A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.2; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium 2 mEq/L; serum sodium 130 mEq/L. The patient reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?
Increased glucose use causes the shift of fluid from the intravascular to the intracellular spaces
Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss
Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic acidosis
Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis
The Correct Answer is D
Choice A reason: Increased glucose use doesn’t occur in DKA; insulin deficiency reduces glucose uptake. Fluid shifts are due to osmotic diuresis, not intravascular to intracellular movement, so this is incorrect for DKA’s mechanism.
Choice B reason: DKA involves metabolic, not respiratory, acidosis from ketones. Protein catabolism occurs, but fatty acid use and ketogenesis are primary, leading to acidosis and diuresis, so this is incorrect.
Choice C reason: Increased glucose and fatty acids contribute, but the mechanism is decreased glucose use causing ketogenesis. This option omits ketogenesis, a key DKA feature, so it’s less precise and incorrect.
Choice D reason: Insulin deficiency in DKA reduces glucose use, leading to fatty acid breakdown, ketogenesis, metabolic acidosis (pH 7.2), and osmotic diuresis (electrolyte loss). This fully explains the lab values, making it correct.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Atherosclerosis erodes the vessel wall by forming plaques that weaken arterial layers, promoting aneurysm formation. This degenerative process destabilizes the wall, making it the correct effect in aneurysm development.
Choice B reason: Ischemia of the intima is not a primary atherosclerosis effect; plaques cause wall damage, not just intimal ischemia. Vessel wall erosion is more accurate for aneurysm formation, so this is incorrect.
Choice C reason: Atherosclerosis narrows vessels but doesn’t primarily obstruct them in aneurysm formation. Wall erosion and weakening lead to dilation, not blockage, so this is incorrect for aneurysm development.
Choice D reason: Atherosclerosis reduces nitric oxide, impairing vasodilation, but this isn’t directly linked to aneurysms. Vessel wall erosion by plaques is the key mechanism, so this is incorrect for the effect.
Correct Answer is D
Explanation
Choice A reason: Increased glucose use doesn’t occur in DKA; insulin deficiency reduces glucose uptake. Fluid shifts are due to osmotic diuresis, not intravascular to intracellular movement, so this is incorrect for DKA’s mechanism.
Choice B reason: DKA involves metabolic, not respiratory, acidosis from ketones. Protein catabolism occurs, but fatty acid use and ketogenesis are primary, leading to acidosis and diuresis, so this is incorrect.
Choice C reason: Increased glucose and fatty acids contribute, but the mechanism is decreased glucose use causing ketogenesis. This option omits ketogenesis, a key DKA feature, so it’s less precise and incorrect.
Choice D reason: Insulin deficiency in DKA reduces glucose use, leading to fatty acid breakdown, ketogenesis, metabolic acidosis (pH 7.2), and osmotic diuresis (electrolyte loss). This fully explains the lab values, making it correct.
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