What is the main difference between diabetic ketoacidosis(DKA) and hyperosmolar hyperglycemia syndrome (HHS)?
DKA always only occurs in patient with Type 2 diabetes
DKA is usually caused by acute illness, whereas HHS is not
HHS does not require IV insulin, but DKA does
In HHS, the body has enough insulin so ketoacidosis does not occur
The Correct Answer is D
A. DKA always only occurs in patients with Type 2 diabetes is incorrect because DKA most commonly occurs in Type 1 diabetes due to absolute insulin deficiency. While it can rarely occur in Type 2 diabetes, it is not exclusive to this type. Patients with Type 2 diabetes usually retain some endogenous insulin, which prevents the severe ketosis seen in DKA.
B. DKA is usually caused by acute illness, whereas HHS is not is incorrect because both DKA and HHS are often precipitated by acute illness, infection, surgery, or noncompliance with diabetes medications. The presence of a precipitating factor does not distinguish between the two syndromes.
C. HHS does not require IV insulin, but DKA does is incorrect because both DKA and HHS may require IV insulin, particularly when glucose levels are high or hyperglycemia is not resolving with fluid replacement alone. In HHS, the primary focus is aggressive fluid resuscitation to correct severe dehydration, but insulin therapy is often necessary as well.
D. In HHS, the body has enough insulin so ketoacidosis does not occur is correct. HHS patients typically have residual circulating insulin, which is sufficient to inhibit lipolysis and ketone production, preventing metabolic acidosis. In contrast, DKA occurs when insulin deficiency is severe or absolute, leading to uncontrolled fat breakdown, ketone accumulation, and metabolic acidosis. This explains why DKA presents with acidosis and ketonuria, while HHS presents with extreme hyperglycemia, profound dehydration, and little to no ketosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Monitor for skin breakdown is incorrect because while skin care is always important, it is not the priority concern during the diuretic phase of AKI. The main issue in this phase is fluid and electrolyte losses rather than pressure-related skin issues.
B. Monitor for loose stools is incorrect because gastrointestinal issues like diarrhea are not directly associated with the diuretic phase of AKI. Loose stools may occur due to other causes, but they are not a primary concern in this stage.
C. Monitor neurological status is incorrect because although electrolyte imbalances can affect neurological function, the most immediate risk during the diuretic phase is volume depletion and hypotension, which can worsen kidney injury.
D. You want to monitor for hypotension is correct because the diuretic phase of AKI is characterized by high urine output, which can lead to significant fluid and electrolyte losses. This puts the patient at risk for hypovolemia and hypotension, which can compromise renal perfusion and delay recovery. Nursing care during this phase focuses on careful monitoring of blood pressure, fluid status, and electrolytes, and replacing fluids as needed to maintain hemodynamic stability.
Correct Answer is B
Explanation
A. This is used more commonly than an AV fistula is incorrect because AV fistulas are preferred over AV grafts for long-term hemodialysis due to lower infection rates and longer patency. AV grafts are generally used when a patient’s vasculature is not suitable for a fistula.
B. This is more likely to become infected when compared to an AV fistula is correct because AV grafts involve synthetic material that connects an artery and vein. The presence of synthetic material increases the risk of infection compared to a native AV fistula. Additionally, grafts are more prone to thrombosis and stenosis.
C. This is a temporary access site is incorrect because AV grafts are considered semi-permanentaccess sites. Temporary access is typically established with a central venous catheter. Grafts are intended for repeated use over months to years, although they have a shorter lifespan than fistulas.
D. Patient cannot be discharged home with an AV graft is incorrect because patients with AV grafts can safely go home and perform regular daily activities. Proper education on infection prevention, graft care, and monitoring for complications is essential, but hospitalization is not required solely because of the graft.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.