A client diagnosed with type II diabetes is prescribed prednisone for an acute exacerbation of inflammatory bowel disease. Which management strategy should the nurse discuss with the client?

Notifying the healthcare provider if they are experiencing a moon phase.

Taking the steroid medication as prescribed.

Notifying the healthcare provider if the blood glucose level is over 150 mg/dL.

Taking this medication on an empty stomach.

Answer and Explanation

The Correct Answer is B

A. "Moon phase" is not a correct term related to prednisone use. The term "moon face" refers to the round, puffy face that can result from prolonged steroid use, which is a side effect, but it is not something the patient needs to notify the healthcare provider about unless it is accompanied by other severe symptoms.
B. Taking the steroid medication as prescribed is essential. Prednisone is a corticosteroid, and missing doses or abruptly stopping the medication can lead to complications such as adrenal insufficiency. It's important for the client to adhere to the prescribed regimen to manage inflammation and minimize the risk of side effects.
C. Steroids like prednisone can cause increased blood glucose levels, so it's important for the client to monitor blood glucose more frequently. If blood glucose levels exceed 150 mg/dL, they should notify their healthcare provider, but this is not the immediate management strategy for this scenario.
D. Prednisone should be taken with food to reduce gastrointestinal irritation, not on an empty stomach. Taking it without food can increase the risk of stomach upset and ulcers, particularly in patients with inflammatory bowel disease.

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Correct Answer is B

Explanation

A. Epigastric discomfort is a common symptom of peptic ulcer disease, but it is not the priority finding. This symptom is usually manageable with appropriate treatment, such as antacids or proton pump inhibitors.
B. Hematemesis (vomiting blood) is a critical finding and indicates active bleeding, which can be life-threatening. This requires immediate attention as it suggests a potential complication, such as ulcer perforation or severe gastric bleeding, that can lead to hypovolemic shock. It is the priority finding because it indicates the need for urgent medical intervention.
C. Constipation is not a priority concern in a patient with peptic ulcer disease unless it is severe and related to medication (such as opioids). While it may be uncomfortable, it does not pose the immediate risk that hematemesis does.
D. Dyspepsia, or indigestion, is another common symptom of peptic ulcer disease. While it can be bothersome, it does not represent an acute, life-threatening issue like hematemesis does.

A. An intolerance to the feedings B. Esophageal perforation with fistula formation into the lung C. Extension of the tumor into the aorta D. Leakage of fluids into the mediastinum

Correct Answer is B

Explanation

A. An intolerance to the feedings might cause discomfort, but it would not typically cause increasing pain, fever, and dyspnea. These symptoms are more indicative of a serious complication.
B. Esophageal perforation with fistula formation into the lung is the most likely cause of these symptoms. A perforation can lead to leakage of gastric contents into the pleural space or mediastinum, causing fever, pain, and respiratory distress. The formation of a fistula between the esophagus and the lung would lead to dyspnea.
C. Extension of the tumor into the aorta is a rare complication that would typically manifest with symptoms related to cardiovascular issues, not gastrointestinal symptoms like fever and dyspnea.
D. Leakage of fluids into the mediastinum is a possible cause of the symptoms, but esophageal perforation with a fistula into the lung is more directly linked to these specific symptoms, especially dyspnea.

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A client diagnosed with type II diabetes is prescribed prednisone for an acute exacerbation of inflammatory bowel disease. Which management strategy should the nurse discuss with the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Correct Answer is B

Explanation

A patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. The nurse recognizes that these symptoms are most indicative of:

Correct Answer is B

Explanation

A client comes to the clinic complaining of dysphagia and states that "he feels like food is stuck in his throat." The physician suspects esophageal cancer. Which of the following is a risk factor for esophageal cancer?

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