Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dl (1.4 mmol/L). Which action is most important for the nurse to take?

Reference Range:

Total Calcium 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L)
A. Notify the healthcare provider immediately

B.Administer a calcium supplement as ordered by the healthcare provider

C. Administer the medication with a glass of milk.

D. Begin tapering the drug dose per protocol.

Notify the healthcare provider immediately

Administer a calcium supplement as ordered by the healthcare provider

Administer the medication with a glass of milk.

Begin tapering the drug dose per protocol.

Answer and Explanation

The Correct Answer is A

A) A total calcium level of 5.5 mg/dL (1.4 mmol/L) is critically low, as the normal reference range for total calcium is between 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L). Hypocalcemia can lead to serious complications such as tetany, arrhythmias, and seizures. Before administering methylprednisolone, which can further decrease calcium levels and contribute to osteoporosis, it is essential to notify the healthcare provider to address the client's low calcium level. This may involve correcting the calcium deficiency before proceeding with the administration of the

B) If a healthcare provider orders a calcium supplement for the client, administering it would be appropriate to help correct the hypocalcemia before administering methylprednisolone. However, in the absence of a direct order, the nurse should first notify the healthcare provider to ensure that the client's calcium levels are addressed appropriately before proceeding with any medication that could exacerbate the issue. The priority is to manage the low calcium levels before administering corticosteroids like methylprednisolone.

C) Administering methylprednisolone with a glass of milk may help with calcium absorption; however, this does not directly address the critical issue of hypocalcemia. The nurse must first prioritize notifying the healthcare provider and correcting the calcium imbalance before proceeding with medication administration.

D) Tapering the dose of methylprednisolone is not immediately appropriate based on the low calcium level alone. Methylprednisolone is often tapered to avoid withdrawal symptoms, but the nurse's first priority is to address the client's hypocalcemia, which can have more immediate clinical consequences. The focus should be on stabilizing the calcium level first.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A) Bronchitis: Methylphenidate, a central nervous system stimulant, is not contraindicated in clients with bronchitis. While caution may be warranted in individuals with respiratory conditions due to potential stimulant effects, bronchitis alone does not necessitate specific precautions or contraindications for methylphenidate use.

B) Diabetes mellitus: Methylphenidate use does not typically pose significant risks for individuals with diabetes mellitus. While stimulant medications may affect appetite and blood glucose levels, they are not contraindicated in clients with diabetes. Monitoring blood glucose levels may be prudent, but it is not the primary concern when reviewing the medical record before administering methylphenidate.

C) Hypertension: Reviewing the medical record for hypertension is essential before administering methylphenidate. Stimulant medications like methylphenidate can increase heart rate and blood pressure, potentially exacerbating hypertension or cardiovascular conditions. Clients with uncontrolled hypertension may require dose adjustments or alternative treatments to mitigate cardiovascular risks associated with methylphenidate use.

D) Hypercholesterolemia: Methylphenidate is not contraindicated in clients with hypercholesterolemia. While stimulant medications may have minor effects on lipid profiles, they are not typically considered significant enough to warrant specific precautions or contraindications in individuals with hypercholesterolemia.

A. Obtain transportation to the emergency department. B. Increase Intake of fluids and high protein foods. C. Stop taking the medication Immediately. D. Avoid hazardous activities until symptoms subside.

Correct Answer is D

Explanation

A) Obtaining transportation to the emergency department may be unnecessary at this time. The client's sy’ptoms of fatigue and dizziness are likely side effects of the new medication, baclofen, and not indicative of a medical emergency. It's es’ential to assess the severity of symptoms and provide appropriate guidance before considering emergency care.

B) Increasing intake of fluids and high-protein foods may be beneficial for overall health but is not directly related to addressing the side effects of baclofen. While adequate hydration and nutrition are essential, this recommendation may not specifically address the client's sy’ptoms of fatigue and dizziness.

C) Stopping the medication immediately without consulting a healthcare provider is not advisable. Abruptly discontinuing baclofen can lead to withdrawal symptoms and a potential worsening of muscle spasticity. It's cr’cial for the client to discuss any concerns or side effects with their healthcare provider before making any changes to their medication regimen.

D) Advising the client to avoid hazardous activities until symptoms subside is the most appropriate action. Baclofen, as a muscle relaxant, can cause dizziness and fatigue, which may impair the client's ab’lity to safely engage in activities such as driving or operating machinery. By avoiding hazardous activities, the client can reduce the risk of injury or accidents while experiencing these side effects.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Correct Answer is C

Explanation

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

Correct Answer is D

Explanation

A client with myasthenia gravis receives a now prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

A client with a history of smoking cigarettes for many years arrives to the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?

Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

A female client with mild depression reports to the nurse of recently starting St. John's wo’t. Which information provided by the client requires further instruction?

The loop diuretic furosemide is prescribed for a client with a history of heart failure (HF). Which foods should the nurse encourage this client to eat?

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?