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 a nutritious diet provides adequate fiber and nutrients for the GI tract, avoiding alcohol prevents dehydration and irritation of the GI mucosa, and cautious use of laxatives prevents dependency and electrolyte imbalance.
Choice A is wrong because caffeine can stimulate the GI motility and cause diarrhea or cramps.
Choice C is wrong because some prescription medications can affect the GI function, such as antibiotics, opioids, or antacids.
Increased fluid intake is good, but not enough to promote optimal GI function.
Vigorous exercise can also cause GI distress or dehydration.
Choice D is wrong because adequate fluid intake is essential for preventing constipation and maintaining hydration.
Exercise can also help with bowel movements and overall health.
Normal ranges for GI function vary depending on the individual, but generally, a person should have at least one bowel movement every 3 days and no more than 3 bowel movements per day.
The stool should be soft, formed, and easy to pass.
Correct Answer is B
Explanation
Metoclopramide is a medication that increases muscle contractions in the upper digestive tract and speeds up the rate at which the stomach empties into the intestines. It is used to treat gastroparesis (slow stomach emptying) in people with diabetes, which can cause heartburn and stomach discomfort after meals.
Choice A is wrong because impaction is a condition where a large mass of dry, hard stool becomes stuck in the rectum and cannot be passed.
Metoclopramide does not treat impaction, but laxatives or enemas may be used instead.
Choice C is wrong because encopresis is a condition where a child over the age of 4 has involuntary bowel movements, usually due to chronic constipation.
Metoclopramide does not treat encopresis, but behavioral therapy, laxatives, or dietary changes may be used instead.
Choice D is wrong because metoclopramide is not used for clients requiring diagnostic procedures involving the stomach or intestines.
However, it may be used to prevent nausea and vomiting caused by chemotherapy or surgery.
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