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: pH 7.53 and low CO2 (32) indicate respiratory alkalosis from hyperventilation, not typical in chest trauma where breathing is impaired. HCO3 (24) is normal, showing no compensation yet, misaligning with trauma physiology.
Choice B reason: pH 7.30, high CO2 (52), and near-normal HCO3 (22) reflect respiratory acidosis from hypoventilation in chest trauma, like rib fractures, reducing air exchange. Compensation is minimal acutely, fitting the clinical scenario.
Choice C reason: pH 7.49 and low CO2 (30) suggest respiratory alkalosis, while low HCO3 (14) indicates metabolic compensation. This doesn’t match chest trauma’s ventilatory restriction, which elevates CO2 instead.
Choice D reason: pH 7.26, CO2 (45), and low HCO3 (18) show mixed acidosis. Chest trauma primarily causes respiratory acidosis from CO2 retention, not a significant metabolic drop acutely, making this less precise.
Correct Answer is A
Explanation
Choice A reason: Gamma globulins (IVIG) provide antibodies to fight infections and stabilize platelet and RBC counts in lupus by modulating immunity, addressing cytopenias effectively.
Choice B reason: Prednisone suppresses immunity, reducing lupus inflammation but lowering infection resistance and not directly boosting platelets or RBCs, risking suppression.
Choice C reason: Methotrexate inhibits folate, suppressing lupus immune activity, but it can reduce blood cell production, not increase platelets or RBCs, worsening counts.
Choice D reason: Hydroxychloroquine prevents lupus flares by stabilizing lysosomes, not boosting blood counts or immunity, focusing on symptom control, not cytopenias.
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