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 A
Explanation
Desmopressin is a synthetic analog of antidiuretic hormone (ADH) that acts on the kidneys to increase water reabsorption and decrease urine output. Neurogenic diabetes insipidus is a condition caused by a deficiency of ADH due to damage to the hypothalamus or pituitary gland. Patients with this condition have excessive thirst and urination, dehydration, and low urine specific gravity.
Choice B. Methylprednisolone is wrong because it is a corticosteroid that suppresses inflammation and immune response.
It is not used to treat diabetes insipidus.
Choice C. Dexamethasone is wrong because it is also a corticosteroid that has similar effects as methylprednisolone.
It is not used to treat diabetes insipidus.
Choice D. Physostigmine is wrong because it is a cholinesterase inhibitor that increases the levels of acetylcholine in the body.
It is used to treat myasthenia gravis and anticholinergic poisoning.
It has no effect on diabetes insipidus.
Correct Answer is D
Explanation
Glulisine is a rapid-acting insulin that has an onset of action of 2 to 5 minutes and peaks in 30 to 90 minutes, making it the fastest among the choices. Some possible explanations for the other choices are:
Choice A. Aspart is also a rapid-acting insulin, but it has a slightly longer onset of action (10 to 20 minutes) and peak time (1 to 3 hours) than glulisine.
Choice B. Lispro is another rapid-acting insulin, but it has a similar onset of action (<15 minutes) and peak time (30 to 90 minutes) as glulisine, so it is not the fastest.
Choice C. Regular is a short-acting insulin that has a much longer onset of action (30 to 60 minutes) and peak time (2 to 4 hours) than glulisine, so it is not suitable for fast therapeutic effects.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
Insulin doses are adjusted based on blood glucose monitoring, carbohydrate intake, physical activity, and other factors.
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