A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

He will become hyperglycemic.

le will become hypotensive.

He will retain excess fluid.

He can safely pause prednisone for a few days.

Answer and Explanation

The Correct Answer is B

A.   The immediate concern with abrupt cessation is more related to adrenal insufficiency rather than hyperglycemia. However, chronic use of prednisone can contribute to glucose intolerance and diabetes, but this is not the primary issue with sudden discontinuation.
B.   Abrupt discontinuation of prednisone can lead to adrenal insufficiency because the body has become reliant on the medication to suppress inflammation and regulate various bodily functions. The adrenal glands may not immediately resume normal cortisol production, which can lead to symptoms of adrenal insufficiency, including hypotension.

C.   Fluid retention is a common side effect of prednisone use. However, stopping prednisone suddenly does not typically cause fluid retention; rather, it can lead to other issues like adrenal insufficiency. Fluid retention is more related to the medication's use rather than its abrupt discontinuation.
D.   Abruptly stopping high-dose prednisone, especially after long-term use, can be dangerous. The body may not immediately resume normal cortisol production, leading to symptoms of adrenal insufficiency, such as fatigue, weakness, and hypotension. It is crucial to taper off prednisone gradually under medical supervision to allow the adrenal glands time to recover and to avoid withdrawal symptoms.

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Correct Answer is C

Explanation

A. Women with lupus should ensure that they get plenty of sun each day while they are pregnant. Exposure to sunlight can exacerbate lupus symptoms, especially in women with lupus photosensitivity. It's important for women with lupus to avoid excessive sun exposure and wear protective clothing and sunscreen.

B. Women with lupus should not become pregnant, because the disease poses too many risks. While pregnancy can pose additional risks for women with lupus, it is not always contraindicated. With proper management, many women with lupus can have healthy pregnancies.
C. It is important for women with lupus to receive frequent prenatal care and close monitoring of their lupus symptoms throughout pregnancy. This includes regular check-ups with a rheumatologist and obstetrician, monitoring of blood pressure, kidney function, and lupus activity, as well as screening for fetal development.
D. Women with lupus should avoid all medications during pregnancy to prevent harm to the baby. This is not always the case. Some medications may be necessary to manage lupus symptoms during pregnancy, and the benefits often outweigh the risks. It's important to discuss medication options with healthcare providers to determine the best course of action.

A. Mucositis and diarrhea B. Nausea and vomiting C. Fever and chills D. Alopecia and weight loss

Correct Answer is C

Explanation

A. Mucositis and diarrhea are side effects commonly associated with chemotherapy but are not directly related to myelosuppression. These symptoms are due to the impact of chemotherapy on rapidly dividing cells in the gastrointestinal tract.
B. Nausea and vomiting are common side effects of chemotherapy, primarily due to the treatment's impact on the gastrointestinal tract and the central nervous system.
C. Fever and chills are manifestations directly related to myelosuppression. Myelosuppression leads to a decrease in white blood cells (leukocytes), which compromises the immune system. This increased susceptibility to infection can result in symptoms such as fever and chills. These symptoms are indicative of potential infections or sepsis, which are more common in patients with compromised immune systems due to myelosuppression.

D. Alopecia (hair loss) and weight loss are common side effects of chemotherapy, but they are not directly related to myelosuppression. Alopecia results from the effects of chemotherapy on rapidly dividing hair follicle cells, while weight loss can be a consequence of changes in metabolism or appetite due to chemotherapy.

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A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

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Naxlex Comprehensive Predictor Exams

A female client with systemic lupus erythematosus (SLE) asks the nurse about pregnancy and lupus. Which information should the nurse include when educating the client?

Correct Answer is C

Explanation

A client who is receiving chemotherapy for breast cancer is experiencing myelosuppression as a side effect of the treatment. Which of the following is a manifestation directly related to myelosuppression?

Correct Answer is C

Explanation

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