Registered Nurse (RN) Endocrine Licensure Exam

This condition happens gradually and is more likely to affect older adults?

1. A. HHNS

2. B. DKA

3. C. Type 1 diabetes

4. D. Insulinoma

The correct answer is: A. HHNS

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) is indeed a condition that typically develops gradually and is more prevalent among older adults, particularly those with type 2 diabetes. In HHNS, extremely high blood sugar levels lead to severe dehydration and hyperosmolarity, but unlike Diabetic Ketoacidosis (DKA), it does not commonly involve ketosis. This gradual onset can happen over days or even weeks, allowing time for the body's adaptive mechanisms to falter, particularly in older patients who may have underlying health issues or impaired physiological responses. Type 1 diabetes usually presents more suddenly, especially in younger populations, due to the acute lack of insulin production. Insulinoma, a rare tumor of the pancreas that secretes insulin, can cause episodes of hypoglycemia but does not present with the gradual onset of symptoms typical of HHNS. DKA is more acute and is often seen in individuals with type 1 diabetes due to their inability to produce insulin leading to rapid onset of symptoms related to metabolic acidosis. Given these characteristics, the gradual progression and older adult predominance make HHNS the fitting choice for this question.