What acute complication is more common in type 2 diabetes and causes high blood sugar and severe dehydration?
Hypoglycemia.
Diabetic ketoacidosis (DKA).
Hyperosmolar hyperglycemic syndrome (HHS).
Renal failure.
The Correct Answer is C
Choice A rationale
Hypoglycemia refers to blood glucose levels that are too low, typically below 70 mg/dL. This is an acute complication of diabetes management, often caused by too much insulin or oral medications, skipped meals, or excessive exercise. It does not cause high blood sugar or severe dehydration. While dangerous, it is the opposite of the hyperosmolar state described, which involves extreme hyperglycemia and the massive osmotic diuresis that leads to profound fluid loss.
Choice B rationale
Diabetic ketoacidosis is an acute complication characterized by hyperglycemia, ketosis, and metabolic acidosis. While it involves high blood sugar and dehydration, it is much more common in type 1 diabetes. In type 2 diabetes, there is usually enough circulating insulin to prevent the breakdown of fats into ketones, so patients rarely develop the significant ketosis seen in DKA. Instead, they develop much higher glucose levels without the corresponding acidosis found in DKA.
Choice C rationale
Hyperosmolar hyperglycemic syndrome is a life-threatening complication most common in type 2 diabetes. It is characterized by extreme hyperglycemia, often exceeding 600 mg/dL, which creates a hyperosmolar extracellular environment. This draws water out of the cells and into the blood, leading to massive osmotic diuresis and severe dehydration. Because type 2 diabetics have some residual insulin, they avoid ketosis, but the dehydration is often much more severe than that seen in ketoacidosis.
Choice D rationale
Renal failure can be a chronic complication of long-term, poorly controlled diabetes due to nephropathy, but it is not an acute complication characterized by high blood sugar and dehydration. Rather, renal failure is a result of the damage caused by chronic hyperglycemia over many years. While acute kidney injury can occur during a crisis like HHS due to severe hypovolemia, it is not the name of the metabolic syndrome itself.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A body mass index of 23 is within the normal range of 18.5 to 24.9. This indicates a healthy weight relative to height, which generally supports optimal metabolic function. Maintaining a normal body mass index reduces the risk of insulin resistance, as excessive adipose tissue, particularly visceral fat, releases inflammatory cytokines that interfere with insulin signaling pathways and glucose uptake in peripheral tissues like skeletal muscle.
Choice B rationale
A diet low in saturated fats is a protective factor rather than a risk factor. Saturated fats can contribute to systemic inflammation and lipotoxicity, which are known to impair the sensitivity of insulin receptors. By keeping saturated fat intake low, the lipid profile remains favorable, often resulting in lower low-density lipoprotein levels and improved vascular health, which indirectly supports efficient transport and regulation of blood glucose.
Choice C rationale
A sedentary lifestyle is a significant risk factor because physical inactivity reduces the expression of glucose transporter type 4 (GLUT4) in muscle cells. Exercise naturally stimulates glucose uptake through insulin-independent pathways. Without regular movement, the body requires higher levels of insulin to move glucose into cells, eventually leading to hyperinsulinemia and decreased pancreatic beta-cell efficiency. This lack of muscle contraction prevents the burning of stored glycogen.
Choice D rationale
A high-fiber diet is considered a lifestyle modification that improves glucose regulation. Soluble fiber slows the rate of gastric emptying and delays the absorption of carbohydrates in the small intestine. This results in a more gradual rise in postprandial blood glucose levels, preventing the sharp insulin spikes that can lead to receptor desensitization over time. Fiber also promotes a healthy gut microbiome, which is linked to better metabolic health.
Correct Answer is C
Explanation
Choice A rationale
Cancer treatments, such as chemotherapy or radiation, can lead to various types of anemia by suppressing bone marrow function. However, they do not specifically address the deficiency of intrinsic factor associated with pernicious anemia. In pernicious anemia, the primary problem is an autoimmune destruction of gastric parietal cells, which are responsible for secreting the intrinsic factor needed for nutrient processing in the distal ileum.
Choice B rationale
Increased blood loss typically results in iron deficiency anemia due to the depletion of iron stores needed for hemoglobin synthesis. While blood loss can cause a reduction in total red blood cell count, it is not the physiological mechanism behind pernicious anemia. Pernicious anemia is a macrocytic anemia characterized by the body's inability to absorb enough vitamin B12 because of the lack of intrinsic factor.
Choice C rationale
Pernicious anemia is specifically caused by a deficiency of intrinsic factor, a glycoprotein secreted by the stomach's parietal cells. Intrinsic factor is essential for the absorption of vitamin B12 in the small intestine. Without it, vitamin B12 cannot be absorbed, leading to impaired DNA synthesis in red blood cells. This results in the production of large, immature, and dysfunctional megaloblastic cells that cannot carry oxygen effectively.
Choice D rationale
Iron storage relates to the body's levels of ferritin and hemosiderin, which are crucial for producing heme in red blood cells. A decrease in iron storage leads to microcytic, hypochromic anemia, which is distinct from the macrocytic nature of pernicious anemia. Pernicious anemia focuses on the malabsorption of cobalamin rather than a lack of mineral iron, making iron storage irrelevant to the specific pathology of intrinsic factor loss.
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