ARRT Patient Care Practice Exam

Which symptoms are indicative of impending diabetic coma?

1. Increased urination and sweet smelling breath only

2. Increased urination and extreme thirst only

3. Sweet smelling breath and extreme thirst only

4. Increased urination, sweet smelling breath, and extreme thirst

The correct answer is: Increased urination and extreme thirst only

The symptoms indicative of impending diabetic coma, particularly in the context of diabetic ketoacidosis (DKA), include increased urination, sweet smelling breath (often described as fruity due to the presence of acetone), and extreme thirst. These symptoms arise due to the body's attempt to eliminate excess glucose and ketones, which accumulate due to insufficient insulin. When a person experiences increased urination, it is often a result of hyperglycemia (high blood sugar levels) that leads to osmotic diuresis, where excess glucose in the urine draws more water out of the body. Extreme thirst, or polydipsia, occurs as the body tries to counteract dehydration caused by increased urination. The presence of sweet smelling breath signals ketoacidosis, where the body starts breaking down fat for energy in the absence of sufficient glucose, leading to the formation of ketones. The collective presence of all these symptoms suggests a critical state of health where immediate medical attention is necessary. Choosing only two symptoms, as seen in the incorrect options, does not encompass the full clinical picture necessary to indicate impending diabetic coma. In this case, the correct answer reflects the comprehensive symptomatology that healthcare providers should monitor in patients at risk for this serious condition.