A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?
Potassium.
Calcium.
Phosphate.
pH.
The Correct Answer is C
Choice A reason:
Calcium acetate is not used to lower potassium levels. Potassium levels in the blood are typically managed through dietary restrictions, medications like potassium binders, and dialysis in patients with CKD. The normal range for blood potassium levels is 3.5 to 5.2 mEq/L for adults.
Choice B reason:
Calcium acetate can increase calcium levels in the blood, not decrease them. It is important to monitor calcium levels to avoid hypercalcemia, which can lead to complications such as vascular calcification and cardiac issues. The normal range for blood calcium levels is 8.6 to 10.2 mg/dL.
Choice C reason:
Calcium acetate is used to lower phosphate levels in patients with CKD. It works by binding to dietary phosphate in the intestines, forming insoluble calcium phosphate that is excreted in the stool. This helps prevent hyperphosphatemia, a common issue in CKD patients. The normal range for blood phosphate levels is 2.5 to 4.5 mg/dL.
Choice D reason:
Calcium acetate does not directly affect blood pH levels. Blood pH is regulated by the kidneys and lungs, and the normal range is 7.35 to 7.45. While CKD can affect acid-base balance, calcium acetate’s primary role is to manage phosphate levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason
Morphine, an opioid analgesic, is commonly prescribed for severe pain management, such as in cases of metastatic cancer. One of the well-known side effects of morphine is constipation. This occurs because opioids slow down gastrointestinal motility, leading to harder and less frequent stools. Therefore, it is crucial for patients taking morphine to monitor their bowel movements and use stool softeners or laxatives as needed to prevent constipation. This choice indicates that the client understands the importance of managing this common side effect, which can significantly impact their comfort and quality of life.
Choice B Reason
Grapefruit juice is known to interact with various medications by inhibiting the cytochrome P450 3A4 (CYP3A4) enzyme in the liver, which can lead to increased blood levels of certain drugs. However, morphine is primarily metabolized by the liver enzyme UGT2B7, not CYP3A4. Therefore, grapefruit juice does not significantly affect morphine metabolism. This choice reflects a misunderstanding of the specific interactions relevant to morphine.
Choice C Reason
Taking a benzodiazepine at the same time as morphine can be dangerous due to the risk of additive central nervous system (CNS) depression. Both morphine and benzodiazepines can cause sedation, respiratory depression, and impaired cognitive and motor functions. Concurrent use increases the risk of severe side effects, including potentially life-threatening respiratory depression. This choice indicates a lack of understanding of the risks associated with combining these medications.
Choice D Reason
While it is important to monitor for signs of agitation and insomnia, these are not the primary concerns associated with morphine use. Morphine is more likely to cause sedation rather than agitation, and insomnia is not a common side effect. This choice does not reflect a comprehensive understanding of the primary side effects and necessary precautions related to morphine use.
Correct Answer is D
Explanation
Choice A reason: While it is true that breastfeeding is not recommended while taking isotretinoin due to the potential for adverse effects on the infant, this is not the most critical information for a client planning to become pregnant. The primary concern is the teratogenic effects of isotretinoin, which can cause severe birth defects.
Choice B reason: Advising the client not to take multiple vitamins that contain vitamin A while on isotretinoin is important because excessive vitamin A can increase the risk of toxicity. However, this is not the most crucial information for someone planning to become pregnant. The teratogenic risks of isotretinoin are a higher priority.
Choice C reason: Obtaining baseline liver function results is necessary during isotretinoin therapy due to the potential for hepatotoxicity. Regular monitoring helps ensure the liver is functioning properly. However, this information is secondary to the need to avoid pregnancy while on isotretinoin due to its severe teratogenic effects.
Choice D reason: Discontinuing isotretinoin one month before attempting to conceive is the most important information. Isotretinoin is highly teratogenic and can cause serious birth defects. It is crucial to stop the medication well before conception to ensure it is completely cleared from the body, reducing the risk of harm to the fetus.
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