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DIABETES, DKA, HHS NCLEX REVIEW
EXAMS GUIDE 2025- 2026
aS | r---- An 18-ycar-old female client, 5° 47 ~ tall, weighing 113 kg, comos to the clinic for anon healing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed? 1. Type 1 diabetes.’ 2. Type 2 diabetes. 3. Gestational diabetes. 4. Acanthosis nigricans. - 4151) MQ BB RilaBeEes ist alsellen stalls ueeinaiae snd The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (Alc) of 8.1%. Which inlerpretalion should the nurse make based on this resull? 1. This result is below normal levels. 2. This result is within acceptable levels. 3. This result is above recommended levels. 4. This result is dangerously high. - 8. This result parallels a serum blood glicose Mn ec ee ee ee ee ee ee ee ee aS | The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement? 1. Ensure the client eats the bedtime snack. 2. Determine how much food the client ate at lunch. 3. Perform a glucometer reading at 0700. 4. Offer the client protein after administering insulin. - ANS —-1. Humulin N peaks in 6 to 8 The client diagnosed with type 1 diabetes is receiving Humalog, a rapid-acting insulin. by sliding scale. The order reads blood glucose level: <150, zero (0) units; 131 to 200,three (3) units; 201 to 250, six (6) units; >251, contact health-care provider. The UAP reports to the nurse the client’s glucometer reading is 189. How much insulin should the nurse administer to the client? - > z = i The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the tcaching about diabetes? 1. Eat a simple carbohydrate snack before exercising. 2. Carry peanul. bulter crackers when cxercising. 3. Encourage the client to walk 20 minutes three (3) times a week. 4. Perform warm up and cool-down exe s.- ANS _-4 Allelients who exercise should Mn ec ee ee ee ee ee ee ee ee aS | 3. Obtain an informed consent form for the test \ A, Administer pancre: 2 Biguanide medication must be yes prior to the gE g is 1 The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion?Select all that apply. 1. Take diabetic medication even if unable to eat the client’s normal diabetic diet. 2. If unable to eat, drink liquids equal to the client’s normal caloric intake. 3. It is not necessary to notify the health-care provider if ketones are in the urine. 4. Test blood glucose levels and test urine ketones once a day and keep a record. 5. Call the health-care provider if ghicose levels are higher than 180 mg/dL. - ANS wer 2B The client received 10 units of Humulin R. a fast-acting insulin, at 0700. At 1030 the UAP tells the nurse the client has a headache and is really acting “funny. hich intervention should the nurse implement first? Mn ec ee ee ee ee ee ee ee ee Por === -- 1. Instruct the IAP to obtain the blood glucose level. 2. Have the client drink eight (8) ounces of orange juice. 3. Go to the client’s room and assess the client for hypog. 4. Prepare to administer one (1) ampule 50% dextrose intravenously. - ANSWER SRS The nurse at a free standing health care clinic is caring for a 46-year-old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an cxample of client advocacy? I 1. Ask the client if he has somewhere he can go and live. 2. Arrange for someone Lo give him insulin at a local homeless shelter. 3. Notify Adult Protective Services about the client’s situation. 4, Ask the HCP 10 Lake the client off insulin because he is homeless. - ANSWER The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse | identifies the problem “high risk for hyperglycemia related to non compliance with the medication regimen.” Which statement is an appropriate short-term goal for the client? L. The client will have a blood glucose level bet 90 and 140 mg/dL. 2. The client will demonstrate appropriate insulin injection technique. 3. The nurse will monitor the client’s blood glucose levels four (4) times a day. Mn a a aS | 3. Calcium. 4.Soniu- _-2.The client in DKA loses potassium fromincreased urinary ontput, The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement? 1. Increase the regular insulin IV drip. 2. Check the client's urine for ketones. 3. Provide the client with a therapeutic diabetic meal. 4. Notify the HCP to obtain an order to decrease insulin. - ANS WP MCCS The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first? 1. Administer 50% dextrose IVP. 2. Notify the health-care provider. 3. Move the client to the ICU. 4. Check the serum glucose level. - +1, The nurse should assume the client is Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment? Mn ec ee ee ee ee ee ee ee ee aS | 1. The client has tented skin turgor and dry mucous membranes. 2. The client is alert and oriented to date, time, and place. 3. The client’s ABG results are pH 7.29, PaCO2 44, HCO315. 4. The client's serum potassium level is 3.3 mEd/L. - ANSWERS eet The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement? 1. Instruct the UAP to get the client additional food. 2. Notify the dictilian about the client’s request. 3. Request the HCP increase the client’s caloric intake. 4. Tell the UAP the client cannol. have anything else. - ANS 2. The client will not be The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client Lo determine the cause of this acute complication? 1. "When is the last time you took your insulin?” 2." ‘hen did you have your last meal?" 3. “Have you had some type of infection lately?” 4. "How long have you had diabetes?" - 8, The most common precipitating factoris Mn ec ee ee ee ee ee ee ee ee aS | 3. pH 7.46, PaQ285, PaCO230, HCO326. 4. - PaC0230, HCO318. NSW) ISA aes eso The client is admitted to the ICU diagnosed with DKA. Which interventions shouldthe nurse implement? Select all that apply. 1. Maintain adequate ventilation. 2. Assess fluid volume status. 3. Administer intravenous potassium. 4. Check for urinary ketones. 3. Monitor intake and output. - ANSWER BES Aclient is brought to the emergency department in an unresponsive state, and a diagnosis of alo (HHS) is made. The nurse would immediately prepare Lo hyperglycemic hyperosmolar ¢ initiate which anticipated health care provider's prescription 1.Endotracheal intubation 2.100 units of NPH insulin 3 Intravenous infusion of normal saline A Intravenous infusion of sodium bicarbonate - ANS WER| The primary goal of treatment in hyperglycemic hyperosmolar state (HHS) is to rehydrate the client to restore fluid volume and to correct electrolyte deficiency. Intravenous fluid replacement is similar Lo that administered in diabetic kcLoacidosis (DKA) and begins with TV. infusion of normal saline. Regular insulin, not NPH insulin, would be administered. The use of Mn ec ee ee ee ee ee ee ee ee aS | sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHS. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings would the nurse expect to note as confirming this diagnosis? Select all thal apply. 1 Increase in pH 2.Comatose state 3.Deep, rapid breathing 4.Decreased urine output 3.Elevated blood glucose level 6.Low plasma bicarbonate level - ANS wer SRB The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop? Select all that apply 1.Polyuria 2.Shakiness 3.Palpitations Mn ec ee ee ee ee ee ee ee ee 
