The nurse is providing discharge instructions to a client with gout in the left great toe who received a prescription for prednisone 30 mg by mouth to be administered each day. Which symptom should the nurse explain is most important for the client to report to the healthcare provider?

Gastric Irritation.

Moon facies.

Abdominal striae.

Rapid weight gain.

Answer and Explanation

The Correct Answer is D

A. Gastric Irritation.

While gastric irritation is a common side effect of prednisone, it is not as critical as some other potential adverse effects and can often be managed with medication or dietary changes.

B. Moon facies.

Moon facies is a sign of Cushing's syndrome, a potential long-term side effect of prednisone, but it does not require immediate reporting compared to more acute symptoms.

C. Abdominal striae.
Abdominal striae (stretch marks) are a long-term side effect of corticosteroids like prednisone, but they are not typically an urgent concern.

D. Rapid weight gain.

This is the correct answer because rapid weight gain can indicate fluid retention, which may be a sign of more serious side effects such as heart failure or severe hypertension. It requires prompt medical attention to prevent further complications.

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Correct Answer is D

Explanation

A. Begin abdominal girth measurements.
Abdominal girth measurements may be important for assessing fluid status in clients with liver disease and ascites, but in this case, the elevated polymorphonuclear leukocyte count indicates a possible infection, requiring immediate intervention.

B. Review serum protein levels.
While monitoring serum protein levels is important in clients with liver disease, the priority in this situation is to address the potential infection indicated by the elevated leukocyte count.

C. Assess neurological status.
Neurological assessment may be relevant in some cases, but it is not the priority in a client with suspected infection after a paracentesis.

D. Initiate antibiotic therapy.
Given the client's symptoms and the elevated polymorphonuclear leukocyte count in the ascitic fluid, indicating possible infection (spontaneous bacterial peritonitis), initiating antibiotic therapy is the priority action to address the infection and prevent further complications.

A. Every 5 minutes for 30 minutes, then every 4 hours thereafter. B. Every 5 minutes for one hour. C. Every 15 minutes for one hour, then every 1 hour for 2 hours. D. Every 1 hour for 2 hours.

Correct Answer is A

Explanation

A. Every 5 minutes for 30 minutes is crucial after paracentesis to closely monitor for signs of hypovolemia, such as a sudden drop in blood pressure. After this initial intensive monitoring period, the frequency can be reduced to every 4 hours to assess for any delayed effects or complications.

B. Every 5 minutes for one hour is a shorter duration of monitoring compared to option A and

may not provide adequate time to detect and respond to any significant changes in blood pressure that could occur after paracentesis, especially considering the volume of fluid removed.

C. Every 15 minutes for one hour, then every 1 hour for 2 hours provides frequent monitoring

initially, but the interval between assessments is too long after the first hour, potentially missing early signs of complications such as hypovolemia.

D. Every 1 hour for 2 hours does not provide sufficient frequency of monitoring, especially during the critical immediate post-paracentesis period when rapid changes in blood pressure can occur. This schedule may delay the detection and management of complications.

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The nurse is providing discharge instructions to a client with gout in the left great toe who received a prescription for prednisone 30 mg by mouth to be administered each day. Which symptom should the nurse explain is most important for the client to report to the healthcare provider?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with decompensated liver disease who is experiencing fever, chills, and abdominal tenderness. Following a paracentesis, the nurse receives laboratory results. Exhibits After notifying the healthcare provider, which action should the nurse take next?

Correct Answer is D

Explanation

A client with pancreatic cancer develops ascites, and 2 liters of fluid are removed via paracentesis. Which schedule should the nurse implement to assess the client's blood pressure after this procedure?

Correct Answer is A

Explanation

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