Nursing Acceleration Challenge Exam (NACE) PN-RN Practice Test

A poorly controlled diabetic patient is likely to have which electrolyte imbalance when presenting with dry mucous membranes and high serum glucose?

1. Hyponatremia

2. Hypernatremia

3. Hypokalemia

4. Hyperkalemia

The correct answer is: Hypernatremia

A poorly controlled diabetic patient presenting with dry mucous membranes and high serum glucose is likely experiencing hypernatremia. This condition occurs due to the osmotic effects of elevated glucose levels in the blood. When serum glucose is high, it can lead to osmotic diuresis, where the kidneys excrete excess glucose along with water. This results in a net loss of water and can lead to dehydration, which is reflected in the dry mucous membranes observed in the patient. As dehydration progresses, the concentration of sodium in the serum increases, leading to hypernatremia. Elevated sodium levels can have significant physiological effects, including increasing the risk of neurological deficits, as it can disrupt cellular function and fluid balance. While other electrolytes might fluctuate in response to the metabolic changes associated with uncontrolled diabetes, the primary concern in the scenario described focuses on the loss of water relative to sodium levels, resulting in hypernatremia.