A nurse is planning care for a client who has multiple sclerosis and is receiving methylprednisolone. Which of the following adverse effects should the nurse anticipate? (Select all that apply.)
Bladder spasms
Hypotension
Delayed wound healing
Hirsutism
Hyperglycemia
Correct Answer : C,D,E
Choice A Reason:
Bladder spasms are not commonly reported as adverse effects of methylprednisolone. However, bladder dysfunction can occur in individuals with multiple sclerosis due to the disease process itself, but it is not specifically related to corticosteroid therapy.
Choice B Reason:
Hypotension is not a common adverse effect of methylprednisolone. In fact, corticosteroids can often lead to fluid retention and sodium retention, which can contribute to hypertension rather than hypotension.
Choice C Reason:
Delayed wound healing is correct. Corticosteroids can impair the body's ability to heal wounds by suppressing the inflammatory response and collagen synthesis. Therefore, clients receiving methylprednisolone may experience delayed wound healing, which can be problematic, especially in individuals with pre-existing wounds or undergoing surgical procedures.
Choice D Reason:
Hirsutism (excessive hair growth, especially in women) can occur with long-term corticosteroid use due to the effect of steroids on hair follicles. It is a possible adverse effect of methylprednisolone.
Choice E Reason:
Hyperglycemia is correct. Corticosteroids can increase blood glucose levels by promoting gluconeogenesis, reducing glucose uptake by tissues, and inducing insulin resistance. Clients receiving methylprednisolone may develop hyperglycemia, which can be particularly concerning for individuals with diabetes or those at risk of developing diabetes.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A Reason:
Weight control if the client's BMI is greater than 35 is correct. Obesity is a risk factor for cardiovascular disease and can exacerbate symptoms of heart failure. Weight control, particularly if the client's BMI is greater than 35, is important for managing cardiac conditions such as heart failure and reducing the risk of pulmonary edema.
Choice B Reason:
Healthy lifestyle is correct. Adopting a healthy lifestyle, including regular exercise, balanced diet, adequate hydration, and stress management, is essential for managing cardiac conditions and reducing the risk of complications such as pulmonary edema.
Choice C Reason:
Smoking cessation is correct. Smoking is a major risk factor for cardiovascular disease and can worsen heart failure symptoms. Smoking cessation is crucial for managing cardiac conditions and reducing the risk of pulmonary edema and other complications.
Choice D Reason:
Heart disease prevention is correct. Providing information about heart disease prevention strategies, such as maintaining a healthy diet, managing blood pressure and cholesterol levels, regular exercise, and regular medical check-ups, can help reduce the risk of exacerbations and complications in clients with pre-existing cardiac conditions.
Choice E Reason:
Glycemic control if the client is diabetic is correct. Diabetes is a risk factor for cardiovascular disease and can contribute to the development and progression of heart failure. Glycemic control, along with lifestyle modifications and medication management, is important for managing diabetes and reducing the risk of complications such as pulmonary edema.
Correct Answer is B
Explanation
Choice A Reason:
A client with a decreased potassium level is incorrect. Hypokalemia (decreased potassium level) can cause various neurological symptoms, but it doesn't directly lead to osmotic cerebral edema.
Choice B Reason:
When plasma glucose levels are rapidly lowered, an osmotic gradient develops between the brain and plasma, which can lead to cerebral edema.Brain cells pull water from the plasma, resulting in widespread edema.
Choice C Reason:
While HbA1c is an important marker of diabetes control and may indicate poor long-term management, it does not directly relate to the acute metabolic derangements (e.g., rapid osmotic shifts, severity of acidosis) that predispose to cerebral edema in DKA.
Choice D Reason:
A client with an increased creatinine level is incorrect. Elevated creatinine levels typically indicate kidney dysfunction or dehydration, but they don't directly cause osmotic cerebral edema.
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