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.”.

Answer and Explanation

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.

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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 would only need one injection per day.

Choice A. Aspart is wrong because aspart is a rapid-acting insulin that has a peak effect within 1 to 3 hours and lasts for 3 to 5 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 has a similar onset and duration as aspart.

It would not provide adequate coverage for a long international flight.

Choice C. Glulisine is wrong because glulisine is another rapid-acting insulin that has an onset of 15 minutes and a duration of 2 to 4 hours.

It would also require multiple injections and frequent blood glucose checks.

Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.

A. Number of times client’s family reports the client is nauseated. B. How well the client is eating. C. Color and amount of vomit, and frequency of vomiting episodes. D. Client’s nutritional status and fluid balance.

Correct Answer is C

Explanation

The nurse would assess these factors to determine the need for therapy. Some possible explanations for the other choices are:

Choice A. Number of times client’s family reports the client is nauseated.

This is not a reliable indicator of the severity or cause of nausea and vomiting.

The nurse should assess the client directly and not rely on the family’s reports.

Choice B. How well the client is eating.

This is not a specific or objective measure of nausea and vomiting.

The client may have other reasons for not eating well, such as loss of appetite, taste changes, or pain.

The nurse should also monitor the client’s weight, hydration status, and electrolyte levels.

Choice D. Client’s nutritional status and fluid balance.

These are important aspects of the client’s overall health, but they are not directly related to nausea and vomiting.

The nurse should assess these factors as part of the comprehensive care plan, but they are not sufficient to determine the need for therapy.

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The home health nurse provides client teaching to a client who is taking oral prednisolone. The nurse provides what instruction to the client?

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Naxlex Comprehensive Predictor Exams

A client with type 1 diabetes presents to the diabetes educator and asks about a change in insulin. The client’s occupation requires long international flights, and the client does not want to administer insulin on the plane. What kind of insulin would best meet this client’s needs?

Correct Answer is D

Explanation

A client has begun reporting nausea and vomiting. What would the nurse assess to determine the need for therapy?

Correct Answer is C

Explanation

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The home health nurse provides client teaching to a client who is taking oral prednisolone.
The nurse provides what instruction to the client?