Registered Nurse (RN) Endocrine Licensure Exam

What is the primary physiological disturbance in DKA?

1. A. Hyperglycemia

2. B. Hyponatremia

3. C. Hypokalemia

4. D. Lactic acidosis

The correct answer is: A. Hyperglycemia

In diabetic ketoacidosis (DKA), the primary physiological disturbance is hyperglycemia. In this condition, patients typically experience elevated blood glucose levels due to insufficient insulin, which is necessary for glucose uptake by cells. Without adequate insulin, the body cannot effectively utilize glucose for energy, leading to an accumulation of glucose in the bloodstream. As the glucose levels rise, the body begins to break down fat as an alternative energy source, resulting in the production of ketone bodies. This metabolic process contributes to the ketoacidosis aspect of the condition, where the accumulation of ketones leads to a decrease in blood pH. Although other imbalances, such as electrolyte abnormalities and possible metabolic acidosis, can occur as a result of DKA, hyperglycemia is the foundational disturbance that initiates the cascade of events leading to the clinical presentation of DKA.