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 A
Explanation
Choice A reason: Hypoparathyroidism lowers PTH, reducing phosphorus excretion, raising serum levels as kidneys reabsorb more, while calcium drops, a classic imbalance.
Choice B reason: Calcium decreases in hypoparathyroidism due to low PTH, impairing bone resorption and gut absorption, opposite to being high, so this is incorrect.
Choice C reason: Magnesium isn’t directly regulated by PTH; hypoparathyroidism doesn’t consistently elevate it, staying normal unless other factors intervene.
Choice D reason: Potassium is unaffected by hypoparathyroidism, controlled by aldosterone and kidneys, not PTH, so it doesn’t rise with this condition.
Correct Answer is D
Explanation
Choice A reason: Salmeterol, a long-acting bronchodilator, opens airways in asthma or COPD but doesn’t dilate coronary arteries or improve cardiac ischemia, targeting lungs instead.
Choice B reason: Aspirin prevents clotting by inhibiting platelet aggregation, reducing ischemia risk, but it doesn’t directly dilate coronary arteries or acutely redirect blood flow.
Choice C reason: Digoxin increases cardiac contractility in heart failure, improving output, but it doesn’t dilate coronary vessels or specifically oxygenate ischemic myocardium.
Choice D reason: Nitroglycerin, a vasodilator, relaxes coronary arteries, increasing blood flow to ischemic areas, relieving angina by enhancing oxygen delivery to the heart muscle.
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