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
This is because cortisol exhibits a proper 24-h circadian rhythm that affects the cardiovascular system and other organs. Cortisol levels are normally low at the beginning of sleep and high at the moment of awakening. Taking corticosteroids at this time mimics the natural cortisol rhythm and may reduce side effects such as adrenal suppression, sleep disturbances and cardiovascular complications.
Choice A is wrong because taking corticosteroids at 08:00 may not coincide with the client’s natural cortisol peak and may cause insomnia or unpleasant dreams.
Choice B is wrong because taking corticosteroids at 22:00 may disrupt the client’s sleep quality and increase the risk of nocturnal hypertension.
Choice D is wrong because taking corticosteroids at 16:00 may interfere with the client’s natural cortisol decline and cause hyperglycemia or dyslipidemia.
Correct Answer is D
Explanation
Glargine is a long-acting insulin that can provide a steady level of insulin for up to 24 hours. This would be suitable for a client who does not want to administer insulin on the plane, as they can take it once a day at the same time.
Choice A. Glulisine is wrong because glulisine is a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would require frequent injections and monitoring of blood glucose levels.
Choice B. Lispro is wrong because lispro is also a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Choice C. Aspart is wrong because aspart is another rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.
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