Insulin forces which electrolyte out of the plasma and into the cells?
Calcium
Potassium
Magnesium
Sodium
The Correct Answer is B
Choice A reason: Calcium levels in plasma are primarily regulated by parathyroid hormone and vitamin D, not insulin. Insulin has minimal direct effect on calcium transport into cells. Calcium is critical for bone health and muscle function, but its movement is not significantly influenced by insulin’s action on cellular membranes.
Choice B reason: Insulin promotes potassium uptake into cells by activating the sodium-potassium ATPase pump, particularly in muscle and liver cells. This shifts potassium from plasma to intracellular spaces, lowering serum levels. This mechanism is critical in managing hyperkalemia, as insulin facilitates potassium movement alongside glucose, stabilizing membrane potentials.
Choice C reason: Magnesium is regulated by renal and gastrointestinal mechanisms, not directly by insulin. While insulin may indirectly influence magnesium via metabolic effects, it does not actively drive magnesium into cells like potassium. Magnesium is essential for enzymatic reactions, but its plasma levels are not significantly altered by insulin.
Choice D reason: Sodium is primarily regulated by aldosterone and the renin-angiotensin system, not insulin. Insulin does not directly force sodium into cells but may influence sodium-potassium ATPase indirectly. Sodium’s extracellular role in fluid balance is distinct from insulin’s intracellular potassium transport, making it an incorrect choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Gout results from hyperuricemia, leading to urate crystal deposition in joints. A 45-year-old male with obesity (BMI 40) has increased purine turnover, elevating uric acid. Hydrochlorothiazide reduces urate excretion, and aspirin impairs renal uric acid clearance, significantly increasing gout risk, making this patient the most susceptible due to multiple risk factors.
Choice B reason: Bulimia may cause electrolyte imbalances, but it is not strongly linked to hyperuricemia or gout. A BMI of 24 is normal, reducing obesity-related purine production. This 39-year-old female has fewer gout risk factors compared to an obese male on medications that elevate uric acid, making her less likely to develop gout.
Choice C reason: Ulcerative colitis may cause systemic inflammation, but it is not a direct risk factor for gout. Hyperuricemia is not typically associated with inflammatory bowel diseases unless complicated by other factors like diuretic use. This 27-year-old female has a lower gout risk compared to the obese male with predisposing medications.
Choice D reason: Limiting purine-rich foods like smoked meat and cheeses reduces uric acid production, lowering gout risk. This 56-year-old male’s dietary habits mitigate hyperuricemia, making him the least likely to develop gout compared to the obese patient on medications that impair uric acid metabolism and excretion.
Correct Answer is A
Explanation
Choice A reason: Crush injuries release myoglobin from damaged muscles, causing rhabdomyolysis. Myoglobin precipitates in renal tubules, obstructing them and leading to acute tubular necrosis, an intra-renal acute kidney injury. This toxic effect, combined with oxidative stress, impairs filtration, making this statement accurate for the pathophysiology of renal injury.
Choice B reason: Large IV fluid volumes are used to prevent renal injury in rhabdomyolysis by diluting myoglobin and maintaining perfusion. Fluid overload may cause pulmonary edema but does not typically cause pre-renal damage, which results from hypoperfusion. This statement is inaccurate, as fluids are protective, not harmful.
Choice C reason: Pain medications like NSAIDs can be nephrotoxic, causing intra-renal damage by reducing renal blood flow or causing interstitial nephritis. However, pre-renal damage results from hypoperfusion, not direct toxicity. In crush injuries, myoglobin is the primary cause, making this statement less accurate than myoglobin-related tubular damage.
Choice D reason: Significant blood loss causes pre-renal injury by reducing renal perfusion, not post-renal damage, which involves urinary obstruction. Crush injuries primarily cause intra-renal damage via myoglobin. This statement is inaccurate, as it misattributes the mechanism and type of renal injury in this context.
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