Calcium Quiz: Hypo Or Hypercalcemia?

1. A patient with hypercalcemia reports polyuria and polydipsia. What is the underlying cause?

Hypercalcemia-induced nephrogenic diabetes insipidus

Primary polydipsia

Osmotic diuresis from hyperglycemia

Acute tubular necrosis

2. Which medication is contraindicated in a patient with acute hypercalcemia?

Furosemide with IV hydration

Thiazide diuretics

Bisphosphonates

Corticosteroids

3. A patient with malignancy-related hypercalcemia has PTHrP elevation. What is the mechanism of hypercalcemia?

Increased osteoblast activity

PTHrP mimics PTH and increases bone resorption

Increased vitamin D production

Decreased urinary calcium excretion

4. Which clinical finding is most consistent with chronic hypercalcemia?

Acute tetany

Kidney stones and bone loss

Seizures

Acute heart failure

5. A patient receiving cisplatin chemotherapy develops hypocalcemia. What is the primary cause?

Increased urinary calcium loss

Hypomagnesemia-induced PTH resistance

Direct bone toxicity

Increased vitamin D metabolism

6. Which food is highest in bioavailable calcium for a patient with hypocalcemia?

Spinach

Dairy products and fortified orange juice

Whole grains

Red meat

7. A patient with hypocalcemia has a normal PTH level. What is the likely cause?

Vitamin D deficiency

Primary hyperparathyroidism

Hyperthyroidism

Paget's disease

8. Which symptom suggests acute severe hypercalcemia requiring emergency intervention?

Mild nausea

Confusion and cardiac arrhythmias

Fatigue

Mild headache

9. A patient taking thiazide diuretics develops hypercalcemia. What is the mechanism?

Increased urinary calcium excretion

Decreased renal calcium reabsorption

Increased renal calcium reabsorption

Increased vitamin D metabolism

10. Which lab value should be monitored when treating hypercalcemia with IV hydration?

Serum sodium and potassium

Serum calcium and magnesium

Serum creatinine and phosphate

All of the above

11. A patient with acute hypocalcemia presents with paresthesias and muscle cramps. Which laboratory value would you expect?

Serum calcium 6.5 mg/dL

Serum calcium 10.5 mg/dL

Serum calcium 12 mg/dL

Serum calcium 11 mg/dL

12. Which nursing intervention is appropriate for acute symptomatic hypocalcemia?

Administer oral calcium supplements

IV calcium gluconate infusion

Restrict dietary calcium

Encourage weight-bearing exercise

13. A patient with chronic kidney disease develops secondary hyperparathyroidism. What causes hypocalcemia?

Decreased calcitriol production

Increased phosphate retention

Both decreased calcitriol and increased phosphate

Increased urinary calcium loss

14. Which ECG change is associated with severe hypercalcemia?

Prolonged QT interval

Shortened ST segment

Widened QRS complex

Peaked T waves

15. A patient with sarcoidosis has hypercalcemia. What is the mechanism?

Increased parathyroid hormone

Granulomas produce calcitriol

Increased bone resorption

Decreased urinary excretion

16. Which medication increases serum calcium levels?

Bisphosphonates

Calcitriol (active vitamin D)

Loop diuretics

Corticosteroids

17. A patient receiving a blood transfusion develops tingling around the mouth. What is the likely cause?

Hypercalcemia from citrate metabolism

Hypocalcemia from citrate in blood products

Hyperkalemia from stored blood

Hypomagnesemia from transfusion

18. Which sign is most specific for hypocalcemia?

Chvostek's sign

Trousseau's sign

Both Chvostek's and Trousseau's signs

Kernig's sign

19. A patient with hypoparathyroidism develops hypocalcemia. What is the primary mechanism?

Decreased parathyroid hormone secretion