The nurse is reviewing a patient's laboratory test results and current medications and notes that the patient's prothrombin time is prolonged. The nurse checks the patient's medication list. What vitamin or mineral might be contributing to this?

Correct Answer: D

Rationale: Vitamin E can interfere with vitamin K-dependent clotting factors, leading to prolonged prothrombin time and increased bleeding risk. Vitamin A (A), selenium (B), and vitamin D (C) do not typically affect coagulation. The nurse should assess for excessive vitamin E supplementation or dietary intake.

Correct Answer: D

Rationale: A 25 percent albumin solution contains 25 grams of albumin per 100 milliliters. To administer 1 gram of albumin, the nurse would calculate the volume as follows: 1 gram ÷ 25 grams/100 milliliters = 4 milliliters. Therefore, the nurse will administer 4 milliliters of the 25 percent albumin solution to deliver the ordered dose of 1 gram. Using the entire vial or not using the product at all would be incorrect.

Correct Answer: A

Rationale: Metoclopramide, a D2 antagonist, causes acute dystonia (e.g., oculogyric crisis). Procyclidine, an anticholinergic, rapidly reverses this IV, relaxing muscles, a suitable treatment. Benzhexol (trihexyphenidyl) works orally but is slower. Levodopa and bromocriptine, dopamine agonists, treat Parkinson's, not dystonia from dopamine blockade. Risperidone worsens it. IV procyclidine's speed is critical in acute settings, restoring normal movement effectively.

Correct Answer: D

Rationale: Dobutamine, a β1-selective agonist, can cause arrhythmias, so no arrhythmogenic effect is false. It increases myocardial oxygen consumption by enhancing contractility, not decreases it. It's selective, not non-selective, targeting cardiac β1 receptors. It doesn't act on CNS D2 dopamine receptors but on peripheral β1. It's used in heart failure to boost cardiac output, a true statement, making it valuable in acute settings. This inotropic effect distinguishes it from non-selective agents, critical for managing cardiogenic shock.

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.