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 D
Explanation
Oxygen cannot diffuse rapidly across the membrane to tissues in the eye. This is because diabetic retinopathy is a condition that occurs when high blood sugar levels damage the tiny blood vessels that nourish the retina, the light-sensitive tissue at the back of the eye. As a result, the retina becomes ischemic (lacking oxygen) and tries to grow new blood vessels that are fragile and leaky.
Choice A is wrong because inability of cells in the eye to reproduce is not a cause of diabetic retinopathy.
The retina has a high metabolic rate and needs a constant supply of oxygen and nutrients to function properly.
Choice B is wrong because increase of aqueous humor in the eye is not a cause of diabetic retinopathy.
Aqueous humor is the clear fluid that fills the front part of the eye, not the retina.
An increase of aqueous humor can cause glaucoma, which is a different eye disorder that affects the optic nerve.
Choice C is wrong because decrease of nerve innervations throughout the eye is not a cause of diabetic retinopathy.
Nerve innervations are the connections between nerves and other tissues, such as muscles or glands.
Diabetic retinopathy affects the blood vessels, not the nerves, of the retina.
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