Route of administration of 1,25-dihydroxyvitamin D3 (calcitriol) is:

Correct Answer: D

Rationale: In pharmacology, understanding the route of administration for medications is crucial as it impacts drug absorption, distribution, and overall effectiveness. In the case of 1,25-dihydroxyvitamin D3 (calcitriol), the correct route of administration is oral (Option D). The rationale for this is that calcitriol is a fat-soluble vitamin D hormone that is primarily administered orally for optimal absorption in the gastrointestinal tract. This route allows for gradual and controlled absorption, ensuring proper bioavailability and therapeutic effects. The other options can be ruled out for various reasons: A) Subcutaneous: Calcitriol is not typically administered subcutaneously as it may lead to unpredictable absorption rates and potential tissue irritation. B) Intravenous: Intravenous administration of calcitriol is not common practice due to the risk of rapid and uncontrollable effects, as well as potential adverse reactions. C) Intranasal: Administering calcitriol intranasally would not be appropriate as it is a hormone that requires systemic distribution through the bloodstream, which is best achieved via oral administration. Educational context: Understanding the appropriate route of administration for medications is essential for safe and effective patient care. Healthcare providers must be knowledgeable about drug properties, patient factors, and best practices to ensure optimal outcomes. By selecting the correct route of administration, healthcare professionals can maximize therapeutic benefits while minimizing potential risks and adverse effects.

Correct Answer: C

Rationale: In understanding the major causes of hypercalcemia in adults, it is crucial to recognize that renal failure and malabsorption, option C, are not typically primary causes of elevated calcium levels. Hypercalcemia is most commonly associated with conditions such as hyperparathyroidism (option A), where overproduction of parathyroid hormone leads to increased calcium release from bones and decreased excretion from the kidneys. Cancer, with or without bone metastases (option B), can also lead to hypercalcemia due to the production of factors that promote bone resorption. Hypervitaminosis D (option D) can cause increased absorption of calcium from the intestines and can lead to elevated levels. Educationally, this question highlights the importance of recognizing common causes of hypercalcemia in clinical practice. Understanding these key etiologies can aid healthcare providers in prompt diagnosis and management of patients presenting with hypercalcemia, thereby improving patient outcomes. It is essential for healthcare professionals to differentiate between various causes of hypercalcemia to provide optimal care and treatment to patients across the lifespan.

Correct Answer: D

Rationale: In this question, the correct answer is D) All of the above. Gallium nitrate is used for the management of hypercalcemia of malignancy, making option A correct. Option B is also correct because gallium nitrate works by inhibiting bone resorption. Option C is correct as well because one of the potential adverse effects of gallium nitrate is nephrotoxicity, so ensuring adequate hydration and renal output is crucial. Option A is incorrect because gallium nitrate is not FDA-approved for hypercalcemia of malignancy; it is actually used off-label for this purpose. Option B is incorrect as it falsely states that gallium nitrate functions by inhibiting bone resorption. Option C is incorrect as it does not accurately reflect the precautionary measures needed for gallium nitrate administration. Educationally, this question tests the student's understanding of gallium nitrate's pharmacological properties, indications, and potential side effects. It reinforces the importance of knowing the specific uses and monitoring requirements for different medications, highlighting the need for accuracy and attention to detail in pharmacological practice.

Correct Answer: A

Rationale: In the context of pharmacology across the lifespan, understanding how different diuretics act on the renal system is crucial. In this question, the correct answer is A) Acetazolamide (Diamox) because it acts at the proximal tubule. Acetazolamide is a carbonic anhydrase inhibitor that works in the proximal tubule of the nephron to inhibit the reabsorption of bicarbonate ions, leading to diuresis. Option B) Furosemide (Lasix) is a loop diuretic that acts on the thick ascending loop of Henle, not the proximal tubule. Option C) Hydrochlorothiazide (HydroDiuril) is a thiazide diuretic that acts on the distal convoluted tubule. Option D) Spironolactone (Aldactone) is a potassium-sparing diuretic that acts on the collecting duct. Understanding where each diuretic acts in the nephron is essential for nurses and healthcare providers to make informed decisions about their use in patients of different ages and conditions. This knowledge helps in prescribing the appropriate diuretic based on the patient's specific needs and medical history, ensuring safe and effective pharmacological interventions.

Correct Answer: B

Rationale: The correct answer is B) Amiloride (Midamor) because it is a potassium-sparing diuretic. Administering Amiloride to patients already taking potassium supplements can lead to hyperkalemia, a dangerous condition characterized by high levels of potassium in the blood. This combination increases the risk of developing life-threatening cardiac arrhythmias. Hydrochlorothiazide (A) and Furosemide (C) are both loop diuretics that promote the excretion of potassium. While they can cause hypokalemia (low potassium levels), they are not contraindicated in patients taking potassium supplements. In fact, patients on loop diuretics may require potassium supplementation to prevent hypokalemia. Educationally, understanding the interactions between drugs and their effects on electrolyte balance is crucial in pharmacology practice. Nurses must be able to identify medications that can lead to dangerous interactions, like the combination of potassium-sparing diuretics and potassium supplements. This knowledge is vital for safe medication administration and patient care.