Nokea
The nurse is administering phosphate excreting medications to a client with hypocalcemia. The reason for administering this medication is because
- A. as phosphorus exits the body so does calcium.
- B. calcium is managed by the excretion of phosphorus.
- C. when serum phosphorus decreases, serum calcium increases.
- D. phosphorus must be above 4.5 mg/dL (1.45 mmol/L) [3.0-4.5 mg/dL,0.81-1.58 mmol/L] before calcium can increase.
Correct Answer: C
Rationale: Phosphate-excreting medications reduce serum phosphorus levels, which inversely increases serum calcium levels due to the physiological relationship between phosphorus and calcium. Options A, B, and D are incorrect as they misrepresent this relationship.
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A client was admitted to the emergency department due to low serum calcium levels. Upon further examination, the client demonstrates carpopedal spasms and reports numbness in their lips and hands. An ECG revealed a prolonged QT interval. Based on this information, the nurse should suspect which condition?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Hyperparathyroidism
- D. Hypoparathyroidism
Correct Answer: D
Rationale: Hypoparathyroidism leads to low serum calcium levels, causing symptoms like carpopedal spasms, numbness, and prolonged QT interval due to decreased parathyroid hormone.
The nurse is caring for a client who was newly prescribed warfarin. Which medication on the client's medication list requires follow-up with the primary healthcare provider (PHCP)?
- A. Loratadine
- B. Saw Palmetto
- C. Furosemide
- D. Pantoprazole
Correct Answer: B
Rationale: Saw Palmetto can interact with warfarin by potentially increasing bleeding risk due to its antiplatelet effects, requiring follow-up with the PHCP. Loratadine (A), Furosemide (C), and Pantoprazole (D) have minimal interactions with warfarin.
The nurse is caring for a client who has fluid volume deficit receiving intravenous fluids. Which of the following would indicate the client is achieving the treatment goals?
- A. urine output 20 mL/hr
- B. BUN 15 mg/dL (5.355 mmol/L) [10-20 mg/dL (3.6-7.1 mmol/L)]
- C. urine specific gravity 1.039 [1.005-1.030]
- D. flattened jugular veins
Correct Answer: B
Rationale: Normal BUN (15 mg/dL) indicates improved renal perfusion and fluid balance, suggesting effective treatment for fluid volume deficit.
The nurse is teaching a client with hypercalcemia appropriate dietary measures. Which food selections by the client would require follow-up by the nurse? Select all that apply.
- A. broccoli
- B. 2% milk
- C. whole wheat pasta
- D. bananas
- E. seafood
Correct Answer: B
Rationale: Milk is high in calcium and should be limited in hypercalcemia to prevent worsening the condition.
The nurse is caring for a client who is severely hypernatremic. The nurse should prioritize assessing the client's
- A. cardiovascular status.
- B. genitourinary status.
- C. neurological status.
- D. gastrointestinal status.
Correct Answer: C
Rationale: Hypernatremia affects neurological status due to cellular dehydration, causing confusion, seizures, or coma, requiring priority assessment.