A 45-year-old man with a history of poorly controlled type 2 diabetes mellitus presents with generalized weakness and muscle cramps. His laboratory results show: Na 138 mEq/L, K 6.8 mEq/L, Cl 102 mEq/L, HCO3 20 mEq/L, BUN 45 mg/dL, Cr 3.2 mg/dL. ECG shows peaked T waves. Which of the following is the most appropriate immediate intervention?

The correct answer to the question "A 45-year-old man with a history of poorly controlled type 2 diabetes mellitus presents with generalized weakness and muscle cramps. His laboratory results show: Na 138 mEq/L, K 6.8 mEq/L, Cl 102 mEq/L, HCO3 20 mEq/L, BUN 45 mg/dL, Cr 3.2 mg/dL. ECG shows peaked T waves. Which of the following is the most appropriate immediate intervention?" is Option D: Administer intravenous calcium gluconate.

The other options — A) Administer intravenous insulin and dextrose, B) Administer oral sodium polystyrene sulfonate, C) Initiate a continuous intravenous normal saline infusion — are incorrect for this USMLE Exam Prep question. As explained above: Intravenous calcium gluconate is the immediate intervention for severe hyperkalemia with ECG changes (peaked T waves) to stabilize the cardiac membrane and prevent life-threatening arrhythmias. Insul…