Nokea
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct Answer: C
Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration.
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When the nurse reads in the drug handbook the section related to recommended dosage, it is important to remember that this suggested dosage is based on what?
- A. A 40-year-old man
- B. An average-sized adult
- C. A 150-pound adult male
- D. A healthy young adult
Correct Answer: B
Rationale: Recommended dosages are typically based on an average-sized adult, not specific age, weight, or health status unless specified.
An disorder develops lactic acidosis, and nearly dies, as a result of an uncommon but serious adverse response to therapy with an 'endocrine' drug. Which of the following was the most likely cause of this severe problem?
- A. Insulin glargine, prescribed for Type 1 diabetes mellitus
- B. Levothyroxine, prescribed to maintain euthyroid status following thyroidectomy
- C. Metformin, prescribed for Type 2 diabetes mellitus
- D. Propylthiouracil, prescribed for hyperthyroidism
Correct Answer: C
Rationale: Metformin is the most likely cause of lactic acidosis, a rare but life-threatening complication.
All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding:
- A. Potential for causing life-threatening GI bleeds
- B. Increased risk of developing systemic arthritis with prolonged use
- C. Risk of life-threatening rashes, including Stevens-Johnson
- D. Potential for transient changes in serum glucose
Correct Answer: A
Rationale: NSAIDs carry a Black Box Warning for GI bleeding risk; rashes or glucose aren't highlighted.
The nurse is caring for a patient who is receiving gentamicin, 250 mg and fluconazole (Diflucan), 500 mg at the same time. The nurse knows that if these two drugs competed with each other for protein-binding sites, what would this do?
- A. Make the patient gentamicin deficient
- B. Make the patient fluconazole deficient
- C. Counteract any positive benefit the drugs would have
- D. Alter the effectiveness of both drugs
Correct Answer: D
Rationale: Some drugs compete with each other for protein-binding sites, altering effectiveness or causing toxicity when the two drugs are given together. Nothing in the scenario would indicate that the patient would be either Gentamicin or Diflucan deficient, nor does it indicate that these drugs cannot be given together because they would counteract each other.
The role of the NP in the use of herbal medication is to:
- A. Maintain competence in the prescribing of common herbal remedies
- B. Recommend common over-the-counter herbs to patients
- C. Educate patients and guide them to appropriate sources of care
- D. Encourage patients to not use herbal therapy due to the documented dangers
Correct Answer: C
Rationale: NPs should educate patients and guide them to safe herbal use, not universally discourage it.