Practice Question
Which of the following can be a cause of metabolic acidosis with an anion gap >16? (Select all that apply)
Answer Choices:
Correct Answer:
Salicylate toxicity
Rationale:
Salicylate toxicity
🟤 Salicylates increase production of organic acids, raising the anion gap.
🟤 Early respiratory alkalosis shifts to metabolic acidosis as salicylate levels rise.
🟤 The accumulation of acids overwhelms the buffering system.
🟤 This is a well-known cause of high-anion-gap metabolic acidosis.
🟤 Therefore, salicylate toxicity is a correct choice.
Diabetic ketoacidosis
🟤 DKA results from the breakdown of fat, producing ketone acids (beta-hydroxybutyrate, acetoacetate).
🟤 Ketones accumulate, raising the anion gap significantly.
🟤 DKA is a classic high-anion-gap metabolic acidosis.
🟤 The acidosis persists until insulin therapy halts ketone production.
Lactic acidosis
🟤 Lactic acid builds up during hypoxia, sepsis, shock, or liver failure.
🟤 Excess lactate increases the anion gap dramatically.
🟤 The body cannot buffer the acid load quickly enough.
🟤 This is one of the most common causes of high-anion-gap metabolic acidosis.
. Continuous NG suction
🟤 NG suction causes loss of hydrochloric acid, leading to metabolic alkalosis, not acidosis.
🟤 It reduces hydrogen ion concentration, raising pH.
🟤 There is no anion-gap widening because this is a chloride-responsive alkalosis.
🟤 This option contradicts basic acid–base physiology.
Repetitive vomiting
🟤 Vomiting removes stomach acid, causing metabolic alkalosis.
🟤 It cannot produce metabolic acidosis or increase the anion gap.
🟤 Hydrogen ions are lost rather than retained.
🟤 This option reflects chloride-loss alkalosis, not acidosis.
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This question is from SDAP FALL 25 EXAM2 which contains 34 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Medical-Surgical
- Answer Choices: 5