Diabetic Ketoacidosis Quiz
This quiz will test you on your knowledge of Diabetic Ketoacidosis (DKA) for the
NCLEX exam.
Which of the following is not a sign or symptom of Diabetic Ketoacidosis?*
Positive Ketones in the urine
Oliguria
Polydipsia
Abdominal Pain
A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous
fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus
and then to start an insulin drip per protocol. The patient’s labs are the
following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most
appropriate nursing intervention to perform next?*
Start the IV fluids and administer the insulin bolus and drip as ordered
Hold the insulin and notify the doctor of the potassium level of 2.5
Hold IV fluids and administer insulin as ordered
Recheck the glucose level
Which patient is MOST likely to develop Diabetic Ketoacidosis?*
A 25 year old female newly diagnosed with Cushing's Disease taking
glucocorticoids.
A 36 year old male with diabetes mellitus who has been unable to eat the past 2
days due to a gastrointestinal illness and has been unable to take insulin.
A 35 year old female newly diagnosed with Type 2 diabetes.
None of the options are correct.
Which of the following statements are INCORRECT about Diabetic Ketoacidoisis?*
Extreme Hyperglycemia that presents with blood glucose >600 mg/dL
Ketones are present in the urine
Metabolic acidosis is present with Kussmaul breathing
Potassium levels should be at least 3.3 or higher during treatment of DKA with
insulin therapy
True or False: When priming the tubing for an Insulin infusion it is best practice
to waste 50cc to 100cc of insulin prior to starting the infusion because insulin
absorbs into the plastic lining of the tubing.*
True
False
You are providing care to a patient experiencing diabetic ketoacidosis. The patient
is on an insulin drip and their current glucose level is 300. In addition to this,
the patient also has 5% Dextrose 0.45% NS infusing in the right antecubital vein.
Which of the following patient signs/symptoms causes concern?*
Patient complains of thirst.
Patient has a potassium level of 2.3
Patient's skin and mucous membranes are dry.
Patient is nauseous.
What type of insulin do you expect the doctor to order for treatment of DKA?*
IV Novolog
IV Levemir
IV NPH
IV Regular Insulin
A patient diagnosed with diabetes mellitus is being discharged home and you are
teaching them about preventing DKA. What statement by the patient demonstrates they
understood your teaching about this condition?*
"I should not be alarmed if ketones are present in my urine because this is
expected during illness."
"It is normal for my blood sugar to be 250-350 mg/dL while I'm sick."
"I will hold off taking my insulin while I'm sick."
"It is important I check my blood glucose every 3-4 hours when I'm sick and
consume liquids."
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NCLEX Questions on Diabetic Ketoacidosis
1. Which of the following is not a sign or symptom of Diabetic Ketoacidosis?
A. Positive Ketones in the urine
B. Oliguria
C. Polydipsia
D. Abdominal Pain
2. A patient is admitted with Diabetic Ketoacidosis. The physician orders
intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular
insulin IV bolus and then to start an insulin drip per protocol. The patient’s labs
are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is
the most appropriate nursing intervention to perform next?
A. Start the IV fluids and administer the insulin bolus and drip as ordered
B. Hold the insulin and notify the doctor of the potassium level of 2.5
C. Hold IV fluids and administer insulin as ordered
D. Recheck the glucose level
3. Which patient is MOST likely to develop Diabetic Ketoacidosis?
A. A 25 year old female newly diagnosed with Cushing’s Disease taking
glucocorticoids.
B. A 36 year old male with diabetes mellitus who has been unable to eat the past 2
days due to a gastrointestinal illness and has not been taking insulin.
C. A 35 year old female newly diagnosed with Type 2 diabetes.
D. None of the options are correct.
4. Which of the following statements are INCORRECT about Diabetic Ketoacidoisis?
A. Extreme Hyperglycemia that presents with blood glucose >600 mg/dL
B. Ketones are present in the urine.
C. Metabolic acidosis is present with Kussmaul breathing.
D. Potassium levels should be at least 3.3 or higher during treatment of DKA with
insulin therapy.
5. True or False: When priming the tubing for an Insulin infusion it is best
practice to waste 50cc to 100cc of insulin prior to starting the infusion because
insulin absorbs into the plastic lining of the tubing.
6. You are providing care to a patient experiencing diabetic ketoacidosis. The
patient is on an insulin drip and their current glucose level is 300. In addition
to this, the patient also has 5% Dextroxe 0.45% NS infusing in the right
antecubital vein. Which of the following patient signs/symptoms causes concern?
A. Patient has a potassium level of 2.3
B. Patient complains of thirst.
c. Patient is nauseous.
D. Patient’s skin and mucous membranes are dry.
7. What type of insulin do you expect the doctor to order for treatment of DKA?
A. IV NPH
B. IV Novolog
C. IV Levemir
D. IV Regular Insulin
8. A patient diagnosed with diabetes mellitus is being discharged home and you are
teaching them about preventing DKA. What statement by the patient demonstrates they
understood your teaching about this condition?
A. “I will hold off taking my insulin while I’m sick.”
B. “It is normal for my blood sugar to be 250-350 mg/dL while I’m sick.”
C. “It is important I check my blood glucose every 3-4 hours when I’m sick and
consume liquids.”
D. “I should not be alarmed if ketones are present in my urine because this is
expected during illness.”
Answer Key:
1. B
2. B
3. B
4. A
5. True
6. A
7. D
8. C
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