Symptoms of hypokalemia are all of the following EXCEPT:

Appeared in: IGNOU PB. Bsc. Nsg. Entrance-2025

Explanation

Cough is a protective respiratory reflex to clear the airways and is not a clinical manifestation of an electrolyte imbalance like hypokalemia.
The primary effect of hypokalemia on the respiratory system is muscle weakness, which leads to shallow breathing and diminished breath sounds, not an active cough.
Causes of cough are typically related to infections, allergies, irritants, or fluid in the lungs, none of which are directly caused by low potassium levels.

Option A: Skeletal muscle weakness is a hallmark symptom of hypokalemia. Low potassium levels hyperpolarize the resting membrane potential of muscle cells, making them less excitable and leading to weakness.
Option B: Constipation is a common gastrointestinal symptom of hypokalemia. The condition impairs smooth muscle function, leading to decreased peristalsis and potentially a paralytic ileus.
Option D: Flaccid paralysis is a sign of severe hypokalemia. As potassium levels drop significantly, the profound muscle weakness can progress to paralysis, often starting in the lower extremities.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of hypokalemia as background academic context rather than a clinical decision trigger.
Nurses must monitor for signs of hypokalemia in at-risk patients, such as those taking potassium-wasting diuretics (e.g., furosemide), those with diarrhea or vomiting, or those with poor nutritional intake.
Early recognition of muscle weakness, constipation, and cardiac changes is critical to prevent severe complications like paralysis and life-threatening arrhythmias.
Patient education should include dietary sources of potassium and the signs and symptoms of hypokalemia to report.

How to Approach the Question

First, identify the core concept of the question, which is the symptoms of hypokalemia.
Note the keyword 'EXCEPT'. This means you are looking for the option that is NOT a symptom of hypokalemia.
Review each option and evaluate if it is a known manifestation of low potassium.
Option A (Skeletal muscle weakness), Option B (Constipation), and Option D (Flaccid paralysis) are all related to the effect of low potassium on muscle function (skeletal and smooth).
Option C (Cough) is a respiratory reflex and is not caused by electrolyte imbalances.
Therefore, the option that does not fit with the pathophysiology of hypokalemia is the correct answer.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 381-383

E6 Medicine Harrison 22e Part 1 p. 397-399

Practise the full IGNOU PB. Bsc. Nsg. Entrance-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.