Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

Patient stopped taking the medication 2 days ago

Patient has not been taking the prescribed vitamin D

Patient has bilateral 2+ pitting ankle edema

Patient's blood pressure is 148/94 mm Hg

Answer and Explanation

The Correct Answer is A

Choice A reason: Patient stopped taking the medication 2 days ago is the most important information to report to the health care provider. Prednisone is a corticosteroid medication that suppresses the immune system and reduces inflammation. Prednisone also affects the production of cortisol, a hormone that regulates the stress response, blood pressure, blood sugar, and metabolism. Prednisone should not be stopped abruptly, as this can cause adrenal insufficiency, a condition where the adrenal glands cannot produce enough cortisol. Adrenal insufficiency can cause symptoms such as fatigue, weakness, nausea, vomiting, low blood pressure, and hypoglycemia. The patient should be instructed to resume taking the prednisone and taper the dose gradually under the supervision of the health care provider.

Choice B reason: Patient has not been taking the prescribed vitamin D is not as important as choice A, but still requires further education by the nurse. Vitamin D is a fat-soluble vitamin that helps the body absorb calcium and phosphorus, and maintain bone health. Prednisone can interfere with the metabolism of vitamin D and cause bone loss, osteoporosis, and fractures. The patient should be advised to take the prescribed vitamin D supplement and eat foods rich in vitamin D, such as fatty fish, egg yolks, cheese, and fortified milk.

Choice C reason: Patient has bilateral 2+ pitting ankle edema is not as critical as choice A, but still needs to be monitored by the nurse. Ankle edema is swelling of the ankles due to fluid accumulation in the tissues. Prednisone can cause ankle edema by increasing the sodium and water retention in the body, and reducing the potassium excretion by the kidneys. The patient should be assessed for signs of fluid overload, such as weight gain, shortness of breath, and crackles in the lungs. The patient should also be encouraged to limit the intake of salt and fluids, and elevate the legs when sitting or lying down.

Choice D reason: Patient's blood pressure is 148/94 mm Hg is not as urgent as choice A, but still needs to be addressed by the nurse. Blood pressure is the force of blood against the walls of the arteries. Prednisone can increase the blood pressure by stimulating the renin-angiotensin-aldosterone system, a hormonal system that regulates the blood volume and pressure. The patient should be advised to check the blood pressure regularly, and report any readings above 140/90 mm Hg to the health care provider. The patient should also be counseled to follow a healthy lifestyle, such as exercising, quitting smoking, reducing stress, and eating a balanced diet low in sodium, fat, and cholesterol.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: This statement is false. Edema is a sign of fluid overload, not fluid deficit. Edema occurs when fluid accumulates in the interstitial space due to increased capillary hydrostatic pressure or decreased plasma oncotic pressure. Edema is more common in patients with heart failure, liver disease, or kidney disease¹.

Choice B reason: This statement is false. Skin turgor is a measure of skin elasticity and hydration. It can be affected by factors such as age, skin condition, and ambient temperature. Skin turgor is not a reliable indicator of fluid balance, as it can be normal in patients with mild to moderate hypovolemia².

Choice C reason: This statement is false. Urine output is a measure of kidney function and fluid excretion. It can be influenced by factors such as fluid intake, diuretics, hormones, and renal diseases. Urine output is not a sensitive indicator of fluid balance, as it can be normal or even increased in patients with hypovolemia due to compensatory mechanisms.

Choice D reason: This statement is true. Daily weight is a measure of body mass and fluid status. It can reflect changes in fluid balance more accurately than other methods, as long as the weight is measured at the same time, on the same scale, and with the same clothing each day. A decrease in weight can indicate fluid loss due to hypovolemia.

A. A serum potassium level of 5.6 mEq/L B. A serum sodium level of 142 mEq/L C. A serum sodium level of 138 mEq/L D. A serum potassium level of 2.8 mEq/L

Correct Answer is D

Explanation

Choice A reason: A serum potassium level of 5.6 mEq/L is not a common side effect of furosemide, but of hyperkalemia. Hyperkalemia is a condition where the blood potassium level is too high. It can cause muscle weakness, irregular heartbeat, and cardiac arrest. Furosemide is a loop diuretic that increases the urinary excretion of water, sodium, chloride, and potassium. It can cause hypokalemia, which is a low blood potassium level, not hyperkalemia.

Choice B reason: A serum sodium level of 142 mEq/L is not a common side effect of furosemide, but of normal sodium level. The normal range of serum sodium level is 135 to 145 mEq/L. Sodium is an electrolyte that helps regulate the fluid balance, nerve impulses, and muscle contractions in the body. Furosemide can cause hyponatremia, which is a low blood sodium level, but not a normal sodium level.

Choice C reason: A serum sodium level of 138 mEq/L is also not a common side effect of furosemide, but of normal sodium level. As explained in choice B, the normal range of serum sodium level is 135 to 145 mEq/L. Furosemide can cause hyponatremia, which is a low blood sodium level, but not a normal sodium level.

Choice D reason: A serum potassium level of 2.8 mEq/L is a common side effect of furosemide, and of hypokalemia. Hypokalemia is a condition where the blood potassium level is too low. It can cause muscle cramps, fatigue, weakness, arrhythmias, and paralysis. Furosemide is a loop diuretic that increases the urinary excretion of water, sodium, chloride, and potassium. It can cause hypokalemia, which is a low blood potassium level. The nurse should monitor the client's serum potassium level and signs of hypokalemia, and advise the client to eat potassium-rich foods, such as bananas, oranges, and potatoes. The nurse should also report the lab value to the prescriber, who may adjust the dose of furosemide or prescribe a potassium supplement.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with multiple draining wounds is admitted for hypovolemia. Which assessment would be the most accurate way for the nurse to evaluate fluid balance?

Correct Answer is D

Explanation

A client is taking furosemide (Lasix) for management of mild hypertension. The nurse knows to assess laboratory results for a side effect of this diuretic. Select the lab value that matches a common side effect of this medication.

Correct Answer is D

Explanation

After change-of-shift report, which patient will the nurse assess first?

Jo is a client with Type 1 Diabetes. Jo has a blood glucose level of 644 mg/dL. The nurse interprets that this client is most at risk of developing which type of acid-base imbalance?

A patient with diabetes is starting on insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

A client is taking furosemide (Lasix) for management of mild hypertension. The nurse knows to assess laboratory results for a side effect of this diuretic. Select the lab value that matches a common side effect of this medication.

The nurse reads the chart for a client with diabetes. The chart indicates 'history of autonomic neuropathy.' The nurse knows that autonomic neuropathy may cause which symptoms?

Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

When Jo returns home, the nurse provides education about long-term complications. The nurse explains the importance of annual/yearly screenings, such as eye exams and...

Which patient statement indicates a need for further education regarding medications after a bilateral adrenalectomy?