A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

Orthostatic hypotension

Hyperglycemia

Paresthesia

Jaundice

Answer and Explanation

The Correct Answer is B

A. Orthostatic hypotension. Prednisone does not typically cause orthostatic hypotension. Instead, corticosteroids can lead to fluid retention and hypertension due to their effects on sodium and water balance. Orthostatic hypotension is more commonly associated with medications such as diuretics or antihypertensives.

B. Hyperglycemia. Prednisone is a glucocorticoid that increases blood glucose levels by enhancing gluconeogenesis and reducing insulin sensitivity. This effect can make blood sugar more difficult to control in clients who take insulin, potentially requiring higher insulin doses to maintain glycemic control. Clients with diabetes or those taking insulin should closely monitor their blood glucose levels while on prednisone.

C. Paresthesia. Paresthesia (numbness or tingling) is not a common adverse effect of prednisone or a direct interaction with insulin. While uncontrolled diabetes can cause diabetic neuropathy, prednisone does not typically cause neurological symptoms like tingling.

D. Jaundice. Prednisone is not commonly associated with hepatotoxicity or liver dysfunction leading to jaundice. However, long-term corticosteroid use may increase liver enzyme levels, but it does not typically cause direct liver damage or bile obstruction. Jaundice would require evaluation for other underlying liver conditions.

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Correct Answer is B

Explanation

A. Anorexia. While gastrointestinal side effects such as nausea and esophageal irritation can occur with alendronate, anorexia is not a common adverse effect. If severe nausea leads to decreased appetite, the client should report this to their provider, but it is not a primary concern compared to more serious side effects.

B. Jaw pain. Jaw pain can indicate osteonecrosis of the jaw (ONJ), a rare but serious adverse effect associated with long-term bisphosphonate use. This condition involves poor bone healing, especially after dental procedures, and can lead to bone deterioration. Clients taking alendronate should report any persistent jaw pain and undergo regular dental exams to monitor bone health.

C. Insomnia. Alendronate does not typically cause insomnia. While some medications, such as corticosteroids and stimulants, are linked to sleep disturbances, alendronate does not affect the central nervous system in a way that would disrupt sleep patterns.

D. Bruising. Alendronate does not interfere with platelet function or coagulation, making bruising an unlikely adverse effect. Clients who experience unexplained bruising should be evaluated for other underlying causes, such as blood disorders or medication interactions.

A. A pregnant parent B. Receiving treatment for leukemia C. Taking acetaminophen for mild discomfort D. An allergy to eggs

Correct Answer is B

Explanation

A. A pregnant parent. A child can receive the varicella vaccine even if the parent is pregnant. While the varicella vaccine is a live attenuated vaccine, the vaccinated child does not pose a significant risk of transmission to others. The parent should avoid direct contact with the vaccinee's rash if one develops, but this is not a contraindication to immunization.

B. Receiving treatment for leukemia. Children undergoing treatment for leukemia often have weakened immune systems due to chemotherapy or radiation. The varicella vaccine is a live attenuated vaccine, meaning it contains a weakened form of the virus that could cause severe illness in immunocompromised individuals. These children should not receive live vaccines until their immune function improves and their healthcare provider approves vaccination.

C. Taking acetaminophen for mild discomfort. Acetaminophen is an over-the-counter pain reliever and fever reducer that does not interfere with the efficacy or safety of the varicella vaccine. There is no evidence that mild analgesic use before or after vaccination affects immune response, so it is not a reason to withhold the immunization.

D. An allergy to eggs. Unlike some influenza and yellow fever vaccines, the varicella vaccine is not produced using egg-based components. An egg allergy is not a contraindication to receiving the varicella vaccine, as it does not contain egg proteins.

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A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

Nursing Test Bank

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