A nurse is planning to teach a client about taking prednisone. Which of the following instructions should the nurse include?

Take on an empty stomach.

Schedule dosage at bedtime.

Increase dietary calcium.

Monitor for weight loss.

Answer and Explanation

The Correct Answer is C

A. Prednisone should generally be taken with food or after a meal to reduce the risk of gastric irritation or ulcer formation. Taking it on an empty stomach can irritate the stomach lining and increase the risk of gastrointestinal side effects, such as gastritis or peptic ulcers.

B. While some medications are best taken at bedtime (such as those with sedative effects), prednisone is a corticosteroid that can affect the body's circadian rhythm and may interfere with sleep. It typically causes insomnia or restlessness, so it’s usually advised to take it in the morning.

C. Prednisone and other corticosteroids can lead to bone loss (osteoporosis) over time, especially with long-term use. One of the side effects of corticosteroid therapy is decreased calcium absorption and bone density loss, making individuals at higher risk for fractures.

D. Prednisone more commonly causes weight gain rather than weight loss. Corticosteroids increase appetite and can lead to fluid retention, both of which can result in weight gain. Additionally, prednisone can cause redistribution of fat, often leading to characteristic side effects like "moon face" or increased abdominal fat.

B. Incorrect. Prednisone is often prescribed as a single daily dose in the morning to coincide with the body's natural cortisol release.

C. Incorrect. While calcium supplementation might be necessary for some individuals on long-term prednisone therapy, it is not a primary instruction related to taking prednisone.

D. Correct. Monitoring for weight loss is important due to the potential for weight changes (both weight gain and weight loss) as a result of prednisone's effects on metabolism and appetite.

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Correct Answer is D

Explanation

A. Incorrect. This client is immobile but not at immediate risk from fire.
B. Incorrect. While a bedridden client wearing a hearing aid requires assistance, they are not in immediate danger like a client in traction.
C. Incorrect. A client using a wheelchair and being confused requires assistance, but the urgency is not as high as with a client in traction.
D. Correct. Oxygen is a highly combustible gas, and any spark or open flame near an oxygen source can ignite a fire. Therefore, clients receiving oxygen are at the highest risk during a fire.

A. Evaluate upper and lower extremities for perfusion, pulse volume, and pitting edema. B. Secure client consent for coronary angiography and percutaneous coronary intervention. C. Administer four 81 mg aspirin tablets providing instructions to chew before swallowing. D. Place an indwelling urinary catheter and institute strict intake and output measurements.

Correct Answer is C

Explanation

Given the client's symptoms of constant chest pressure that is unrelieved with rest, along with the client's appearance of anxiety, pallor, and diaphoresis, it indicates a high likelihood of an acute coronary event, such as a myocardial infarction (heart attack). In this situation, the nurse should prioritize immediate actions that address the potential cardiac emergency.

Aspirin is an essential medication in the initial management of acute coronary syndrome, including unstable angina and myocardial infarction. It helps to inhibit platelet aggregation and reduce the risk of clot formation in the coronary arteries. The chewable form of aspirin is recommended because it allows for more rapid absorption.

While evaluating extremities for perfusion, pulse volume, and pitting edema is important in assessing the client's overall cardiovascular status, it is not the immediate next step when faced with a suspected acute coronary event.

Securing client consent for coronary angiography and percutaneous coronary intervention (PCI) is a relevant step in the management of unstable angina and myocardial infarction, but it is not the immediate action to be taken in the emergency department. The client requires stabilization and initial medical interventions before procedural consent can be obtained.

Placing an indwelling urinary catheter and instituting strict intake and output measurements is not a priority action in this situation. The focus should be on addressing the potential acute coronary event and ensuring the client's cardiac stability. Urinary catheterization and monitoring of intake and output can be considered later, if necessary.

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A nurse is planning to teach a client about taking prednisone. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing an in-service about client evacuation during a fire. Which of the following clients should the nurse instruct the staff to evacuate first?

Correct Answer is D

Explanation

A client with a history of unstable angina presents to the emergency department with constant chest pressure that is unrelieved with rest. The client appears anxious, pale, and diaphoretic. After obtaining the client's vital signs, which action should the nurse take next?

Correct Answer is C

Explanation

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