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
The nurse should caution the student to avoid using alcohol with trimethobenzamide because this combination can cause side effects such as drowsiness, dizziness, and impaired reactions. Alcohol can also worsen the symptoms of nausea and vomiting.
Choice A is wrong because St.
John’s wort is a herbal supplement that is used to treat depression and anxiety.
It does not interact with trimethobenzamide.
Choice C is wrong because calcium channel blockers are a class of medications that are used to treat high blood pressure and heart problems.
They do not interact with trimethobenzamide.
Choice D is wrong because selective serotonin reuptake inhibitors (SSRIs) are a class of medications that are used to treat depression and anxiety.
They do not interact with trimethobenzamide.
Trimethobenzamide is an antihistamine that works by blocking the D receptor in the brain and suppressing the chemoreceptor trigger zone that causes nausea and vomiting.
It is available as an oral capsule or an intramuscular injection.
It can cause side effects such as skin rash, tremors, parkinsonism, and jaundice.
It should not be used in children or people with liver or kidney disease.
Correct Answer is A
Explanation
This is because levothyroxine can increase the anticoagulant effect of oral anticoagulants and increase the risk of bleeding. The nurse should check the client’s prothrombin time and international normalized ratio (INR) regularly and report any abnormal values to the prescriber.
Choice B is wrong because hypothyroidism does not increase the risk of infection.
Choice C is wrong because hypothyroidism does not affect the level of consciousness unless it is severe and causes myxedema coma.
Choice D is wrong because hypothyroidism does not cause electrolyte imbalances.
Normal ranges for prothrombin time are 11 to 13.5 seconds and for INR are 0.8 to 1.22.
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