‼️FINAL DKA‼️ Flashcards
(30 cards)
Which of the following is a hallmark sign of diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Hypertension
C. Kussmaul respirations
D. Constipation
Answer: C. Kussmaul respirations
Rationale: Kussmaul respirations are rapid, deep breaths that help compensate for metabolic acidosis in DKA.
What is the primary cause of DKA?
A. Excess carbohydrate intake
B. Insulin deficiency
C. Renal failure
D. Excessive exercise
Answer: B. Insulin deficiency
Rationale: A profound lack of insulin leads to fat breakdown and ketone production, resulting in acidosis.
Which lab finding supports the diagnosis of DKA?
A. Blood glucose < 70 mg/dL
B. Serum bicarbonate > 26 mEq/L
C. pH < 7.30
D. Positive troponin
Answer: C. pH < 7.30
Rationale: A pH below 7.30 indicates metabolic acidosis, which is typical in DKA.
Which electrolyte is most critical to monitor during initial DKA treatment?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Insulin drives potassium into cells, risking hypokalemia; K+ must be replaced if low.
What causes fruity breath odor in DKA patients?
A. Dehydration
B. Lactic acid
C. Acetone
D. Alcohol ingestion
Answer: C. Acetone
Rationale: Acetone, a ketone body, gives the breath a sweet, fruity smell in DKA.
Which intervention is priority in the treatment of DKA?
A. Administering IV antibiotics
B. Giving IV insulin
C. Providing a high-protein meal
D. Administering oral fluids
Answer: B. Giving IV insulin
Rationale: IV insulin reduces blood glucose and halts ketone production.
What initial fluid is typically given to a patient with DKA?
A. D5W
B. 0.45% NaCl
C. Lactated Ringer’s
D. 0.9% NaCl
Answer: D. 0.9% NaCl
Rationale: Isotonic saline (0.9% NaCl) is used first to restore perfusion and correct dehydration.
What symptom is most associated with early DKA?
A. Bradycardia
B. Lethargy and weakness
C. Chest pain
D. Tremors
Answer: B. Lethargy and weakness
Rationale: Weakness and fatigue often appear early due to dehydration and acidosis.
Which ABG result is expected in a patient with DKA?
A. pH 7.45, PaCO2 35, HCO3 24
B. pH 7.28, PaCO2 28, HCO3 14
C. pH 7.50, PaCO2 48, HCO3 32
D. pH 7.38, PaCO2 40, HCO3 26
Answer: B. pH 7.28, PaCO2 28, HCO3 14
Rationale: Metabolic acidosis results in low pH, low HCO3, and respiratory compensation (low PaCO2).
What is the purpose of adding dextrose to IV fluids when glucose approaches 250 mg/dL?
A. To promote insulin resistance
B. To prevent rebound hyperglycemia
C. To prevent hypoglycemia and cerebral edema
D. To enhance potassium excretion
Answer: C. To prevent hypoglycemia and cerebral edema
Rationale: Adding dextrose helps prevent a rapid drop in glucose, which could cause cerebral edema.
Which symptom is a result of osmotic diuresis in DKA?
A. Weight gain
B. Bradycardia
C. Polyuria
D. Hyperreflexia
Answer: C. Polyuria
Rationale: Hyperglycemia causes osmotic diuresis, leading to excessive urination.
What clinical sign suggests worsening dehydration in DKA?
A. Moist mucous membranes
B. Soft, sunken eyes
C. Bounding pulses
D. Increased skin turgor
Answer: B. Soft, sunken eyes
Rationale: As dehydration progresses, eyes may appear sunken and skin dry/loose.
What is the best nursing diagnosis for a patient with DKA?
A. Risk for infection
B. Risk for fluid volume deficit
C. Impaired gas exchange
D. Risk for falls
Answer: B. Risk for fluid volume deficit
Rationale: Due to osmotic diuresis and vomiting, fluid loss is the major concern.
Which ABG result supports that metabolic acidosis is improving?
A. pH 7.25
B. HCO3 12
C. pH 7.35
D. pH 6.98
Answer: C. pH 7.35
Rationale: Normal pH range (7.35–7.45) suggests resolution of metabolic acidosis.
Why should insulin therapy be delayed until potassium is known?
A. Insulin lowers sodium levels
B. Insulin increases urine output
C. Insulin lowers potassium rapidly
D. Insulin stops ketone formation
Answer: C. Insulin lowers potassium rapidly
Rationale: Insulin drives potassium into cells, risking hypokalemia if levels are already low.
Which of the following findings requires immediate intervention in a patient being treated for DKA?
A. Blood glucose of 260 mg/dL
B. Potassium of 2.8 mEq/L
C. Urine output of 50 mL/hour
D. Mild abdominal cramps
Answer: B. Potassium of 2.8 mEq/L
Rationale: Hypokalemia can be life-threatening and must be corrected before insulin is started.
Which treatment helps reverse acidosis in DKA?
A. IV dextrose
B. IV insulin
C. IV potassium
D. IV calcium
Answer: B. IV insulin
Rationale: Insulin stops fat breakdown and ketone production, resolving metabolic acidosis.
What symptom is a sign of cerebral edema during DKA treatment?
A. Polyuria
B. Slurred speech
C. Diarrhea
D. Kussmaul respirations
Answer: B. Slurred speech
Rationale: Slurred speech and mental status changes may indicate cerebral edema from rapid fluid shifts.
What is the most appropriate evaluation outcome after DKA treatment?
A. Blood glucose remains at 500 mg/dL
B. ABG shows pH 7.28
C. Normal mental status, stable vital signs, and resolved ketonuria
D. Urine ketones remain moderate
Answer: C. Normal mental status, stable vital signs, and resolved ketonuria
Rationale: These signs indicate glucose control and correction of acidosis.
Which teaching point is most important for preventing future episodes of DKA?
A. Avoid all sugar
B. Take medication only when sick
C. Monitor glucose and ketones during illness
D. Stop insulin if not eating
Answer: C. Monitor glucose and ketones during illness
Rationale: Monitoring and following sick-day rules prevent DKA during stress or illness.
What is a common precipitating factor of DKA?
A. Hypertension
B. Hypothyroidism
C. Infection
D. Hyperlipidemia
Answer: C. Infection
Rationale: Infection increases metabolic demand and insulin need, triggering DKA.
Which finding on urinalysis is expected in DKA?
A. No abnormalities
B. Positive nitrites
C. Glycosuria and ketonuria
D. Proteinuria only
Answer: C. Glycosuria and ketonuria
Rationale: Elevated glucose and ketone excretion are classic in DKA.
What is the function of 5–10% dextrose in later stages of DKA treatment?
A. Prevent rebound hyperglycemia
B. Prevent hypoglycemia
C. Prevent protein loss
D. Decrease potassium
Answer: B. Prevent hypoglycemia
Rationale: Once glucose nears 250 mg/dL, dextrose prevents dangerous drops.
Which lab value would confirm metabolic acidosis in DKA?
A. Serum bicarbonate 14 mEq/L
B. Sodium 140 mEq/L
C. Potassium 4.0 mEq/L
D. Calcium 9.2 mg/dL
Answer: A. Serum bicarbonate 14 mEq/L
Rationale: Bicarb < 16 mEq/L indicates acidosis in DKA.
