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NCLEX Question of the Day

July 18, 2026 Physiological Adaptation

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Physiological Adaptation QID 78

A patient with chronic renal failure is experiencing secondary hyperparathyroidism. The nurse understands that this condition occurs due to which underlying mechanism?

  1. Correct answer Low calcium levels due to impaired calcium absorption and phosphate retention stimulating parathyroid hormone secretion.

  2. Underproduction of thyroid hormone leading to compensatory parathyroid hormone secretion.

  3. High calcium levels suppressing parathyroid hormone secretion.

  4. Overproduction of parathyroid hormone due to an adenoma.

Rationale

In chronic renal failure, the kidneys are less able to convert vitamin D to its active form, which impairs calcium absorption from the gastrointestinal tract. Additionally, phosphate retention occurs due to decreased renal excretion. The low calcium levels and high phosphate levels stimulate the parathyroid glands to secrete parathyroid hormone (PTH) in an attempt to increase calcium levels, leading to secondary hyperparathyroidism.

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