The nurse is providing discharge teaching for a client prescribed prednisone to be taken on alternate days. The client asks why he cannot just take half a pill every day.
What rationale should the nurse describe?
To decrease adrenal suppression.
To eliminate adverse side effects.
To prevent steroid tolerance.
To prolong therapeutic effects.
The Correct Answer is A
Prednisone is a glucocorticoid that suppresses the production of natural cortisol by the adrenal glands. Taking prednisone on alternate days allows the adrenal glands to recover and produce some cortisol on the days without prednisone.
Choice B is wrong because prednisone does not eliminate adverse side effects, but may cause some such as weight gain, fluid retention, increased blood pressure, increased blood glucose, and increased risk of infection.
Choice C is wrong because there is no evidence of steroid tolerance, which means that higher doses are needed to achieve the same effect.
Choice D is wrong because prednisone does not prolong therapeutic effects, but may decrease them over time due to feedback inhibition of cortisol secretion.
Normal ranges for cortisol are 6 to 23 mcg/dL in the morning and 2 to 11 mcg/dL in the afternoon.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should advise the client to avoid aluminum salts because they can increase the risk of aluminum toxicity when taken with sucralfate. Sucralfate forms a protective coating over the ulcer and binds to aluminum in the stomach.
Choice A is wrong because Milk of Magnesia is a magnesium-based antacid that can cause diarrhea, but does not interact with sucralfate.
Choice B is wrong because Calcium carbonate is a calcium-based antacid that can cause constipation, but does not interact with sucralfate.
Choice D is wrong because Proton pump inhibitors are drugs that reduce the production of stomach acid and can help heal ulcers.
They do not interact with sucralfate.
Correct Answer is A
Explanation
800 mg PO at bedtime is an appropriate dosage and frequency of cimetidine for the treatment of gastric ulcer. Cimetidine is a histamine H antagonist that reduces the secretion of gastric acid.
Choice B is wrong because 150 mg PO b.i.d. is too low of a dose for cimetidine. The usual adult dose for duodenal ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
Choice C is wrong because 20 mg PO b.i.d. is not a valid dose for cimetidine.
The lowest available tablet strength is 100 mg.
Choice D is wrong because 300 mg PO at bedtime is also too low of a dose for cimetidine.
The usual adult dose for gastric ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
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