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.

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Correct Answer is ["0.8"]

Explanation

The nurse should administer 0.8 mL of the enoxaparin sodium injection.

Here's th’ breakdown of the calculation:

Prescribed dose: 80 mg

Available medication: 60 mg/0.6 mL

The nurse needs to determine the volume of the available medication that delivers the prescribed dose of 80 mg. We can set up a proportion to find the desired volume (x):

Prescribed dose (mg) : Desired volume (mL) = Concentration (mg/mL) : Available volume (mL)

Plugging in the values:

80 mg : x mL = 60 mg/0.6 mL : 0.6 mL

To isolate x (desired volume), we can cross-multiply:

x mL x (60 mg/0.6 mL) = 80 mg x 0.6 mL

Simplifying the equation

0.6x mL = 48 mg

To find x (desired volume), we can divide both sides by 0.6 mL:

x mL = (48 mg) / (0.6 mL/mL) // Cancel out units (mg/mL)

x = 80 mL

However, the answer needs to be rounded to the nearest tenth since medication dosages are measured precisely.

Therefore, the nurse should administer 0.8 mL of the enoxaparin sodium injection.

A. Intolerance to cold. B. Constipation. C. Restlessness. D. Decreased appetite.

Correct Answer is C

Explanation

A) Intolerance to cold: Intolerance to cold is a common symptom of hypothyroidism, not a sign of taking too much levothyroxine sodium. Therefore, this symptom would not indicate an overdose of the medication.

B) Constipation: Constipation can be a symptom of hypothyroidism, and it may improve with appropriate thyroid hormone replacement therapy. It is not typically associated with taking too much levothyroxine sodium.

C) Restlessness: This is the correct answer. Restlessness, anxiety, nervousness, or feeling jittery are symptoms of hyperthyroidism, which can occur if the client is taking too much levothyroxine sodium. If the dose of levothyroxine is too high, it can lead to hyperthyroid symptoms, even though the medication is intended to treat hypothyroidism.

D) Decreased appetite: Decreased appetite is not a typical symptom of taking too much levothyroxine sodium. In fact, weight loss is more commonly associated with hyperthyroidism, which can occur if the dose of levothyroxine is too high. However, decreased appetite alone may not specifically indicate an overdose of levothyroxine.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["0.8"]

Explanation

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

Correct Answer is C

Explanation

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

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A client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH), Which instruction is most important for the nurse to provide?

The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

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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?