Which of the following are key differences between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)? (Select all that apply).
Blood glucose levels in DKA are typically higher than in HHS
DKA involves significant ketosis and metabolic acidosis, while HHS typically does not
DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes
None of the above
HHS patients often have more severe dehydration than DKA patients
Correct Answer : A,B,C,E
A. Blood glucose levels in DKA are typically higher than in HHS: In fact, HHS usually presents with higher blood glucose levels than DKA—often exceeding 600 mg/dL, while DKA typically ranges from 250 to 600 mg/dL.
B. DKA involves significant ketosis and metabolic acidosis, while HHS typically does not: DKA is characterized by the breakdown of fats into ketones, leading to metabolic acidosis. HHS typically lacks significant ketosis because insulin levels, while low, are still sufficient to suppress ketogenesis.
C. DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes: DKA usually occurs in individuals with type 1 diabetes due to absolute insulin deficiency. HHS is more often seen in type 2 diabetics who still produce some insulin but not enough to prevent severe hyperglycemia and dehydration.
D. None of the above: This choice is incorrect, as B, C, and E are valid differences between DKA and HHS.
E. HHS patients often have more severe dehydration than DKA patients: HHS leads to profound osmotic diuresis over a longer period, causing extreme dehydration. DKA progresses faster but with less total fluid loss compared to HHS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The patient requires painful stimuli to elicit a response and has no purposeful movement: This indicates a severe decrease in consciousness where the patient is minimally responsive, unable to respond to verbal stimuli, and shows no purposeful movement. It reflects significant brain dysfunction and is often seen in severe brain injury or coma.
B. The patient is drowsy but responds to verbal stimuli appropriately: This describes mild to moderate impairment of consciousness, where the patient is lethargic but still able to respond meaningfully to verbal commands, indicating a less severe condition.
C. The patient responds to commands but is slow to do so: A slowed response suggests some cognitive or neurological impairment but not a severe decrease in consciousness. The patient remains alert enough to follow instructions, albeit slowly.
D. The patient can follow simple commands like "open your eyes": This shows the patient is conscious and able to interact, reflecting a mild or normal level of consciousness rather than severe impairment.
Correct Answer is A
Explanation
A. The Somogyi effect results from an excessive insulin dose causing hypoglycemia overnight, triggering a rebound hyperglycemia via release of glucagon, cortisol, and growth hormone. In contrast, the dawn phenomenon is a natural early morning rise in blood glucose due to circadian increases in cortisol and growth hormone without preceding hypoglycemia.
B. The Somogyi effect happens only in type 2 diabetes, while the dawn phenomenon happens only in type 1 diabetes: Both effects can occur in either type 1 or type 2 diabetes depending on insulin therapy and individual physiology.
C. Both the Somogyi effect and the dawn phenomenon occur due to nighttime hyperglycemia: The Somogyi effect starts with nighttime hypoglycemia, not hyperglycemia, while the dawn phenomenon involves a gradual early morning rise in glucose levels.
D. The Somogyi effect is caused by insufficient insulin at night, while the dawn phenomenon is caused by excessive nighttime insulin: The Somogyi effect is caused by excessive insulin leading to hypoglycemia, not insufficient insulin. The dawn phenomenon is unrelated to nighttime insulin dosing and is caused by hormonal changes.
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