The nurse is caring for a client with hyperparathyroidism. Which of the following orders from the healthcare provider can be expected to reduce the client's overproduction of calcium? (Select all that apply)

Calcium carbonate PO three times a day

Low calcium, high fiber diet

Parathyroidectomy

Furosemide PO daily

Fluid restriction

Answer and Explanation

Correct Answer : B

Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.

Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.

Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.

Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.

Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.

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Correct Answer is D

Explanation

Choice A reason: Increasing oxygen to 3 L/min may help but risks CO2 retention in COPD without assessing respiratory rate, depth, and saturation first, making it premature.

Choice B reason: Coughing clears secretions, but without assessing respiratory status, it’s unclear if secretions are the issue or if the client can effectively cough, so it’s not priority.

Choice C reason: Calling emergency services assumes severity without data like oxygen saturation or distress level, delaying care by skipping initial assessment in this stable setting.

Choice D reason: Assessing respiratory status (rate, oxygen saturation, lung sounds) identifies the cause of difficulty, guiding interventions like oxygen adjustment or escalation, per ABC priority.

A. Symptoms improve immediately after starting the medication B. The medication decreases the overproduction of the thyroid hormone thyroxine C. Take this medication until your symptoms are gone and then discontinue D. Tremors, nervousness, and insomnia may indicate your dose is too high

Correct Answer is D

Explanation

Choice A reason: Levothyroxine takes weeks to normalize metabolism in hypothyroidism as T4 converts to T3 gradually, so immediate symptom relief isn’t accurate or expected.

Choice B reason: Levothyroxine supplements, not decreases, thyroxine in hypothyroidism. Decreasing overproduction applies to hyperthyroidism treatments like antithyroid drugs, not this condition.

Choice C reason: Hypothyroidism requires lifelong levothyroxine since the thyroid can’t produce hormone. Stopping when symptoms resolve risks recurrence, making this advice incorrect.

Choice D reason: Excess levothyroxine mimics hyperthyroidism, causing tremors, nervousness, and insomnia from overstimulated metabolism, correctly indicating a need for dose adjustment.

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The nurse is caring for a client with hyperparathyroidism. Which of the following orders from the healthcare provider can be expected to reduce the client's overproduction of calcium? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

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Explanation

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