Registered Nurse (RN) Endocrine Licensure Exam

Which statement about Diabetic Ketoacidosis (DKA) is incorrect?

1. A. DKA occurs mainly in Type 1 diabetics

2. B. Severe hypoglycemia is a hallmark sign in DKA

3. C. Ketones are present in the urine in DKA

4. D. Cheyne-stokes breathing will always be present in DKA

The correct answer is: B. Severe hypoglycemia is a hallmark sign in DKA

Severe hypoglycemia is not a hallmark sign of Diabetic Ketoacidosis (DKA). Instead, DKA is characterized by significantly high levels of blood glucose, not low. In DKA, the body experiences a profound deficiency of insulin, leading to increased glucose production and decreased utilization, which contributes to hyperglycemia. This state is compounded by the production of ketone bodies due to fat metabolism, resulting in metabolic acidosis. The presence of ketones in urine is indeed a key indicator of DKA, reflecting the body's alternative energy sources when glucose utilization is impaired. The condition does present with various signs and symptoms, including metabolic acidosis, dehydration, polyuria, and Kussmaul respirations rather than Cheyne-Stokes breathing, which is associated with other conditions. Cheyne-Stokes respiration is characterized by periods of deep, fast breathing followed by periods of no breathing, and while it could occur in some cases of severe metabolic disturbances, it is not a definitive respiratory pattern seen in DKA. Thus, highlighting the association of severe hypoglycemia with DKA is inaccurate; the opposite is true, as hyperglycemia is a defining feature of this condition.