‼️Exam- DKA Flashcards
(15 cards)
What is the primary cause of diabetic ketoacidosis (DKA)?
A. Increased insulin levels
B. Decreased carbohydrate intake
C. Insulin deficiency
D. Excess fluid intake
Answer: C. Insulin deficiency
Rationale: DKA occurs due to absolute or relative insulin deficiency, leading to hyperglycemia, ketosis, and acidosis.
Which lab finding is most consistent with DKA?
A. Blood glucose < 100 mg/dL
B. Serum bicarbonate > 24 mEq/L
C. Serum pH 7.35–7.45
D. Positive serum ketones
Answer: D. Positive serum ketones
Rationale: Ketone production from fat metabolism is a hallmark of DKA.
A patient with DKA is at risk for which electrolyte imbalance during treatment?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C. Hypokalemia
Rationale: Insulin drives potassium into cells, lowering serum potassium levels during therapy.
Which clinical manifestation is expected in a patient with DKA?
A. Bradycardia
B. Cool, clammy skin
C. Kussmaul respirations
D. Hypertension
Answer: C. Kussmaul respirations
Rationale: Deep, labored breathing compensates for metabolic acidosis.
Priority nursing intervention for DKA includes:
A. Restrict fluids
B. Administer IV insulin
C. Give oral hypoglycemics
D. Apply cooling blanket
Answer: B. Administer IV insulin
Rationale: IV insulin corrects hyperglycemia and stops ketone production.
Which fluid is typically given first in the treatment of DKA?
A. D5W
B. Normal saline
C. 0.45% NaCl
D. Lactated Ringer’s with dextrose
Answer: B. Normal saline
Rationale: Isotonic saline is used first to restore perfusion.
Which lab value confirms metabolic acidosis in DKA?
A. pH 7.48
B. pCO₂ 60 mmHg
C. HCO₃⁻ 14 mEq/L
D. Sodium 145 mEq/L
Answer: C. HCO₃⁻ 14 mEq/L
Rationale: Low bicarbonate confirms metabolic acidosis.
Which sign indicates improvement in a patient with DKA?
A. Blood glucose 420 mg/dL
B. Ketones still positive in urine
C. pH of 7.34
D. Bicarbonate <10 mEq/L
Answer: C. pH of 7.34
Rationale: Near-normal pH shows resolution of acidosis.
What is a complication of overtreating DKA with insulin?
A. Hypernatremia
B. Hyperglycemia
C. Cerebral edema
D. Hypothermia
Answer: C. Cerebral edema
Rationale: Rapid glucose correction may cause cerebral fluid shifts.
When treating DKA, what is the goal rate for blood glucose reduction?
A. 200 mg/dL/hr
B. 100 mg/dL/hr
C. 25 mg/dL/hr
D. 50-75 mg/dL/hr
Answer: D. 50-75 mg/dL/hr
Rationale: This rate avoids complications like cerebral edema.
Which medication is essential in DKA treatment?
A. Oral metformin
B. IV insulin regular
C. SC insulin glargine
D. IM glucagon
Answer: B. IV insulin regular
Rationale: Only regular insulin is used IV for rapid effect.
What triggers potassium replacement in DKA treatment?
A. Potassium <3.5 mEq/L
B. Normal serum glucose
C. Urine output <30 mL/hr
D. WBC >15,000
Answer: A. Potassium <3.5 mEq/L
Rationale: Hypokalemia must be corrected to avoid cardiac issues.
A nurse monitors which cardiac sign during DKA management?
A. ST elevation
B. Irregular rhythm
C. Normal sinus rhythm
D. Bradycardia
Answer: B. Irregular rhythm
Rationale: Electrolyte shifts, especially potassium, can cause arrhythmias.
Why is dextrose added to IV fluids during DKA treatment?
A. Prevent hyponatremia
B. Maintain ketosis
C. Prevent hypoglycemia
D. Replace potassium
Answer: C. Prevent hypoglycemia
Rationale: Once glucose <250 mg/dL, dextrose is added to avoid hypoglycemia.
What is the cause of fruity breath in DKA?
A. Acetone
B. Ammonia
C. Lactic acid
D. Sulfur
Answer: A. Acetone
Rationale: Acetone, a ketone body, causes fruity odor.
