A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient?

Correct Answer: C

Rationale: In a patient with a history of pancreatitis and cirrhosis, medications that may exacerbate pancreatic or hepatic issues should be avoided. Among the choices provided, diltiazem is the most suitable antihypertensive medication for this patient. Diltiazem is a calcium channel blocker that does not rely on hepatic metabolism for its action, making it a safe choice for patients with liver disease. In addition, it does not have a significant effect on pancreatic function, making it a preferred option in a patient with pancreatitis. Therefore, diltiazem is the most appropriate choice for this patient with a history of pancreatitis and cirrhosis who requires treatment for hypertension.

Correct Answer: A

Rationale: In hyperkalemia (5.9 mEq/L), insulin shifts potassium into cells , lowering serum levels temporarily, paired with glucose to avoid hypoglycemia. Choice B misstates excretion. Choice C compares unnecessarily. Choice D attributes renal action incorrectly. A explains the mechanism accurately, making it the best response.

Correct Answer: C

Rationale: Protamine sulfate is a medication that can antagonize the anticoagulant effects of heparin. Heparin works by binding to antithrombin III to enhance its activity, which leads to the inhibition of factor Xa and thrombin. Protamine sulfate, a positively charged molecule, binds to heparin to form a stable complex, neutralizing the anticoagulant effects of heparin. This makes protamine sulfate a useful antidote for heparin overdose or in situations where rapid reversal of heparin is necessary to reduce the risk of bleeding complications. The other options listed - acetylcysteine, naloxone, warfarin sodium, and phenindione - do not have a direct antagonistic effect on the anticoagulant effects of heparin.

Correct Answer: B

Rationale: Before administering potassium supplements to a patient, it is essential to check the patient's serum potassium level. This allows the healthcare provider to assess the current potassium level in the body and determine if supplementation is necessary. Monitoring serum potassium levels is crucial because both low potassium (hypokalemia) and high potassium (hyperkalemia) levels can have serious health implications. Administering potassium supplements without checking the serum potassium level could lead to adverse effects or complications, so it is important to confirm the need for supplementation based on this laboratory test.

Correct Answer: D

Rationale: Calcium absorption in the small intestine relies heavily on vitamin D, which enhances the process by increasing the expression of calcium-binding proteins and improving gut uptake efficiency. Without adequate vitamin D, calcium absorption drops significantly, leading to potential bone health issues like osteoporosis or osteomalacia. Intrinsic factor, produced in the stomach, is critical for vitamin B12 absorption, not calcium, as it binds B12 for uptake in the ileum. Coenzymes, while involved in metabolic reactions, don't directly facilitate calcium absorption; their role is broader and unrelated to this specific process. Phosphorus, an abundant mineral, works with calcium in bone formation but doesn't enhance its absorption-in fact, excessive phosphorus can compete with calcium. Vitamin D's active form, calcitriol, regulates calcium levels by promoting its transport across intestinal cells, making it indispensable for maintaining skeletal integrity. This mechanism underscores why vitamin D deficiency impairs calcium utilization, distinguishing it from the other options, which lack a direct link to absorption efficiency.