Certified Medical-Surgical Registered Nurse Practice Exam

A patient on hydrochlorothiazide presents with disorientation and weakness. What condition does the patient most likely have?

1. Hypernatremia

2. Hyponatremia

3. Hyperkalemia

4. Hypokalemia

The correct answer is: Hypokalemia

The patient's symptoms of disorientation and weakness align with hypokalemia, which is characterized by low levels of potassium in the blood. Hydrochlorothiazide is a thiazide diuretic that can lead to increased excretion of potassium through the urine. This medication can sometimes cause significant potassium loss, especially if the patient is not taking potassium-sparing supplements or foods rich in potassium. In cases of hypokalemia, the reduction in potassium may lead to various neurological and muscular symptoms, including disorientation (a manifestation of altered mental status due to electrolyte imbalances) and weakness resulting from impaired muscle function. The correct identification of hypokalemia is critical in patients receiving diuretics like hydrochlorothiazide, as it can lead to serious complications if not addressed promptly. Understanding this condition is essential for proper patient management and involves monitoring electrolyte levels, providing potassium supplementation if necessary, and educating the patient about dietary sources of potassium to prevent recurrence.