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Diabetic Ketoacidosis (DKA) and Diabetes Management Quiz, Quizzes of Nursing

Oakwood UniversityNursing

This quiz assesses nursing knowledge related to the recognition, documentation, and management of diabetic ketoacidosis (DKA) and related diabetic emergencies. It includes questions on clinical findings, interpretation of arterial blood gas (ABG) results, and appropriate interventions in cases of hypoglycemia and hyperglycemia. Ideal for nursing students and practicing nurses looking to reinforce their critical thinking and clinical judgment skills in diabetes care.

Typology: Quizzes

2024/2025

Available from 06/20/2025

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QUIZ ON DIABETES
1. A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical
findings related to this event should the nurse document in the client's clinical record? (Select all
that apply.)
2. Sweating
3. Retinopathy
4. Acetone breath
5. Increased arterial bicarbonate level
6. Decreased arterial carbon dioxide level
7. The nurse is caring for a client with a diagnosis of diabetic ketoacidosis. Which arterial blood gas
results are associated with this diagnosis?
8. pH: 7.28; Pco2: 28; HCO3: 18
9. pH: 7.30; Pco2: 54; HCO3: 28
10. pH: 7.50; Pco2: 49; HCO3: 32
11. pH: 7.52; Pco2: 26; HCO3: 20
12. pH: 7.28; Pco2: 28; HCO3: 18
13. A nurse is caring for a client with type 1 diabetes, and the health care provider prescribes one
tube of glucose gel. What is the primary reason for the administration of glucose gel to this
client?
14. Diabetic acidosis
15. Hyperinsulin secretion
QUIZ ON DIABETES
Insulin-induced hypoglycemia
1. A nurse is assessing a client with a diagnosis of diabetes insipidus. For which signs indicative of
diabetes insipidus should the nurse assess the client? (Select all that apply.)
2. Excessive thirst
3. Increased blood glucose
4. Dry mucous membranes
5. Increased blood pressure
6. Decreased serum osmolarity
7. Decreased urine specific gravity
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QUIZ ON DIABETES

  1. A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? (Select all that apply.)
  2. Sweating
  3. Retinopathy
  4. Acetone breath
  5. Increased arterial bicarbonate level
  6. Decreased arterial carbon dioxide level
  7. The nurse is caring for a client with a diagnosis of diabetic ketoacidosis. Which arterial blood gas results are associated with this diagnosis?
  8. pH: 7.28; Pco2: 28; HCO3: 18
  9. pH: 7.30; Pco2: 54; HCO3: 28
  10. pH: 7.50; Pco2: 49; HCO3: 32
  11. pH: 7.52; Pco2: 26; HCO3: 20
  12. pH: 7.28; Pco2: 28; HCO3: 18
  13. A nurse is caring for a client with type 1 diabetes, and the health care provider prescribes one tube of glucose gel. What is the primary reason for the administration of glucose gel to this client?
  14. Diabetic acidosis
  15. Hyperinsulin secretion QUIZ ON DIABETES Insulin-induced hypoglycemia
  16. A nurse is assessing a client with a diagnosis of diabetes insipidus. For which signs indicative of diabetes insipidus should the nurse assess the client? (Select all that apply.)
  17. Excessive thirst
  18. Increased blood glucose
  19. Dry mucous membranes
  20. Increased blood pressure
  21. Decreased serum osmolarity
  22. Decreased urine specific gravity
  1. A nurse is caring for a client who has had type 1 diabetes for 25 years. The client states, "I have been really bad for the last 15 years. I have not paid attention to my diet and have done little to control my diabetes." What signs of common complications of diabetes might the nurse expect to identify when assessing this client? (Select all that apply.)
  2. Leg ulcers
  3. Loss of visual acuity
  4. Thick, yellow toenails QUIZ ON DIABETES Increased growth of body hair
  5. Decreased sensation in the feet
  6. Which clinical indicator should the nurse identify as expected for a client with type 2 diabetes?
  7. Ketones in the blood but not in the urine.
  8. Glucose in the urine but not hyperglycemia.
  9. Urine negative for ketones and hyperglycemia.
  10. Blood and urine positive for both glucose and ketones.
  11. Which insulin should the nurse prepare for the emergency treatment of ketoacidosis?
  12. Glargine (Lantus)
  13. NPH insulin (Novolin N)
  14. Insulin aspart (NovoLog)
  15. Insulin detemir (Levemir)
  16. A client is diagnosed with diabetic ketoacidosis. Which insulin should the nurse expect the health care provider to prescribe?
  17. Insulin lispro (Humalog) QUIZ ON DIABETES
  18. Insulin glargine (Lantus)
  19. NPH insulin (Novolin N)
  20. Regular insulin (Novolin R)
  21. A client is taught how to recognize indications of a hypoglycemic reaction. Which signs and symptoms identified by the client indicate to the nurse that the teaching was effective? (Select all that apply.)
  22. Fatigue
  1. Wearing well-fitting shoes
  2. Performing regular exercise
  3. Powdering the feet after showering
  4. Visiting the health care provider weekly
  5. Testing bathwater with the toes before bathing
  6. A nurse evaluates that a client with diabetes understands the teaching about the treatment of hypoglycemia when the client says, "If I become hypoglycemic I initially should eat:
  7. A nurse evaluates that a client with diabetes understands the teaching about the treatment of hypoglycemia when the client says, "If I become hypoglycemic I initially should eat:
  8. Fruit juice and a lollipop.
  9. Sugar and a slice of bread.
  10. Chocolate candy and a banana.
  11. Peanut butter crackers and a glass of milk.
  12. A nurse is assessing a client with diabetic ketoacidosis. Which clinical manifestations should the nurse expect? (Select all that apply.)
  13. Dry skin
  14. Abdominal pain
  15. Kussmaul respirations
  16. A client who has acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. The nurse identifies that further teaching about the hypophysectomy is necessary when the client states, "I know I will:
  17. Be sterile for the rest of my life.
  18. Require larger doses of insulin than I did preoperatively.
  19. Have to take cortisone or a similar drug for the rest of my life.
  20. Have to take thyroxine or a similar medication for the rest of my life.
  21. A client with type 1 diabetes comes to the clinic because of concerns regarding erratic control of blood glucose with the prescribed insulin therapy. The client has been experiencing a sudden fall in the blood glucose level, followed by a sudden episode of hyperglycemia. Which complication of insulin therapy should the nurse conclude that the client is experiencing?
  22. Somogyi effect
  23. Dawn phenomenon
  24. Diabetic ketoacidosis
  1. Hyperosmolar nonketotic syndrome
  2. A nurse is collecting information about a client who has type 1 diabetes and is being admitted because of diabetic ketoacidotic coma. Which factors can predispose a client to this condition? (Select all that apply.)
  3. Taking too much insulin
  4. Getting too much exercise
  5. Excessive emotional stress
  6. Running a fever with the flu
  7. Eating fewer calories than prescribed
  8. A client with type 1 diabetes consistently has high glucose levels on awakening in the morning. What should the nurse instruct the client to do to differentiate between the Somogyi effect and the dawn phenomenon?
  9. Eat a snack before going to bed.
  10. Measure the blood glucose level between 2 AM and 4 AM.
  11. Administer the prescribed bedtime insulin immediately before going to bed.
  12. Identify whether symptoms experienced in the morning are associated with either hyperglycemia or hypoglycemia.
  13. A nurse is assessing a client and suspects diabetic ketoacidosis (DKA). What clinical findings support this conclusion?
  14. Nervousness and tachycardia
  15. Erythema toxicum rash and pruritus
  16. Diaphoresis and altered mental state
  17. A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiological changes that are associated with a long history of diabetes?
  18. Blurry, spotty, or hazy vision
  19. Arthritic changes in the hands
  20. Hyperactive knee and ankle jerk reflexes
  21. Dependent pallor of the feet and lower legs
  22. A client has a hypoglycemic reaction to insulin. Which client responses should the nurse document as clinical manifestations of hypoglycemia? (Select all that apply.)
  23. Pallor
  24. Tremors
  1. A client newly diagnosed with type 2 diabetes is receiving glyburide (Micronase) and asks the nurse how this drug works. The nurse explains that glyburide:
  2. Stimulates the pancreas to produce insulin
  3. Accelerates the liver's release of stored glycogen
  4. Increases glucose transport across the cell membrane
  5. Lowers blood glucose in the absence of pancreatic function
  6. A client with diabetes is given instructions about foot care. The nurse determines that the instructions are understood when the client states, "I will:
  7. Cut my toenails before bathing.
  8. Soak my feet daily for one hour.
  9. Examine my feet using a mirror at least once a week.
  10. Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of a hypoglycemic reaction? (Select all that apply.)
  11. Confusion
  12. Tremors
  13. Anorexia
  14. Glycosuria
  15. Diaphoresis
  16. A nurse is caring for a client with a diagnosis of type 1 diabetes who has developed diabetic coma. Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with this condition?
  17. Sodium bicarbonate, causing alkalosis
  18. Ketones as a result of rapid fat breakdown, causing acidosis
  19. Nitrogen from protein catabolism, causing ammonia intoxication
  20. Glucose from rapid carbohydrate metabolism, causing drowsiness
  21. A nurse is preparing to administer insulin to a client with diabetes. In which order should the nurse perform the actions associated with insulin administration?
  22. Wash hands with soap and water
  23. Wipe the top of the insulin vial with an alcohol swab
  24. Instill air into the vial of insulin equal to the desired dose
  1. Rotate the vial of insulin between the palms of the hands
  2. Withdraw the correct amount of insulin from the inverted vial
  3. A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them.
  4. Don a pair of clean gloves.
  5. Put air into the short-acting insulin vial.
  6. Withdraw the prescribed amount of short-acting insulin.
  7. Put air into the intermediate-acting insulin vial.
  8. Withdraw the prescribed amount of intermediate-acting insulin.
  9. A client with diabetes asks how exercise will affect insulin and dietary needs. The nurse should respond, "Exercise:
  10. Increases the need for carbohydrates and decreases the need for insulin.
  11. Increases the need for insulin and increases the need for carbohydrates.
  12. Decreases the need for insulin and decreases the need for carbohydrates.
  13. Decreases the need for carbohydrates but does not affect the need for insulin.
  14. A urine specimen is needed to test for the presence of ketones in a client who is diabetic. What should the nurse do when collecting this specimen from a urinary retention catheter?
  15. Disconnect the catheter and drain the urine into a clean container.
  16. Clean the drainage valve and remove the urine from the catheter bag.
  17. Wipe the catheter with alcohol and drain the urine into a sterile test tube.
  18. Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine.
  19. A nurse is caring for a client who is receiving total parenteral nutrition. Which responses indicate that the client is experiencing hyperglycemia? (Select all that apply.)
  20. Polyuria
  21. Polydipsia
  22. Paralytic ileus
  23. Serum glucose of 105 mg/dL
  24. Respiratory rate of 16 breaths per minute
  25. A client with diabetes is being taught to self-administer a subcutaneous injection of insulin. Identify the preferred site for the self-administration of this drug.
  1. Fruity-scented breath
  2. Confusion
  3. The nurse concludes that a client with type 1 diabetes is experiencing hypoglycemia. Which responses support this conclusion? (Select all that apply.)
  4. Vomiting
  5. Headache
  6. Tachycardia
  7. Cool clammy skin
  8. Increased respirations
  9. A nurse working in the diabetes clinic is evaluating a client's success with managing the medical regimen. Which is the best indication that a client with type 1 diabetes is successfully managing the disease?
  10. Reduction in excess body weight
  11. Stabilization of the serum glucose
  12. Demonstrated knowledge of the disease
  13. Adherence to the prescription for insulin
  14. A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information?
  15. "Eat your usual breakfast."
  16. "Have clear liquids for breakfast."
  17. "Take your medication before the test."
  18. "Do not ingest anything before the test."
  19. The nurse provides a list of appropriate food choices to a client with newly diagnosed diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus, broccoli, and mushrooms." In response, the nurse teaches the client about the food exchange list. The nurse evaluates that the teaching is understood when the client states, "Instead of asparagus, broccoli, and mushrooms, I can eat:
  20. String beans, beets, or carrots.
  21. Corn, lima beans, or dried peas.
  22. Baked beans, potatoes, or parsnips.
  23. Corn muffins, corn chips, or pretzels.
  1. A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis?
  2. Increased serum lipids
  3. Decreased hematocrit level
  4. Increased serum calcium levels
  5. Decreased blood urea nitrogen level
  6. A nurse identifies that the client is experiencing a hypoglycemic reaction. Which nursing intervention should the nurse implement to relieve the symptoms associated with this reaction?
  7. Giving 4 oz of fruit juice
  8. Administering 5% dextrose solution intravenously (IV)
  9. Withholding a subsequent dose of insulin
  10. Providing a snack of cheese and dry crackers
  11. A nurse is caring for several clients with type 1 diabetes, and they each have a prescription for a specific type of insulin. Which insulin does the nurse conclude has the fastest onset of action?
  12. Insulin lispro (Humalog)
  13. Insulin glargine (Lantus)
  14. NPH insulin (Novolin N)
  15. Regular insulin (Novolin R)
  16. A nurse is caring for a client newly diagnosed with type 1 diabetes. When the health care provider tries to regulate this client's insulin regimen, the client experiences episodes of hypoglycemia and hyperglycemia, and 15 g of a simple sugar is prescribed. What is the reason this is administered when a client experiences hypoglycemia?
  17. Inhibits glycogenesis
  18. Stimulates release of insulin
  19. Increases blood glucose levels
  20. Provides more storage of glucose
  21. The nurse is counseling a client with type 1 diabetes about the client's favorite foods that are lowest in carbohydrates (CHO). The nurse determines that this concept is understood when the client chooses eight ounces of:
  22. Skim milk
  23. Apple juice
  24. Nonfat yogurt
  1. "It's probably temporary. Your spouse needs more time to adjust."
  2. "You are unhappy. Have you tried to talk with your spouse?"
  3. The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client states, "I will drink orange juice and eat a slice of bread when I feel:
  4. Nervous and weak."
  5. Flushed and short of breath."
  6. Thirsty and have a headache."
  7. Nauseated and have abdominal cramps."
  8. A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing?
  9. Ketoacidosis
  10. Somogyi phenomenon
  11. Hypoglycemic reaction
  12. A nurse administers a tube of glucose gel to a client who is hypoglycemic. What should the nurse consider about this reversal of hypoglycemia?
  13. It liberates glucose from hepatic stores of glycogen.
  14. Insulin action is blocked as it competes for tissue sites.
  15. Glycogen is supplied to the brain as well as other vital organs.
  16. It provides a glucose substitute for rapid replacement of deficits.
  17. The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? (Select all that apply.)
  18. Thirst
  19. Headache
  20. Nervousness
  21. Fruity breath odor
  22. Excessive urination
  1. A client tells the nurse during the admission history that an oral hypoglycemic agent is taken daily. For which condition does the nurse conclude that an oral hypoglycemic agent may be prescribed by the health care provider?
  2. Which is the best advice the nurse can give regarding foot care to a client diagnosed with diabetes?
  3. Remove corns on the feet
  4. Wear shoes that are larger than the feet
  5. Examine the feet weekly for potential sores
  6. Wear synthetic fiber socks when exercising
  7. A client newly diagnosed as having type 1 diabetes is taught to exercise on a regular basis primarily because exercise has been shown to:
  8. Decrease insulin sensitivity
  9. Stimulate glucagon production
  10. Improve the cellular uptake of glucose
  11. Reduce metabolic requirements for glucose
  12. A health care provider prescribes 36 units of NPH insulin (Novolin N) and 12 units of regular insulin (Novolin R). The nurse plans to administer these drugs in one syringe. Identify the steps in this procedure in priority order. (Start with the number of the picture that represents the first step and end with the number by the picture that represents the last step.) (IMAGE QUESTION)!!
  13. A client with diabetes mellitus complains of difficulty seeing. The nurse concludes that the causative factor is:
  14. Lack of glucose in the retina
  15. Neovascularization of the retina
  16. Inadequate glucose supply to rods and cones
  17. Destructive effect of ketones on retinal metabolism
  18. An obese client must self-administer insulin at home. The nurse should teach the client to use what technique?
  19. Pinch the tissue and inject at a 45-degree angle
  20. Pinch the tissue and inject at a 60-degree angle
  21. Spread the tissue and inject at a 45-degree angle
  22. Spread the tissue and inject at a 90-degree angle
  1. A nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. Why should the nurse monitor this client for clinical indicators of diabetes mellitus?
  2. Cortical hormones stimulate rapid weight loss.
  3. Tissue catabolism results in a negative nitrogen balance.
  4. Glucocorticoids accelerate the process of gluco-neogenesis.
  5. Excessive adrenocorticotropic hormone (ACTH) secretion damages pancreatic tissue.
  6. The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include? (Select all that apply.)
  7. It prevents ketoacidosis
  8. It helps cause weight loss
  9. It can improve A1c levels
  10. An insulin pump costs less than subcutaneous injections
  11. Clients can exercise without eating more carbohydrates
  12. A client with type 1 diabetes self-administers Novolin N insulin every morning at 8 AM. The nurse evaluates that the client understands the action of the insulin when the client says, "I should be alert for signs of hypoglycemia between:
  13. 9 am and 10 am.
  14. 10 am and 11 am.
  15. 2 pm and 8 pm.
  16. 8 pm and 12 noon.
  17. A client with type 1 diabetes self-administers NPH insulin (Novolin N) every morning at 8:00 AM. The nurse concludes that the client understands the action of this insulin when the client says, "I should be alert for signs of hypoglycemia between:
  18. 12 PM and 8 PM.
  19. 10 AM and 1 PM.
  20. 10 PM and midnight.
  21. 8:30 AM and 9:30 AM.
  22. When obtaining the history of a client recently diagnosed with type 1 diabetes, the nurse expects to identify the presence of:
  23. Edema
  24. Anorexia
  1. Weight loss
  2. A client newly diagnosed with type 1 diabetes receives information about insulin. The client states, "I hate shots. Why can't I take the insulin in pill form?" What is the nurse's best response?
  3. "Your diabetic condition is too serious for oral insulin."
  4. "Insulin is poorly absorbed and its action is erratic when taken by mouth."
  5. "Insulin by mouth causes a high incidence of allergic and adverse reactions."
  6. "Once your diabetes is controlled, your physician might consider oral insulin."
  7. The nurse is caring for a client with type 1 diabetes. For which signs or symptoms of insulin reaction should the nurse particularly be observant? (Select all that apply.)
  8. Lethargy
  9. Headache
  10. Diaphoresis
  11. Excessive thirst
  12. Deep respirations
  13. A client with diabetes states, "I cannot eat big meals; I prefer to snack throughout the day." What information should the nurse include in a response to this client's statement?
  14. Regulated food intake is basic to control.
  15. Salt and sugar restriction is the main concern.
  16. Small, frequent meals are better for digestion.
  17. Large meals can contribute to a weight problem.
  18. A nurse is planning to teach facts about hyperglycemia to a client with the diagnosis of diabetes. What information should the nurse include in the discussion about what causes diabetic acidosis?
  19. Breakdown of fat stores for energy
  20. Ingestion of too many highly acidic foods
  21. Excessive secretion of endogenous insulin
  22. Increased amounts of cholesterol in the extracellular compartment
  23. A nurse is assessing a client with a diagnosis of hypoglycemia. What clinical manifestations support this diagnosis? (Select all that apply.)
  24. Thirst