Nokea
Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
- A. Protein
- B. Calcium
- C. Iron
- D. Vitamin K
Correct Answer: C
Rationale: Calcium carbonate binds to iron, forming insoluble complexes that reduce iron absorption.
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A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) with plastic measuring caps. How much should the nurse teach the client to take at home?
- A. 1/2 tsp
- B. 1 tsp
- C. 2 tsp
- D. 1 tbsp
Correct Answer: C
Rationale: 10 mL equals 2 teaspoons (1 tsp = 5 mL), the correct household measure for patient teaching.
Patients who are being treated with epoetin alfa need to be monitored for the development of:
- A. Thrombocytopenia
- B. Neutropenia
- C. Hypertension
- D. Gout
Correct Answer: C
Rationale: Epoetin alfa can cause hypertension by increasing red cell mass; blood count issues or gout are less common.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct Answer: B
Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?
- A. Patients with kidney stones
- B. Pregnant patients
- C. Patients with heartburn
- D. Postmenopausal women
Correct Answer: A
Rationale: Calcium carbonate can worsen kidney stones; it's generally safe in pregnancy or heartburn without special caution.
Monitoring of a patient on gabapentin to treat seizures includes:
- A. Routine therapeutic drug levels every 3 to 4 months
- B. Assessing for dermatologic reactions, including Steven's Johnson
- C. Routine serum electrolytes, especially in hot weather
- D. Recording seizure frequency, duration, and severity
Correct Answer: D
Rationale: Monitoring seizure activity is key to assessing gabapentin efficacy.