Which of the following symptoms is indicative of hyperkalemia?

Muscle twitching and confusion are symptoms indicative of hyperkalemia, which is an elevated level of potassium in the blood. Hyperkalemia affects the neuromuscular and cardiovascular systems due to the critical role potassium plays in muscle contractions and nerve function. Elevated potassium levels can lead to increased neuromuscular excitability, causing muscle twitching. Moreover, as the potassium affects the heart's electrical activity, it can also lead to alterations in mental status, such as confusion, due to the effects on CNS function and oxygenation during severe electrolyte imbalances.

Other symptoms associated with hyperkalemia can include abnormal heart rhythms and weakness. While nausea and vomiting can occur with many medical conditions, they are not specific to hyperkalemia. Similarly, an increased heart rate is often seen in conditions such as hypokalemia or in response to stress or pain, making it less indicative of hyperkalemia. Dry skin is not typically associated with electrolyte imbalances but may point to dehydration or other dermatological conditions. Thus, muscle twitching and confusion are the most connected symptoms to hyperkalemia due to the physiological effects of excessive potassium on muscle and nerve function.