A patient is prescribed oral prednisone for an exacerbation of an autoimmune disease.

Which finding in the patient’s past medical history would contraindicate the use of prednisone?

Choice A rationale
Hypermagnesemia, or high levels of magnesium in the blood, is not a common side effect of proton pump inhibitors. These medications do not contain magnesium and do not cause the body to produce more magnesium.
Choice B rationale
Long-term use of proton pump inhibitors may contribute to osteoporosis. Some studies have suggested that these medications can interfere with calcium absorption, potentially leading to bone loss and an increased risk of fractures.
Choice C rationale
While some people may experience diarrhea as a side effect of proton pump inhibitors, it is not one of the most common side effects.
Choice D rationale
Drowsiness is not a typical side effect of proton pump inhibitors. These medications work by reducing the amount of acid produced in the stomach, but they do not typically affect alertness or energy levels.

Choice A rationale
Hyponatremia, or low sodium levels, is not typically associated with the use of milk of magnesia. Milk of magnesia works by drawing water into the intestines, which can help to soften the stool and stimulate bowel movements. While it can affect fluid balance, it does not directly affect sodium levels in the body.
Choice B rationale
This choice is correct. Milk of magnesia contains magnesium and can lead to hypermagnesemia, or high magnesium levels, if taken in excess or if the client has impaired kidney function. Hypermagnesemia can cause various symptoms, including nausea, vomiting, low blood pressure, and in severe cases, heart arrhythmias and cardiac arrest.
Choice C rationale
Hypokalemia, or low potassium levels, is not typically associated with the use of milk of magnesia. While milk of magnesia can affect fluid and electrolyte balance, it does not directly affect potassium levels in the body.
Choice D rationale
Hypercalcemia, or high calcium levels, is not typically associated with the use of milk of magnesia. Milk of magnesia does not contain calcium, so it would not contribute to an increase in calcium levels in the body.