ACCS Practice Exam 2025 – Complete Test Preparation Guide

In a patient with elevated glucose levels, such as 534 mg/dL, along with symptoms of excessive thirst (polydipsia) and excessive urination (polyuria), the presentation is suggestive of diabetic ketoacidosis (DKA). In DKA, the body begins to break down fats for energy due to a lack of insulin, leading to the production of ketone bodies. These ketones are acidic, resulting in an accumulation of acid in the blood, which causes metabolic acidosis.

Metabolic acidosis can be characterized by a decrease in blood pH due to the accumulation of these organic acids. This condition is often associated with compensatory mechanisms, such as hyperventilation, as the body tries to increase oxygen intake to balance the acid-base status, but the primary issue lies in the production of excess acids.

The other potential imbalances do not fit this scenario. Respiratory acidosis typically occurs due to impaired gas exchange or respiratory depression, metabolic alkalosis tends to be caused by excessive vomiting or diuretic use, and respiratory alkalosis usually arises from hyperventilation. In this case, the specific context of high glucose levels and symptomatic signs strongly points to metabolic acidosis as the expected acid-base imbalance.