A 45-year-old patient has been taking Prednisone daily for 12 weeks to manage severe rheumatoid arthritis. The patient's condition has improved, and the healthcare provider decides to discontinue the medication. Which of the following statements best explains why gradually tapering down the Prednisone dose is necessary?
To decrease the cost of medication for the patient
To prevent the risk of acute adrenal insufficiency
To minimize the potential for drug interactions
To reduce the likelihood of rheumatoid arthritis flare-up
The Correct Answer is B
A. To decrease the cost of medication for the patient: While cost may be a consideration in long-term therapy, it is not the primary reason for tapering corticosteroids. The tapering process is necessary to protect the patient’s physiological balance, not driven by cost concerns.
B. To prevent the risk of acute adrenal insufficiency: Long-term prednisone use suppresses the hypothalamic-pituitary-adrenal (HPA) axis. Abrupt discontinuation can lead to adrenal insufficiency, a potentially life-threatening condition characterized by hypotension, fatigue, and electrolyte imbalances. Gradual tapering allows the adrenal glands to resume natural cortisol production.
C. To minimize the potential for drug interactions: Tapering does not reduce drug interactions. Such risks are managed through medication reconciliation and monitoring, not by adjusting steroid taper schedules.
D. To reduce the likelihood of rheumatoid arthritis flare-up: While tapering may reduce flare risk, the primary concern is adrenal suppression. Flare prevention is managed with other disease-modifying agents rather than the tapering schedule alone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "I should avoid antitussives if I have a productive cough with mucus.": Antitussives can inhibit the body’s ability to clear mucus when coughing is suppressed. In the case of a productive cough, clearing secretions is essential to prevent airway obstruction and secondary infections.
B. "Antitussives are helpful in clearing mucus from my lungs during a productive cough.": Antitussives reduce the cough reflex and do not aid in mucus clearance. Their use during a productive cough can lead to mucus retention, worsening congestion and increasing the risk of complications such as pneumonia.
C. "Using antitussives for a productive cough can lead to mucus buildup in my airways.": Suppressing a productive cough prevents the expulsion of mucus, which can accumulate in the lungs. This can impair gas exchange and create an environment for bacterial growth.
D. "Antitussives are used to suppress a dry, nonproductive cough.": These medications are most appropriate when there is no mucus to expel. They help reduce the frequency and intensity of dry coughing, especially when it interferes with sleep or comfort.
Correct Answer is C
Explanation
A. Montelukast: This leukotriene receptor antagonist is used for long-term asthma control and prevention of exercise-induced bronchospasm. It is not effective for treating acute asthma attacks due to its delayed onset of action.
B. Salmeterol: This is a long-acting beta-2 agonist (LABA) used for maintenance therapy in asthma. It has a slower onset and should never be used for rapid symptom relief during an acute attack, as doing so can delay appropriate treatment.
C. Albuterol: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid bronchodilation and is the first-line rescue medication for aborting an acute asthma attack. It works within minutes to relieve bronchospasm and improve airflow.
D. Beclomethasone: This inhaled corticosteroid is used for long-term asthma management by reducing airway inflammation. It is not effective in acute situations because it does not provide immediate bronchodilation.
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