NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is the primary cause of Hyperosmolar hyperglycemic state (HHS)?

  1. Illness leading to less fluid intake

  2. Excessive insulin administration

  3. Low blood sugar

  4. Ketosis

The correct answer is: Illness leading to less fluid intake

In Hyperosmolar hyperglycemic state (HHS), the primary cause is typically a combination of illness leading to reduced fluid intake, resulting in dehydration. This dehydration leads to increased blood sugar levels without significant ketosis, which distinguishes HHS from diabetic ketoacidosis (DKA). Excessive insulin administration (Choice B) is more commonly associated with hypoglycemia rather than HHS. Low blood sugar (Choice C) is indicative of hypoglycemia, which is the opposite of the condition seen in HHS. Ketosis (Choice D) is a hallmark feature of diabetic ketoacidosis (DKA), not HHS.

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