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 B
Explanation
This is because antiemetics should be given to prevent motion sickness rather than after nausea or vomiting develop. Taking the medication 30 minutes before departing allows enough time for the drug to be absorbed and reach its peak effect.
Choice A is wrong because avoiding eating or drinking for 6 hours before the trip may cause dehydration and low blood sugar, which can worsen nausea and vomiting.
It is better to eat a light meal or snack before the trip and avoid spicy, greasy, or acidic foods.
Choice C is wrong because taking two doses if relief is not achieved may cause overdose and adverse effects.
Antiemetics should be taken as prescribed and not exceeded without consulting a doctor.
Choice D is wrong because increasing fluid intake to prevent urinary retention is not relevant for motion sickness.
Urinary retention is a possible side effect of some antiemetics, such as anticholinergics, but it is not a common problem for most people.
Fluid intake should be moderate and not excessive to avoid stomach distension.
Correct Answer is B
Explanation
Levothyroxine is a synthetic thyroid hormone that is used to treat hypothyroidism. It should be taken on an empty stomach, preferably in the morning, with a full glass of water to facilitate absorption and prevent choking. Taking the medication with food or other substances may interfere with its effectiveness.
Choice A is wrong because levothyroxine does not need to be taken after breakfast.
In fact, taking it after breakfast may reduce its absorption and efficacy.
Choice C is wrong because levothyroxine does not require the patient to remain in the upright position for 30 minutes after administering.
This instruction is more applicable to bisphosphonates, which are drugs used to treat osteoporosis.
Choice D is wrong because levothyroxine should not be taken at night.
Taking it at night may cause insomnia, as well as reduced absorption and efficacy.
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