NORCET 8 Prelims-2025
Pharmacology
Medium
Which of the following signs indicate magnesium toxicity, EXCEPT?
Appeared in: NORCET 8 Prelims-2025
Explanation
- A flushed face, along with a feeling of warmth, is a common and expected side effect of magnesium sulfate administration, particularly during the initial loading dose.
- This effect is caused by the drug's vasodilatory properties, which relaxes blood vessels.
- Unlike signs of toxicity, flushing alone does not indicate a dangerously high serum magnesium level and is not a reason to stop the infusion.
Why Other Options Were Wrong
- Option A: Decreased urine output (oliguria) is a critical sign related to magnesium toxicity. Magnesium is excreted almost exclusively by the kidneys.
- Option B: A respiratory rate of 12 breaths per minute is a warning sign for respiratory depression, a life-threatening complication of magnesium toxicity.
- Option C: Diminished or absent deep tendon reflexes (DTRs) are a classic, and often the first, sign of magnesium toxicity.
Related Visual
- Visual 1: Table: Comparison of Magnesium Sulfate Side Effects vs. Toxicity Signs. This table will list common side effects (like flushing, warmth) and contrast them with signs of toxicity (respiratory depression, absent DTRs, oliguria) and their corresponding serum magnesium levels.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiating side effects from toxicity of Magnesium Sulfate as background academic context rather than a clinical decision trigger.
- Nurses administering magnesium sulfate must perform frequent (often hourly) assessments of respiratory rate, urine output, and deep tendon reflexes to detect toxicity early.
- The antidote for magnesium sulfate toxicity, calcium gluconate, must always be readily available at the patient's bedside for emergency use.
- What if? If a patient on magnesium sulfate becomes unresponsive with a respiratory rate of 8/min, the nurse's first action is to stop the magnesium infusion immediately, call for help, and prepare to administer IV calcium gluconate while providing respiratory support.
How to Approach the Question
- First, identify that this is an 'EXCEPT' question. This means you are looking for the option that is NOT a sign of magnesium toxicity.
- Recall the primary actions and risks of magnesium sulfate: it is a CNS depressant used to prevent seizures, and it is excreted by the kidneys.
- Evaluate each option based on the drug's mechanism. CNS depression explains respiratory depression and loss of reflexes. Renal excretion means poor urine output is a major risk for accumulation.
- Consider which option represents a known, common side effect versus a sign of dangerous overdose. Flushing is a well-known side effect of vasodilation caused by magnesium.
- Select the option that represents a common side effect rather than a critical sign of toxicity.
Concept Tested & Keywords
- Concept Tested: Differentiating side effects from toxicity of Magnesium Sulfate
- Stem keywords: magnesium toxicity, signs
- Lead-in keywords: EXCEPT
- Negative lead-in flag: Question asks for the exception, meaning three options are correct signs of toxicity and one is not.
Question ID
QOm_8HIsZImH1hZv92a8Wy
Practise the full NORCET 8 Prelims-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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