PCCN - Endocrine and Renal Issues Questions and Answers

Question 1

A 68-year-old male with a history of type 2 diabetes is admitted to the progressive care unit with altered mental status.
His laboratory results show a blood glucose of 850 mg/dL, serum osmolality of 340 mOsm/kg, and a negative urine ketone test.
Which of the following interventions is the highest priority?

Accepted Answer

Initiating fluid resuscitation with an isotonic solution.

Answer

Administering an intravenous insulin bolus.

Answer

Placing the patient on a cardiac monitor.

Answer

Obtaining a STAT head CT scan.

Question 2

A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). The nurse would expect which of the following laboratory findings?

Accepted Answer

Hyponatremia and decreased serum osmolality

Answer

Hypernatremia and increased serum osmolality

Answer

Hyponatremia and increased serum osmolality

Answer

Hypernatremia and decreased serum osmolality

Question 3

A patient in the progressive care unit develops an acute kidney injury (AKI) following a severe hypotensive episode. Their urine output is 20 mL/hr, BUN is 45 mg/dL, and creatinine is 2.8 mg/dL. Which classification of AKI is most likely?

Accepted Answer

Prerenal

Answer

Intrarenal

Answer

Postrenal

Answer

Chronic

Question 4

The nurse is caring for a patient admitted with Diabetic Ketoacidosis (DKA). The initial potassium level was 5.8 mEq/L. After several hours of treatment with intravenous fluids and an insulin infusion, the patient's potassium level is now 3.2 mEq/L. What is the nurse's priority action?

Accepted Answer

Administer intravenous potassium as ordered.

Answer

Continue to monitor the patient without intervention.

Answer

Decrease the rate of the insulin infusion.

Answer

Administer a dose of sodium polystyrene sulfonate (Kayexalate).

Question 5

A patient is brought to the unit with suspected adrenal crisis (Addisonian crisis). Which of the following assessment findings would be most consistent with this diagnosis?

Accepted Answer

Hypotension, hypoglycemia, and hyperkalemia

Answer

Hypertension, hyperglycemia, and hypernatremia

Answer

Bradycardia, fluid overload, and hypokalemia

Answer

Tachycardia, hypertension, and hypercalcemia

Question 6

Which of the following is a key differentiating feature between Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS)?

Accepted Answer

The presence of significant ketosis and metabolic acidosis

Answer

The presence of severe dehydration

Answer

The degree of hyperglycemia

Answer

The level of consciousness