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NCLEX · Diabetes and Endocrine Care

A nurse is caring for a client in diabetic ketoacidosis (DKA). What is the priority initial treatment?

Reviewed by Jordan Morley, Editorial Lead at 247SimpleTests. Written by the 247SimpleTests Editorial Team from the official source material cited on every question.

Correct answer

IV fluids (rehydration) and IV regular insulin, with electrolyte monitoring (especially potassium)

  1. A IV fluids (rehydration) and IV regular insulin, with electrolyte monitoring (especially potassium)
  2. B Withhold all fluids
  3. C Encourage the client to eat sugar
  4. D Oral hypoglycemic agents

Why this is the answer

DIABETIC KETOACIDOSIS (DKA) — a life-threatening complication mainly of type 1 diabetes with hyperglycemia, ketosis, and metabolic acidosis — is treated with: (1) IV FLUIDS (the client is severely dehydrated — fluid replacement is a priority); (2) IV REGULAR INSULIN (the only insulin given IV — to lower glucose and stop ketone production); (3) ELECTROLYTE monitoring/replacement, especially POTASSIUM (insulin drives potassium into cells, causing hypokalemia — monitor closely and replace as needed). NCLEX physiological/endocrine. Signs of DKA: high glucose, fruity breath (acetone), Kussmaul respirations (deep/rapid breathing), nausea/vomiting, dehydration. Treat the underlying cause. Knowing DKA management (fluids, IV regular insulin, potassium monitoring) is a heavily tested NCLEX concept.
Source: NCLEX Physiological — DKA Management

Practice more questions

This question is from our NCLEX Practice Tests practice test. Take the full practice test to test your knowledge across all Diabetes and Endocrine Care and other topics.

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About this topic: Diabetes and Endocrine Care

Diabetes and endocrine questions cover hypo- and hyperglycaemia recognition and treatment, insulin types and timing, sick-day rules, DKA and HHS, and thyroid and adrenal disorders. This is one of 6 RN: Physiological Integrity questions on diabetes and endocrine care, each with a full explanation on a single study page.

New to this exam? Our NCLEX exam guide explains the format, scoring, and how to prepare.

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