The nurse is aware that efficient absorption of calcium is assisted by

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.

Correct Answer: D

Rationale: HDLs are commonly referred to as the "good cholesterol" because they help remove excess cholesterol from the bloodstream and transport it to the liver for excretion. High levels of HDL cholesterol are associated with a reduced risk of cardiovascular disease, including coronary artery disease. Monitoring HDL levels is important in assessing cardiovascular health. Triglycerides, LDLs, and VLDLs do not qualify as "good cholesterol" and are actually associated with an increased risk of cardiovascular disease when elevated.

Correct Answer: D

Rationale: Valproic acid is metabolized in the liver, and patients with liver disease may have impaired liver function, which can lead to reduced metabolism of the drug and potential toxicity. Therefore, a patient with a history of liver disease starting therapy with valproic acid would be a cause for concern for the nurse. Monitoring of liver function tests would be crucial in this patient population to ensure the medication is being safely metabolized.

Correct Answer: B

Rationale: When administering packed red blood cells, it is important to use a compatible solution. The preferred solution to administer with packed red blood cells is 0.9% sodium chloride (normal saline) because it is isotonic and compatible with red blood cells. Using an isotonic solution like 0.9% sodium chloride helps to prevent hemolysis of the red blood cells and maintains their integrity during administration. Lactated Ringer's solution, D5W, and 0.45% sodium chloride are not recommended for administering packed red blood cells because they can cause hemolysis due to their hypotonic or hypertonic nature.

Correct Answer: B

Rationale: Syrup of ipecac induces vomiting in overdose. It stimulates the chemotactic trigger zone in the medulla-prompting emesis. Gag reflex stimulation is secondary. Suppressing pressures , gag reflex , or motor cortex (E) don't apply. Though less used now, ipecac's CNS action expels pills, aiding this acute scenario, distinct from mechanical or suppressive effects.