What can cause hyperkalemia?
Renal failure.
Polyuria.
Increased aldosterone.
Diarrhea.
The Correct Answer is A
Choice A rationale
The kidneys are the primary organs responsible for the excretion of potassium, maintaining a normal serum range of 3.5 to 5.0 mEq/L. In renal failure, the glomerular filtration rate decreases, and the tubular secretion of potassium is impaired. This leads to the retention of potassium in the extracellular fluid, resulting in hyperkalemia. Since about 90 percent of daily potassium intake is excreted via the urine, any significant decline in renal function poses a high risk.
Choice B rationale
Polyuria refers to the production of abnormally large volumes of dilute urine, which is frequently seen in conditions like diabetes insipidus or the early stages of chronic kidney disease recovery. Increased urine output typically leads to an increased loss of electrolytes, including potassium, through the renal tubules. Therefore, polyuria is more commonly associated with the development of hypokalemia, rather than hyperkalemia, as the body is losing more potassium than it is retaining or taking in.
Choice C rationale
Aldosterone is a mineralocorticoid hormone that acts on the distal tubules and collecting ducts of the kidneys to promote the reabsorption of sodium and the excretion of potassium. When aldosterone levels are increased, such as in primary hyperaldosteronism, the kidneys excessively secrete potassium into the urine. This physiological process results in a decrease in serum potassium levels, or hypokalemia, rather than the elevated levels seen in hyperkalemia, which occurs when aldosterone is deficient.
Choice D rationale
Diarrhea involves the rapid transit of intestinal contents, which are naturally rich in potassium and bicarbonate. The excessive loss of fluid and electrolytes from the gastrointestinal tract during diarrheal episodes typically leads to a significant depletion of total body potassium. Consequently, the serum potassium concentration falls below the normal range, causing hypokalemia. Hyperkalemia would only occur in this context if it triggered acute renal failure due to severe dehydration and subsequent lack of excretion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Neurologic manifestations occur when a cardiac dysrhythmia leads to decreased cerebral perfusion. When the heart beats too fast, too slow, or irregularly, cardiac output can drop significantly. This reduction in oxygenated blood flow to the brain results in symptoms like lightheadedness, dizziness, or syncope. The brain is highly sensitive to even brief interruptions in blood flow, making neurologic symptoms a common and early warning sign of a hemodynamically significant heart rhythm disturbance.
Choice B rationale
Palpitations are a subjective sensation of a racing, fluttering, or skipping heartbeat. While this is a very common symptom of a cardiac dysrhythmia, it is classified as a cardiac or sensory manifestation rather than a neurologic one. Palpitations occur because the patient becomes aware of the irregular mechanical activity of the heart within the chest wall. While they often accompany neurologic symptoms, they do not represent an impairment of the central or peripheral nervous systems.
Choice C rationale
Shortness of breath, or dyspnea, is primarily a respiratory or cardiovascular manifestation of a dysrhythmia. It occurs when an irregular heart rhythm causes blood to back up into the lungs or when the heart cannot pump enough blood to meet the body's oxygen requirements during activity. This leads to a sensation of air hunger. While the brain controls the drive to breathe, the symptom of dyspnea itself is not categorized as a direct neurologic deficit or manifestation.
Choice D rationale
Chest pain is a cardiovascular manifestation often related to myocardial ischemia. During a dysrhythmia, the heart muscle may have an increased demand for oxygen or a decreased supply due to shortened diastolic filling time and reduced coronary artery perfusion. This imbalance results in angina. Like palpitations, chest pain is a critical sign of cardiac distress but is not considered a neurologic symptom, as it originates from sensory fibers in the myocardium and chest rather than cerebral hypoperfusion.
Correct Answer is B
Explanation
Choice B rationale
Smoking cigarettes significantly increases the risk of developing peripheral neuropathy. Nicotine and other chemicals in tobacco cause vasoconstriction and damage the vascular endothelium, leading to reduced blood flow to the peripheral nerves. This chronic ischemia deprives the nerves of essential oxygen and nutrients, eventually causing nerve fiber degeneration. Furthermore, smoking increases oxidative stress, which further accelerates the damage to the myelin sheath and the axons of the peripheral nervous system. +1.
Choice A rationale
A myocardial infarction is an acute event involving the heart muscle and does not directly cause peripheral neuropathy. While the same underlying risk factors like diabetes or hypertension can cause both conditions, the heart attack itself is a localized ischemic event. Chronic poor cardiac output following a massive infarction could theoretically contribute to poor circulation, but smoking is a much more direct and potent systemic risk factor for the actual nerve damage.
Choice C rationale
Increased fruit intake is associated with a lower risk of many chronic diseases and is not a risk factor for peripheral neuropathy. In fact, many fruits are rich in vitamins, particularly the B-complex vitamins and antioxidants, which are essential for maintaining nerve health and repairing damaged tissues. A diet high in fruits and vegetables is generally protective against the oxidative damage and nutritional deficiencies that can contribute to the development of neuropathic symptoms.
Choice D rationale
Daily yoga practice is a beneficial activity that improves circulation, flexibility, and stress management. It is not a risk factor for peripheral neuropathy. Physical activity generally promotes nerve health by enhancing blood flow to the extremities and maintaining healthy glucose levels. Yoga is often recommended as a complementary therapy for people who already have neuropathy to help improve balance and reduce the discomfort associated with the condition. +1.
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