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 A
Explanation
Desmopressin is a synthetic analog of antidiuretic hormone (ADH) that acts on the kidneys to increase water reabsorption and decrease urine output. Neurogenic diabetes insipidus is a condition caused by a deficiency of ADH due to damage to the hypothalamus or pituitary gland. Patients with this condition have excessive thirst and urination, dehydration, and low urine specific gravity.
Choice B. Methylprednisolone is wrong because it is a corticosteroid that suppresses inflammation and immune response.
It is not used to treat diabetes insipidus.
Choice C. Dexamethasone is wrong because it is also a corticosteroid that has similar effects as methylprednisolone.
It is not used to treat diabetes insipidus.
Choice D. Physostigmine is wrong because it is a cholinesterase inhibitor that increases the levels of acetylcholine in the body.
It is used to treat myasthenia gravis and anticholinergic poisoning.
It has no effect on diabetes insipidus.
Correct Answer is A
Explanation
Tolbutamide is preferred for clients with renal dysfunction, who may not be able to excrete chlorpropamide, because it is more easily cleared from the body.
Choice B. Tolazamide is wrong because it is a first-generation sulfonylurea that is used less frequently and is usually tried after tolbutamide and chlorpropamide have been shown to be ineffective.
Choice C. Chlorpropamide is wrong because it is a first-generation sulfonylurea that may accumulate in clients with renal dysfunction and cause hypoglycemia.
Choice D. Chlorpromazine is wrong because it is an antipsychotic agent, not an oral antidiabetic agent.
First-generation sulfonylureas are oral antidiabetic agents that stimulate insulin secretion from the pancreas.
They are used to treat type 2 diabetes mellitus.
The normal range of blood glucose level is 70 to 110 mg/dL.
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