sandra
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2. A 10-year-old girl is brought to the emergency department because of diffuse, aching abdominal
pain, nausea, and recurrent vomiting over the past 5 hours. She has an 8-year history of type 1
diabetes mellitus treated with 20 U of NPH and 6 U of regular insulin in the morning and 14 U of
NPH and 5 U of regular insulin in the evening. She appears lethargic but is easily arousable. There is
an obvious odor of ketones on her breath. Her blood pressure is 100/70 mm Hg, pulse is 95/min,
and respirations are 20/min and deep. Serum studies show:
Na+ 142 mEq/L
K+ 5.3 mEq/L
HCO3– 6 mEq/L
Glucose 710 mg/dL
Which of the following laboratory findings is most likely to be increased?
A ) Arterial pH
B ) Serum C-peptide level
C ) Serum magnesium level
D ) Serum osmolality
E ) Serum phosphorus level
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