Free BCEN Certified Emergency Nurse (CEN) Practice Question

The correct answer is Diabetic Ketoacidosis (DKA). This patient presents with classic symptoms of DKA: nausea, vomiting, and abdominal pain. The high blood glucose (485 mg/dL) and low arterial pH (7.21) are hallmark signs of DKA. In DKA, the body cannot use glucose for energy due to insulin deficiency, leading to the breakdown of fats and the production of ketones, which causes metabolic acidosis.

Hyperosmolar Hyperglycemic State (HHS) typically has even higher glucose levels (often >600 mg/dL) and less severe acidosis. Hypoglycemia would present with a low blood glucose, not high. Lactic acidosis, while it can cause a low pH, doesn't typically present with such high glucose levels and is more commonly associated with severe illness, shock, or certain medications.