An older adult resident of a long-term care facility has been prescribed calcium citrate to address decreasing bone density. The nurse should review the resident’s medication administration record knowing that what medication may decrease the effects of calcium?
Ibuprofen
Hydrochlorothiazide
Diltiazem
Prednisone
The Correct Answer is D
A: Ibuprofen does not typically interact with calcium citrate to decrease its effects. Instead, ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation and, with long-term use, may affect kidney function.
B: Hydrochlorothiazide is a diuretic that can lead to increased calcium levels in the blood. It does not decrease the effects of calcium citrate; rather, it could potentially cause hypercalcemia if used concurrently with calcium supplements.
C: Diltiazem is a calcium channel blocker used to treat hypertension and angina. While it affects calcium channels in the heart and blood vessels, it does not typically interact with calcium citrate supplements to decrease their effectiveness.
D: Prednisone is a corticosteroid that can decrease calcium absorption and increase calcium excretion, leading to lower bone density. Long-term use of prednisone can lead to osteoporosis, making it counterproductive when taken with calcium citrate for bone health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Dextroamphetamine is a central nervous system (CNS) stimulant that is used to treat ADHD and narcolepsy. The drug has a high potential for abuse and dependence, and therefore it carries a black box warning from the FDA. The black box warning is the strongest warning that the FDA requires, and it indicates that a drug has a significant risk of serious or life-threatening adverse effects.
The black box warning for dextroamphetamine relates to its potential for abuse, addiction, and misuse. The drug should only be used as directed by a healthcare provider, and clients should be advised not to share their medication with others or to take more than the prescribed dose. Excessive doses of dextroamphetamine can lead to serious adverse effects, including stroke and heart attack. Clients should also be advised to store their medication securely and to dispose of any unused medication properly.
Correct Answer is A
Explanation
A. An increase in serum lactate – This is a critical laboratory value that can indicate lactic acidosis, a serious side effect associated with metformin, especially in older adults or those with renal impairment. An increase in serum lactate necessitates discontinuation of the medication.
B. A decrease in hemoglobin and hematocrit – While this change may indicate anemia, it is not directly associated with the need to discontinue metformin. Further evaluation of the cause of anemia would be necessary.
C. An increase in white blood cells – This could indicate an infection or inflammatory process but does not specifically necessitate the discontinuation of metformin.
D. A decrease in potassium accompanied by an increase in sodium – While electrolyte imbalances should be monitored, this change does not directly indicate that metformin should be discontinued.
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