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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Elevating legs above heart level aids venous return, not arterial flow, worsening PAD’s poor circulation, reducing oxygen to ischemic tissues further.
Choice B reason: Warm environments dilate peripheral vessels, improving blood flow to PAD-affected limbs, reducing claudication pain and supporting tissue perfusion safely.
Choice C reason: Heating pads risk burns in PAD due to reduced sensation and poor healing, potentially worsening ischemic damage rather than relieving pain effectively.
Choice D reason: Antiembolic stockings prevent clots in venous stasis, not PAD, an arterial issue, and may compress arteries, further impairing circulation to legs.
Correct Answer is D
Explanation
Choice A reason: Epigastric fullness may suggest variceal pressure, but combativeness isn’t typical early bleeding; it’s more neurological, not a direct blood loss sign.
Choice B reason: Yellow sclera and hypoalbuminemia reflect liver dysfunction, not acute bleeding; hypertension contradicts blood loss, which lowers pressure initially.
Choice C reason: Bradycardia and lethargy occur late in severe hypovolemia, not early; hypotension fits bleeding but isn’t paired with early compensatory signs here.
Choice D reason: Tachycardia compensates for early blood loss in varices, restlessness reflects hypoxia, and pallor shows reduced perfusion, all classic initial bleeding indicators.
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