The home health nurse provides client teaching to a client who is taking oral prednisolone.
The nurse provides what instruction to the client?
“Split the dose into two equal doses.”.
“Take before bedtime.”.
“Take 1 hour before meals.”.
“Take it first thing in the morning.”.
The Correct Answer is D
This is because prednisolone can cause insomnia if taken later in the day, and it mimics the natural secretion of cortisol by the adrenal glands, which peaks in the morning.
Choice A is wrong because splitting the dose into two equal doses can increase the risk of adrenal suppression and reduce the efficacy of alternate-day therapy (ADT), which is used to minimize adverse effects of corticosteroids.
Choice B is wrong because taking prednisolone before bedtime can interfere with sleep and cause nocturnal cortisol secretion, which can lead to Cushing syndrome.
Choice C is wrong because taking prednisolone 1 hour before meals can cause gastric irritation and ulceration, and it is recommended to take it with food or milk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
Correct Answer is A
Explanation
This is because proton pump inhibitors (PPIs) are drugs that block the enzyme that produces hydrochloric acid in the stomach, thereby reducing the amount of acid secreted into the lumen. PPIs are commonly used to treat peptic ulcer disease and gastroesophageal reflux disease.
Choice B. Histamine-2 antagonist is wrong because histamine-2 antagonists (H blockers) are drugs that block the action of histamine on the parietal cells of the stomach, thereby reducing the amount of acid secreted into the lumen.
However, PPIs are more potent and effective than H blockers in suppressing acid secretion.
Choice C. Prostaglandin is wrong because prostaglandins are substances that protect the stomach lining from the damaging effects of acid and other factors.
Prostaglandins do not directly affect the secretion of acid into the lumen, but they may increase the production of mucus and bicarbonate that buffer the acid.
Choice D. Antipeptic agent is wrong because antipeptic agents are drugs that form a protective barrier over the ulcer crater, preventing further damage from acid and pepsin.
Antipeptic agents do not affect the secretion of acid into the lumen, but they may enhance healing by creating a favorable environment for tissue repair.
Normal ranges for hydrochloric acid secretion in the stomach are 1.5 to 3.5 liters per day, with a pH of 1.5 to 3.53.
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