The nurse is caring for a patient with hyperparathyroidism.
Upon assessment, the nurse notes polyuria, polydipsia, nausea, and vomiting and the following lab values: Potassium: 130 mg/dL. Calcium: 4.7 mg/dL. Phosphorus: 13.1 mg/dL. Magnesium: 25 mg/dL. Which of the following medications is recommended for this patient?

Regular insulin 10 units subcutaneous.

Chlorothiazide 750 mg intravenous.

Calcitonin 300 international units subcutaneous.

Calcitriol 0.75 mcg orally.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Regular insulin 10 units subcutaneous is used to lower blood glucose levels in hyperkalemia. While insulin can help shift potassium into cells, it is not indicated for hypercalcemia or hyperparathyroidism. Regular insulin would not address the elevated calcium levels in this patient.

Choice B rationale

Chlorothiazide 750 mg intravenous is a diuretic that can increase calcium reabsorption in the kidneys, potentially worsening hypercalcemia. It is contraindicated in hyperparathyroidism because it can exacerbate the high calcium levels and associated symptoms.

Choice C rationale

Calcitonin 300 international units subcutaneous is the correct choice for this patient. Calcitonin inhibits osteoclast activity, reducing bone resorption and lowering serum calcium levels. It provides rapid but short-term control of hypercalcemia, which is crucial for managing acute symptoms of hyperparathyroidism.

Choice D rationale

Calcitriol 0.75 mcg orally is an active form of vitamin D that increases calcium absorption in the gut. It is used to manage hypocalcemia, not hypercalcemia. Administering calcitriol would further elevate the already high calcium levels, worsening the patient's condition.

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Correct Answer is D

Explanation

The correct answer is Choice D.

Choice A rationale

Weight loss in a patient with hyperthyroidism typically occurs due to an increased metabolic rate. Propylthiouracil (PTU) is used to decrease thyroid hormone production. Effective treatment would stabilize metabolism and prevent further weight loss, but not necessarily result in weight gain.

Choice B rationale

Excessive sweating (perspiration) is a common symptom of hyperthyroidism due to an overactive thyroid gland. PTU aims to reduce thyroid hormone levels. Effective treatment should lead to a decrease in sweating as the metabolic rate normalizes.

Choice C rationale

Excess energy and hyperactivity are signs of untreated or inadequately treated hyperthyroidism. PTU reduces the production of thyroid hormones, and effective treatment should alleviate symptoms of excessive energy, resulting in more balanced energy levels.

Choice D rationale

Improved sleep and rest at night indicate effective management of hyperthyroidism. Reduced thyroid hormone levels from PTU help alleviate symptoms such as anxiety, restlessness, and insomnia, allowing the patient to achieve better sleep quality. .

A. Place the patient in a private, lead-lined room during hospitalization. B. Ensure all staff caring for the patient wear a dosimeter badge to track the radiation exposure. C. Monitor the patient's skin integrity and avoid exposing the irradiated area to extreme heat or cold. D. Restrict all visitors and post radioactive precautions signs on the patient's door.

Correct Answer is C

Explanation

Choice A rationale

Placing the patient in a private, lead-lined room is unnecessary for external radiation therapy, which does not make the patient radioactive. This consideration is more applicable to internal radiation therapy (brachytherapy), where radioactive materials are placed inside the body.

Choice B rationale

While dosimeter badges are essential for monitoring radiation exposure, they are more relevant for healthcare workers who may be exposed to radiation, not for patients receiving external radiation therapy. The patient themselves are not a source of radiation exposure.

Choice C rationale

Monitoring the patient's skin integrity is crucial because external radiation can cause skin irritation and damage. Avoiding exposure to extreme heat or cold helps prevent additional skin trauma and promotes healing.

Choice D rationale

Restricting visitors and posting radioactive precautions signs are unnecessary for patients receiving external radiation therapy. These precautions are more applicable to internal radiation therapy, where the patient may emit radiation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is evaluating a patient with hyperthyroidism who is taking propylthiouracil (PTU) 100 mg/day for maintenance therapy.Which statement from the patient indicates the medication therapy is effective?

Correct Answer is D

Explanation

The nurse is caring for a patient receiving external radiation for lung cancer.What nursing considerations will the nurse implement to reduce the risks related to this treatment?

Correct Answer is C

Explanation

The nurse is caring for a patient with stage IV metastatic breast cancer, who has metastasis to the bone.During assessment, the patient appears severely weak, fatigued, confused, and continually repeats "I'm so thirsty!” What will the nurse implement in the patient's plan of care?

The nurse is preparing to administer vancomycin 15 mg/kg/day divided equally every 12 hours to a patient with neutropenic fever. The patient weighs 198 lb. How many mg will the nurse administer with each dose? Round the answer to the nearest whole number. Write numerical answer only - no units.

The nurse is assessing a patient with metastatic prostate cancer who was admitted with sudden onset of back pain, lower extremity weakness, difficulty walking, and paresthesia in their toes.What intervention will the nurse implement for this patient?

A client with severe malnutrition is admitted to the hospital.Which intervention should the nurse implement first?

The nurse is caring for a woman with a family history of breast cancer who received a positive result on a breast tumor marker test.The patient is requesting a bilateral mastectomy.This is an example of which type of oncologic treatment?

The nurse is caring for a patient who is scheduled for thyroid diagnostic testing.Which information, that may affect the test results, should be documented on the patient's electronic medical record (EMR) and communicated to the personnel conducting the test?

The nurse is teaching a patient with hyperparathyroidism how to manage the condition at home.Which response by the patient indicates the need for additional teaching?