A client with Type 2 diabetes, controlled with diet and metformin, also has chronic obstructive pulmonary disease (COPD). During an exacerbation of COPD, the client is prescribed prednisone to control inflammation. For which side effect should the nurse monitor the client?

Increased blood glucose levels.

Increased potassium levels.

Increased white blood cell count.

Increased ketones in the urine.

Answer and Explanation

The Correct Answer is A

Choice A reason:
Prednisone is a corticosteroid that can cause hyperglycemia, especially in clients with diabetes. The nurse should monitor blood glucose levels because prednisone can increase insulin resistance and hepatic glucose production, leading to elevated blood glucose levels. Normal fasting blood glucose levels range from 70 to 99 mg/dL, and for individuals with diabetes, maintaining blood glucose levels within the target range set by their healthcare provider is crucial to prevent complications.

Choice B reason:
While corticosteroids can affect electrolyte balance, they typically cause a decrease in potassium levels, not an increase. Therefore, monitoring for hypokalemia, rather than hyperkalemia, would be more appropriate when a patient is on prednisone. The normal range for serum potassium is 3.5 to 5.0 mEq/L.

Choice C reason:
Corticosteroids like prednisone can cause leukocytosis, an increase in white blood cell count, as part of their immunosuppressive action. However, this is generally not a harmful side effect unless accompanied by infection or other complications. The normal range for white blood cell count is approximately 4,500 to 11,000 cells per microliter.

Choice D reason:
Increased ketones in the urine, or ketonuria, is not a typical side effect of prednisone. Ketonuria is more commonly associated with uncontrolled diabetes, particularly Type 1 diabetes, when there is an insulin deficiency and the body resorts to fat breakdown, leading to ketone production.

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Correct Answer is C

Explanation

Choice A reason:

Offering a warm beverage to a client with suspected appendicitis is not advisable. Preoperative clients are typically required to have an empty stomach to reduce the risk of aspiration during anesthesia. Introducing fluids or food could delay surgery and increase the risk of complications.

Choice B reason:

Monitoring the client's gag reflex is not a priority in the care of a client with suspected appendicitis. The gag reflex is more relevant in neurological assessments or when evaluating swallowing function, not in the context of appendicitis.

Choice C reason:

Helping the client to a side-lying position with knees flexed can provide comfort and may help relieve abdominal pain. This position reduces tension on the abdominal muscles and can be a supportive measure while the client awaits surgery.

Choice D reason:

Applying a heating pad to the abdomen is contraindicated in clients with suspected appendicitis. Heat can cause the appendix to rupture, leading to peritonitis, which is a severe and potentially life-threatening complication. Therefore, this action should be avoided.

A. Intervening when a client with a history of self-mutilation attempts to self-injure. B. Suggesting that two clients who were fighting be restricted to the unit. C. Staying with a client who is demonstrating a high level of anxiety. D. Exploring alternative solutions with a client, who later chooses one alternative.

Correct Answer is D

Explanation

Choice A Reason
Intervening when a client attempts self-injury may be necessary to ensure the client's immediate safety. However, this action does not primarily implement the ethical principle of autonomy. Autonomy involves respecting the client's right to make their own decisions, including the right to refuse treatment. In cases of self-harm, the nurse must balance the ethical principles of autonomy and nonmaleficence (the duty to do no harm)

Choice B Reason
Suggesting restrictions for clients who were fighting might be a measure to maintain safety within the unit. However, this suggestion does not uphold the principle of autonomy, as it involves limiting the clients' freedom and choices. The ethical principle of autonomy emphasizes the clients' right to make independent choices and to control their own actions.

Choice C Reason
Staying with a client who is experiencing a high level of anxiety is a supportive action that can be therapeutic. While it demonstrates care and may provide comfort, it does not directly implement the principle of autonomy. Autonomy is about the capacity to make informed and voluntary decisions, and while support is important, it does not equate to enabling decision-making.

Choice D Reason
Exploring alternative solutions with a client and allowing them to choose an option embodies the ethical principle of autonomy. This approach respects the client's right to be involved in their own care and to make decisions based on their values and beliefs. It empowers the client to have control over their treatment and respects their capacity for self-determination.

In psychiatric nursing, respecting autonomy means acknowledging the client's right to make choices about their care and treatment. It involves providing all necessary information and supporting the client in making informed decisions. By exploring options and allowing the client to choose, the nurse facilitates autonomy and supports the client's right to direct their own care.

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A client with Type 2 diabetes, controlled with diet and metformin, also has chronic obstructive pulmonary disease (COPD). During an exacerbation of COPD, the client is prescribed prednisone to control inflammation. For which side effect should the nurse monitor the client?

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Naxlex Comprehensive Predictor Exams

A client with suspected appendicitis is waiting for surgery. What should the nurse do?

Correct Answer is C

Explanation

Which intervention by a psychiatric nurse implements the ethical principle of autonomy?

Correct Answer is D

Explanation

When teaching a client about cystitis, the nurse explains that women are more prone to the infection than men. Which of the following best explains a woman's increased susceptibility?

The nurse is providing discharge teaching to a client with angina pectoris who is prescribed metoprolol 50 mg PO daily. Which information should the nurse include in the teaching?

A client is prescribed lisinopril 20 mg PO daily for the treatment of hypertension. Which finding would alert the nurse that a side effect of the medication has occurred?

The nurse is evaluating the teaching of self-monitoring of blood glucose levels in a newly diagnosed Type 2 diabetic client. The nurse identifies a need for additional teaching when the client:

The nurse identifies that the goal of decreasing the cardiac workload for a client receiving atenolol 25 mg PO BID for unstable angina is met when the client has:

The physician prescribes risperidone for a client with schizophrenia who displays delusions, hallucinations, apathy, and social isolation. Which symptoms should be monitored to evaluate improvement?

A common sign of hypoglycemia in a client diagnosed with diabetes is:

A client with chronic bronchitis has a non-productive cough, rhonchi in bilateral lung fields, and difficulty expectorating the secretions. Which intervention should the nurse incorporate into the plan of care?