhythmias - Answer ANS: 3
Rat...
NURS 2207 Endocrine Prep Exam
Questions With Solved Solutions.
The nurse adds 20 mEq of potassium chloride to the intravenous solution of a client with diabetic
ketoacidosis. Which purpose would this medication serve?
1. Treats hyperpnea
2. Prevents flaccid paralysis
3. Prevents hypokalemia
4. Treats cardiac dysrhythmias - Answer ANS: 3
Rationale:
Once treatment with insulin for diabetic ketoacidosis is begun, potassium ions reenter the cell, causing
hypokalemia; therefore potassium, along with replacement fluids, is needed to prevent hypokalemia.
Potassium will not correct hyperpnea. Flaccid paralysis does not occur in diabetic ketoacidosis. There is
no mention of dysrhythmias in the scenario; they are not a universal finding in diabetic ketoacidosis (and
are commonly absent) and hypokalemia does not always cause these to occur.
Which rationale explain why intravenous (IV) potassium is prescribed in addition to regular insulin for
clients in diabetic ketosis?
1. Potassium loss occurs rapidly from diaphoresis present during coma.
2. Potassium is carried with glucose to the kidneys to be excreted in the urine in increased amounts.
3. Potassium is quickly used up during the rapid series of catabolic reactions stimulated by insulin and
glucose.
,4. Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the
intracellular fluid compartment. - Answer ANS: 4
Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the
intracellular fluid compartment.
Rationale:
Insulin stimulates cellular uptake of glucose and stimulates the sodium/potassium pump, leading to the
influx of potassium into cells. The resulting hypokalemia is offset by parenteral administration of
potassium. Potassium is not lost from the body by profuse diaphoresis. Potassium moves from the
extracellular to the intracellular compartment rather than being excreted in the urine. Anabolic reactions
are stimulated by insulin and glucose administration; potassium is drawn into the intracellular
compartment, necessitating a replenishment of extracellular potassium.
Intravenous fluids and insulin are prescribed to treat a client's diabetic ketoacidosis. The client develops
peripheral paresthesias and shortness of breath. The cardiac monitor shows the appearance of a U wave.
Which complication would the nurse suspect?
1. Hypokalemia
2. Hypoglycemia
3. Hypernatremia
4. Hypercalcemia - Answer ANS: 1
Hypokalemia
Rationale:
,These are classic signs of hypokalemia that occur when potassium levels are reduced as potassium
reenters cells with glucose. Symptoms of hypoglycemia are weakness, nervousness, tachycardia,
diaphoresis, irritability, and pallor. Symptoms of hypernatremia are thirst, orthostatic hypotension, dry
mouth and mucous membranes, concentrated urine, tachycardia, irregular heartbeat, irritability, fatigue,
lethargy, labored breathing, and muscle twitching or seizures. Symptoms of hypercalcemia are lethargy,
nausea, vomiting, paresthesias, and personality changes.
Which unique response is associated with diabetic ketoacidosis (DKA) that is not exhibited with
hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?
1. Fluid loss
2. Glycosuria
3. Kussmaul respirations
4. Increased blood glucose level - Answer ANS: 3
Kussmaul respirations
Rationale:
Kussmaul respirations occur in diabetic ketoacidosis (DKA) as the body attempts to correct a low pH
caused by accumulation of ketones (ketoacidosis). HHNS affects people with type 2 diabetes who still
have some insulin production; the insulin prevents the breakdown of fats into ketones. Fluid loss is
common to both because an increased blood glucose level ultimately leads to polyuria. Glycosuria is
common to both conditions. Hyperglycemia is common to both conditions.
A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings
related to this event would the nurse document in the client's clinical record? Select all that apply.
A fruity odor to the breath (acetone breath) occurs when the ketone level is elevated in ketoacidosis.
Metabolic acidosis initiates respiratory compensation in the form of Kussmaul respirations to counteract
the effects of ketone buildup, resulting in a decreased arterial carbon dioxide level. As the glucose level
decreases in hypoglycemia, the sympathetic nervous system is activated, and epinephrine and
norepinephrine are secreted, causing diaphoresis. Retinopathy is a long-term complication of diabetes
caused by microvascular changes in the retina; it is not a sign of ketoacidosis. With ketoacidosis, the
serum bicarbonate level is decreased, not increased, in an effort to neutralize ketones when seeking
acid-base balance.
The nurse is assessing a client admitted with diabetic ketoacidosis. Which statement made by the client
indicates a need for further education on sick day management?
1. "I will stop taking my insulin when I am ill because I am not eating."
2. "I will check my urine for ketones when my blood sugar is over 250."
3. "I will alternate drinking Gatorade and water throughout the day while ill."
4. "I will continue all my insulin including my glargine when I am sick." - Answer ANS: 1
"I will stop taking my insulin when I am ill because I am not eating."
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