HESI Registered Nurse EXIT Practice Exam

Which condition may indicate the need for hospitalization in a patient with diabetes?

1. Minor foot sores

2. Consistent blood sugar readings under control

3. Development of diabetic ketoacidosis

4. Mild fatigue requiring extra rest

The correct answer is: Development of diabetic ketoacidosis

The condition that indicates the need for hospitalization in a patient with diabetes is the development of diabetic ketoacidosis (DKA). DKA is a serious and potentially life-threatening complication that occurs primarily in individuals with type 1 diabetes, though it can also occur in those with type 2 diabetes under conditions of severe stress or illness. It arises when the body is unable to produce enough insulin, leading to a buildup of ketones in the bloodstream due to the breakdown of fats for energy. This results in dangerously high blood sugar levels, electrolyte imbalances, and acidosis. Patients exhibiting signs of DKA typically experience symptoms such as excessive thirst, frequent urination, nausea, abdominal pain, and a characteristic fruity smell on their breath. Immediate medical intervention is crucial to manage DKA effectively, often necessitating hospitalization for intravenous fluids, insulin therapy, and close monitoring of vital signs and blood glucose levels. In contrast, minor foot sores, while requiring care and monitoring, usually do not necessitate hospitalization unless there are signs of infection or complications. Consistent blood sugar readings well-controlled indicate effective diabetes management, and mild fatigue, while a common symptom among diabetes patients, typically does not warrant inpatient care unless it is extreme or unexpected and associated with other clinical concerns.