A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for over ten years to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

Monitor for compression fractures of the back and neck.

Glucocorticoids will boost immunity.

Plan to check blood glucose levels for hypoglycemia once each year.

Limit the intake of calcium rich foods while taking the medication.

Answer and Explanation

The Correct Answer is A

A. Monitor for compression fractures of the back and neck: Long-term use of glucocorticoids increases the risk of osteoporosis, leading to compression fractures. Monitoring for these complications is critical for early intervention.

B. Glucocorticoids will boost immunity: Glucocorticoids suppress immune function, increasing susceptibility to infections. This statement is incorrect.

C. Plan to check blood glucose levels for hypoglycemia once each year: Glucocorticoids often cause hyperglycemia, not hypoglycemia, necessitating frequent monitoring, especially in individuals at risk of diabetes.

D. Limit the intake of calcium-rich foods while taking the medication: Calcium-rich foods are encouraged to mitigate the risk of glucocorticoid-induced osteoporosis, making this advice inappropriate.

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Correct Answer is C

Explanation

A. "I will discard the current vial of insulin after six doses have been withdrawn.": Insulin vials can be used for up to 28 days when stored at room temperature, not discarded based on the number of doses withdrawn.

B. "I will return any unused vials of insulin to the pharmacy once they have been on the unit for 1 month.": Unused insulin vials should be stored properly (refrigerated for unopened vials) and do not need to be returned unless there is an error or expired stock.

C. "I can keep the current vial of insulin in use stored at room temperature.": Once opened, insulin vials can be stored at room temperature (below 86°F or 30°C) for up to 28 days to prevent degradation.

D. "I will store unopened vials of insulin in the freezer.": Freezing insulin damages its effectiveness; unopened insulin should be refrigerated but never frozen.

A. Increased urine output B. Fluid retention C. Hypertension D. Elevated blood glucose

Correct Answer is A

Explanation

A. Increased urine output: Diabetes insipidus (DI) results from insufficient antidiuretic hormone (ADH) or kidney insensitivity to ADH, leading to polyuria and dehydration.

B. Fluid retention: Fluid retention is more indicative of the syndrome of inappropriate antidiuretic hormone (SIADH), not DI.

C. Hypertension: DI typically causes dehydration and low blood pressure, not hypertension.

D. Elevated blood glucose: Elevated glucose is a feature of diabetes mellitus, not DI, which is unrelated to glucose metabolism.

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A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for over ten years to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

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