All of the following are true for diabetic ketoacidosis, except:

IGNOU PB Bsc Nsg.Entrance-2026

Medical & Surgical Nursing

Easy

Appeared in: IGNOU PB Bsc Nsg.Entrance-2026

Explanation

The defining characteristic of Diabetic Ketoacidosis (DKA) is an absolute or relative deficiency of insulin.
This lack of insulin prevents cells from using glucose, leading to hyperglycemia and the breakdown of fat for energy.
The breakdown of fat produces acidic byproducts called ketones, leading to metabolic acidosis.
An excess of insulin would lead to hypoglycemia (low blood sugar), which is the opposite of the hyperglycemic state seen in DKA.

Option B: Kussmaul's respiration is a classic and expected sign of DKA. It is a compensatory mechanism where the body attempts to correct metabolic acidosis by breathing deeply and rapidly to blow off excess carbon dioxide.
Option C: Intravenous (IV) infusion of 0.45% Normal Saline (half-normal saline) is a part of the standard fluid resuscitation protocol for DKA. After initial stabilization with 0.9% NS, 0.45% NS is often used to correct total body water deficits.
Option D: Checking the pH of the blood is a critical intervention in managing DKA. DKA causes metabolic acidosis, so monitoring the arterial pH (often below 7.3) is essential to guide therapy and assess the patient's response to treatment.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology and management of Diabetic Ketoacidosis (DKA) as background academic context rather than a clinical decision trigger.
A nurse must be able to quickly differentiate between DKA (hyperglycemia) and hypoglycemia, as their treatments are opposite and a mistake can be fatal. DKA requires insulin; severe hypoglycemia requires glucose.
The nurse's role in DKA management is critical, involving meticulous monitoring of vital signs, neurological status, blood glucose, electrolytes, and fluid balance, as well as administering IV fluids and insulin infusions as prescribed.
What if the patient was found unconscious with a fruity odor on their breath? The nurse should immediately suspect DKA, check a finger-stick blood glucose (which would be high), and prepare for emergency management including IV access for fluids and insulin.

How to Approach the Question

First, identify the core concept: Diabetic Ketoacidosis (DKA).
Recognize the negative framing of the question, indicated by the word "except". This means you are looking for the one option that is FALSE or inconsistent with DKA.
Evaluate each option based on your knowledge of DKA's pathophysiology and treatment.
Option A: Does DKA involve excess insulin? No, it's caused by a lack of insulin.
Option B: Is Kussmaul's respiration seen in DKA? Yes, it's a compensatory response to acidosis.
Option C: Is 0.45% NS used in DKA treatment? Yes, it's part of the fluid resuscitation plan.

Concept Tested & Keywords

Concept Tested: Pathophysiology and management of Diabetic Ketoacidosis (DKA)
Stem keywords: diabetic ketoacidosis, true
Lead-in keywords: except
Negative lead-in flag: The question asks for the statement that is NOT true, which requires identifying the exception among the given options.

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