A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

He will become hyperglycemic.

le will become hypotensive.

He will retain excess fluid.

He can safely pause prednisone for a few days.

Answer and Explanation

The Correct Answer is B

A.   The immediate concern with abrupt cessation is more related to adrenal insufficiency rather than hyperglycemia. However, chronic use of prednisone can contribute to glucose intolerance and diabetes, but this is not the primary issue with sudden discontinuation.
B.   Abrupt discontinuation of prednisone can lead to adrenal insufficiency because the body has become reliant on the medication to suppress inflammation and regulate various bodily functions. The adrenal glands may not immediately resume normal cortisol production, which can lead to symptoms of adrenal insufficiency, including hypotension.

C.   Fluid retention is a common side effect of prednisone use. However, stopping prednisone suddenly does not typically cause fluid retention; rather, it can lead to other issues like adrenal insufficiency. Fluid retention is more related to the medication's use rather than its abrupt discontinuation.
D.   Abruptly stopping high-dose prednisone, especially after long-term use, can be dangerous. The body may not immediately resume normal cortisol production, leading to symptoms of adrenal insufficiency, such as fatigue, weakness, and hypotension. It is crucial to taper off prednisone gradually under medical supervision to allow the adrenal glands time to recover and to avoid withdrawal symptoms.

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Correct Answer is B

Explanation

A. This blood pressure and heart rate are within normal ranges for most patients. For example, a blood pressure of 132/60 mmHg is slightly elevated on the systolic side but not critically so, and a heart rate of 90 beats per minute is within the normal range (60-100 beats per minute).
B. Continuous bladder irrigation is used to prevent clots and debris from obstructing the urinary tract after a TURP. If the output from the Foley catheter has stopped, it may indicate a blockage or clot in the catheter or bladder, which can lead to bladder distension, discomfort, and potential kidney damage.
Immediate reporting to the provider is crucial because this could indicate a severe complication.
C. Pain levels are subjective, and a pain level of 5/10 indicates moderate discomfort. While pain management is important, a pain level of 5/10 is not unusual after TURP, and it can often be managed with appropriate pain relief measures.
D. Pink-colored urine is not uncommon immediately following a TURP as a result of bleeding or irritation from the procedure. This finding can be expected and may not indicate an immediate complication.
However, if the urine color changes to bright red or if there is a significant increase in blood, it could be more concerning.

A. Pneumothorax B. Hyperinflation C. Masses D. Atelectasis

Correct Answer is B

Explanation

A. A pneumothorax, or collapsed lung, occurs when air enters the pleural space, leading to lung collapse. While a pneumothorax can be a serious issue, it is not a typical finding associated with advanced COPD.
B. Hyperinflation is a hallmark finding of advanced COPD. It occurs when air becomes trapped in the lungs due to obstructed airways and damaged alveoli, leading to increased lung volumes and overexpansion of the lungs. On a chest X-ray, hyperinflation appears as an increased retrosternal air space, flattened diaphragm, and possibly increased lung volumes.
C. The presence of masses on a chest X-ray might suggest malignancies or other lung pathologies, but it is not a typical finding in COPD. While lung cancer can co-occur with COPD, masses themselves are not a direct indicator of COPD but rather a potential separate issue that would need further evaluation.
D. Atelectasis refers to the collapse of lung tissue due to loss of air in the alveoli, which can occur from various causes including obstruction or compression of the lung. While atelectasis can be seen in various pulmonary conditions, it is not specific to advanced COPD.

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A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for a client who has shortness of breath and a chronic cough. The client has smoked one pack of cigarettes per day for the last 20 years. Which finding on the client's chest x-ray would be consistent with a diagnosis of advanced COPD?

Correct Answer is B

Explanation

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