1. Which of the following patients is MOST LIKELY experiencing Hyperglycemic Hyperosmolar Nonketotic Syndrome based on their symptoms?
A. A 72 year old with a health history of diabetes who has a blood glucose of 300 mg/dL and is complaining of thirst and frequent urination.
B. A 66 year old with type I diabetes that has ketones present in their urine.
C. A 69 year old admitted with an infection of the right foot with a health history of diabetes that reports missing several doses of Metformin and has a blood glucose of 600 mg/dL.
D. A 6 year old that is presenting with polyuria, polydipsia, abdominal pain, and vomiting.
2. Which of the following is NOT a typical finding in HHNS?
A. Dehydration
B. Blood pH <7.35
C. Mental status changes
D. Osmotic diuresis
Treatment of Hyperglycemic Hyperosmolar Nonketotic Syndrome is similar to the treatment of Diabetic Ketoacidosis.
4. A patient is being discharged home after recovering from HHNS. Which statement by the patient requires patient re-education about this condition?
A. “I will monitor my blood glucose levels regularly.”
B. “This condition happens suddenly without any warning signs.”
C. “If I become sick I will monitor my blood glucose more frequently and drink lots of fluids.”
D. “It is important I take my medication as prescribed.”
DKA and HHNS mainly occur in type 2 diabetics.
Hypertonic fluids, such as 3% saline, are the first line of treatment to correct dehydration in HHNS.
7. Which of the following statements is INCORRECT about Hyperglycemic Hyperosmolar Nonketotic Syndrome?
A. HHNS occurs mainly in type 2 diabetics.
B. This condition presents without ketones in the urine.
C. Metabolic alkalosis presents in severe HHNS.
D. Intravenous Regular insulin is used to treat hyperglycemia.
8. A patient undergoing treatment for Hyperglycemic Hyperosmolar Nonketotic Syndrome has a blood glucose of 799. The doctor has ordered intravenous fluids and intravenous Regular insulin therapy. Which of the following findings causes concern before starting insulin therapy?
A. Regular insulin cannot be given intravenously; therefore, the nurse needs to clarify the doctor’s order.
B. The patient’s potassium level is 3.1.
C. The patient is complaining of severe thirst and has dry mucous membranes.
D. The patient is confused and drowsy.
