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5 Hyperosmolar Hyperglycemic State Online Quiz Questions

Use this free practice quiz with 20 questions to review 5 Hyperosmolar Hyperglycemic State, test your knowledge, and prepare for your next test or exam.

20 questions

True or false

1 point

HHS is typically characterized by severe hyperglycemia and dehydration with little or no significant ketoacidosis.

A
True
B
False

Fill in the blank

1 point

A patient with HHS has a potassium level of 3.1 mmol/L before insulin treatment. Under a monitored protocol, replace and defer insulin until the level is above 3.5 mmol/L.

Written response

1 point

Name one medication-related precipitant of HHS described in the material.

Choose one

1 point

A patient with suspected HHS is hypotensive and markedly dehydrated, with no known heart or kidney failure. Which intervention is generally prioritized while the emergency team evaluates the patient?

A
Begin isotonic intravenous crystalloid fluid replacement and reassess frequently
B
Give rapid-acting insulin without checking potassium
C
Restrict fluids
D
Give oral fluids only

Choose all

1 point

Which actions are useful early in the assessment of suspected HHS? Select all that apply.

A
Assess airway, breathing, circulation, vital signs, mental status, and hydration or perfusion
B
Measure blood glucose, electrolytes, renal function, ketones, and venous blood gas
C
Check serum osmolality and urine output
D
Assess for a possible trigger such as infection, myocardial infarction, or stroke
E
Delay evaluation until the patient can drink fluids

True or false

1 point

After IV fluids are started for HHS, glucose falls and measured sodium rises modestly. Is the sodium rise alone an automatic reason to switch to hypotonic fluid?

A
True
B
False

Fill in the blank

1 point

Older adults and people with heart or kidney disease may need smaller fluid boluses and more frequent to reduce the risk of fluid overload.

Written response

1 point

During initial HHS treatment, about how many hours apart should serum osmolality, electrolytes, and renal function be reassessed?

Choose one

1 point

For an adult with HHS who has no cardiac or renal compromise, which initial isotonic fluid approach is described in the guidance?

A
500–1,000 mL/hour for the first 2–4 hours, with adjustment to clinical status
B
A fixed 100 mL/hour for every patient, without reassessment
C
No IV fluids until glucose is below 600 mg/dL
D
Rapid oral fluid intake instead of IV fluids

Open ended

1 point

A 76-year-old with type 2 diabetes has several days of thirst and frequent urination followed by confusion. Results show glucose 720 mg/dL, sodium 148 mmol/L, β-hydroxybutyrate 1.2 mmol/L, pH 7.36, and bicarbonate 21 mmol/L. Which diagnosis best fits, and what do the findings suggest?

Choose one

1 point

For an older adult with HHS and heart or kidney disease, how may the IV fluid plan need to be adjusted to reduce the risk of fluid overload?

A
Give the usual fluid amount without adjustment and reassess only after several hours.
B
Use smaller fluid boluses and reassess more frequently.
C
Avoid IV fluids until hyperglycemia has resolved.
D
Give oral fluids only, regardless of the patient's condition.

True or false

1 point

HHS and DKA are mutually exclusive diagnoses, so a patient cannot have features of both.

A
True
B
False

Choose one

1 point

A patient with suspected HHS arrives confused and markedly dehydrated. Which initial approach best supports a safe and useful assessment?

A
Assess airway, breathing, circulation, vital signs, mental status, hydration and perfusion; obtain relevant blood tests and assess for a precipitating cause
B
Check glucose only, then wait to assess mental status until glucose has fallen
C
Delay laboratory testing until the patient can drink fluids
D
Assess hydration but avoid checking renal function or ketones

Written response

1 point

Below what potassium threshold should insulin be delayed while potassium is replaced under a monitored protocol?

Choose one

1 point

During treatment, a patient's glucose falls while measured sodium rises modestly. Which interpretation is most appropriate?

A
A modest rise can occur as glucose falls; assess fluid balance and the osmolality trend rather than switching fluids reflexively
B
Any sodium rise proves HHS has resolved
C
A sodium rise always requires immediate hypotonic fluid
D
A sodium rise means insulin must not be given

Choose one

1 point

Which monitoring plan best supports safe treatment of an adult with HHS?

A
Check glucose every 1–2 hours; reassess vital signs, mental status, fluid balance, and urine output; repeat electrolytes, renal function, and osmolality about every 4 hours initially
B
Check glucose once daily and stop fluids once it falls below 600 mg/dL
C
Monitor glucose only because laboratory tests are unnecessary after the first blood draw
D
Avoid tracking urine output and repeat laboratory tests only if symptoms worsen

Written response

1 point

Consensus guidance gives a general upper-end limit range for glucose decline in HHS of 90–120 mg/dL per hour. What is the upper-end value of that range?

Choose one

1 point

An older adult with HHS also has heart failure and kidney disease. How should the fluid plan generally be adapted to reduce the risk of fluid overload?

A
Use smaller fluid boluses and reassess more frequently
B
Give the same fluid volume without reassessment because age and comorbidities do not affect fluid risk
C
Avoid all IV fluids
D
Switch automatically to oral fluids

Choose all

1 point

After initial stabilization, which factors are examples of possible precipitating causes that the care team may investigate? Select all that apply.

A
Infection
B
Myocardial infarction
C
Stroke
D
Missed or insufficient diabetes medication
E
A modest sodium rise as glucose falls

Choose one

1 point

An adult has been diagnosed with HHS. Which care setting is appropriate for managing this medical emergency?

A
Arrange emergency hospital evaluation and treatment.
B
Manage the condition at home and seek routine follow-up.
C
Wait for the patient to become able to drink before seeking care.

5 Hyperosmolar Hyperglycemic State Online Quiz Questions

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