Registered Practical Nurse (RPN) Practice Test

In a client with a diagnosis of bulimia, which laboratory abnormality should be most concerning?

1. Hyperkalemia

2. Hypokalemia

3. Hypernatremia

4. Hypoglycemia

The correct answer is: Hypokalemia

In the context of bulimia, hypokalemia is particularly concerning due to its association with electrolyte imbalances that can occur from repeated vomiting, a common behavior in individuals with this disorder. When a person with bulimia engages in purging behaviors, they can lose significant amounts of potassium through vomiting. Low potassium levels can lead to serious complications, including cardiac arrhythmias, muscle weakness, and overall disturbances in cardiac function. Monitoring potassium levels is crucial for individuals with bulimia because any notable decrease can have immediate and severe consequences on heart health. Furthermore, hypokalemia is often symptomatic of underlying issues in this population, such as inadequate nutritional intake or inappropriate compensatory behaviors aimed at weight control. Although other imbalances like hyperkalemia or changes in sodium or glucose levels can also arise in different contexts or conditions, they are not as directly linked to the typical presentation and immediate risks associated with bulimia. Thus, hypokalemia stands out as the most critical laboratory abnormality to monitor in these patients.