A client who is taking methylprednisolone reports feeling thirsty. Which action should the nurse take first?

Monitor urinary output.

Notify the healthcare provider (HCP).

Prepare to give insulin.

Obtain fingerstick blood glucose.

Answer and Explanation

The Correct Answer is D

A. Monitor urinary output: While monitoring output is important, it does not provide immediate diagnostic information regarding the cause of the client’s thirst. It is a supportive action but not the most efficient first step to investigate potential hyperglycemia.

B. Notify the healthcare provider (HCP): Notifying the HCP is appropriate if there are abnormal findings or the client’s condition worsens. However, the nurse should gather objective data—such as a blood glucose reading—before contacting the provider.

C. Prepare to give insulin: Insulin should not be administered without confirmation of elevated blood glucose. Giving insulin without verifying hyperglycemia could lead to serious complications, including hypoglycemia.

D. Obtain fingerstick blood glucose: Methylprednisolone, a corticosteroid, can raise blood glucose levels, and excessive thirst is a classic symptom of hyperglycemia. Checking the client’s blood glucose is the most appropriate first action to determine if elevated glucose is causing the symptom.

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Correct Answer is B

Explanation

A. Total bilirubin 4 mg/dL (68.4 μmol/L): Elevated bilirubin suggests possible liver dysfunction or hemolysis but is not directly associated with vitamin D toxicity. Vitamin D overdose primarily leads to disturbances in calcium metabolism rather than bilirubin elevations.

B. Total calcium level 12 mEq/L (3 mmol/L): Hypercalcemia is a hallmark of vitamin D overdose because vitamin D increases calcium absorption from the gastrointestinal tract. A calcium level above the normal range signals potential toxicity that needs immediate attention.

C. Sodium level 140 mEq/L (140 mmol/L): A sodium level of 140 mEq/L falls squarely within the normal reference range. This value does not suggest any connection to vitamin D toxicity or indicate any immediate concern regarding electrolyte imbalance.

D. Serum glucose 170 mg/dL (9.4 mmol/L): Elevated blood glucose may point to uncontrolled diabetes or stress response but is not linked to excessive vitamin D intake. Vitamin D toxicity primarily affects calcium regulation, not glucose metabolism.

A. Advise the client that the healthcare provider (HCP) needs to be made aware of the current diet. B. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans. C. Confirm that the clients diet choices will help the medication be more effective in preventing blood clots. D. Commend the client for a healthy lifestyle and encourage the client to continue current diet habits.

Correct Answer is A

Explanation

A. Advise the client that the healthcare provider (HCP) needs to be made aware of the current diet: Green leafy vegetables are high in vitamin K, which can interfere with the effectiveness of warfarin by promoting clotting. The healthcare provider must be informed to adjust the medication dose if necessary or provide specific dietary guidance.

B. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans: Advising the client to eliminate green vegetables is not appropriate because sudden changes in vitamin K intake can destabilize warfarin therapy. Consistency in vitamin K consumption is key rather than abrupt dietary changes.

C. Confirm that the client's diet choices will help the medication be more effective in preventing blood clots: Regular consumption of vitamin K-rich foods without dose adjustment can decrease warfarin's anticoagulant effect, increasing the risk of clot formation. The current diet does not inherently support the intended action of the medication.

D. Commend the client for a healthy lifestyle and encourage the client to continue current diet habits: Although a diet rich in vegetables is generally healthy, with warfarin therapy, any vitamin K intake must be consistent and properly managed. Simply encouraging the client without notifying the provider could lead to therapeutic failure.

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A client who is taking methylprednisolone reports feeling thirsty. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A client who is a vegetarian has a new prescription for warfarin. The client reports eating green leafy vegetables every day. How should the nurse respond?

Correct Answer is A

Explanation

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