Progressive Care Nursing Certification (PCCN) Practice Exam

Which electrolyte imbalance is commonly associated with acute tubular necrosis?

1. Hyponatremia

2. Hypokalemia

3. Hypophosphatemia

4. Hypouricemia

The correct answer is: Hyponatremia

Acute tubular necrosis (ATN) often leads to a state of renal insufficiency where the kidneys are unable to adequately filter waste products from the blood, which can result in various electrolyte imbalances. Hyponatremia, characterized by low sodium levels in the blood, can often occur in ATN due to the impaired renal function preventing the proper reabsorption and excretion of sodium. The kidneys typically play a crucial role in regulating sodium levels, and when they are damaged, as in ATN, sodium may not be reabsorbed adequately, leading to its depletion in the serum. In contrast, hypokalemia, hypophosphatemia, and hypouricemia are less commonly associated with ATN. In fact, hyperkalemia (elevated potassium) is more frequently observed in ATN due to the inability of the kidneys to excrete potassium effectively. Likewise, while hypophosphatemia could occur due to various reasons, it is not a primary feature of ATN, since phosphate levels may actually elevate due to the metabolic disturbances resulting from impaired filtration. Hypouricemia is also not a common association since uric acid levels can rise in kidney injury scenarios. Understanding these associations can help in the clinical management