Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What symptom is most commonly associated with hypercalcemia in a patient with primary hyperparathyroidism?

1. Diarrhea

2. Nausea

3. Dry, flaky skin

4. Brittle nails

The correct answer is: Nausea

In primary hyperparathyroidism, one of the hallmark symptoms associated with hypercalcemia is nausea. This symptom arises due to the impact of elevated calcium levels on the gastrointestinal system, leading to altered motility and sensitivity of the gastrointestinal tract. Hypercalcemia can also stimulate the activity of certain hormones and neurotransmitters that can induce feelings of nausea and may even lead to vomiting in more severe cases. The presence of nausea is significant because it not only affects the quality of life for individuals but can also serve as an indicator for healthcare providers to evaluate calcium levels and consider additional tests for parathyroid function. The understanding of symptoms like nausea helps in recognizing potential disruptions in metabolic balance due to conditions such as primary hyperparathyroidism. Other choices, while they may seem related, are not primarily associated with hypercalcemia in this context. Diarrhea can occur due to various gastrointestinal disorders but is less frequently correlated with hypercalcemia. Dry, flaky skin and brittle nails are also not typical symptoms of hypercalcemia, though they can be seen in various endocrine disorders. Therefore, understanding nausea as a key symptom helps illuminate the broader implications of calcium metabolism alterations in patients with primary hyperparathyroidism.