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 A

Explanation

A. Peaked T-waves and a widened QRS complex on an ECG are often signs of hyperkalemia, which is an elevated potassium level in the blood. This can be a serious complication of acute kidney injury (AKI), especially in the oliguric phase when the kidneys are unable to effectively excrete potassium.A
B. While fluid management is important in AKI, administering a bolus of normal saline is not the first priority in the presence of suspected hyperkalemia. The primary concern is to address the electrolyte imbalance.

C. Administering potassium chloride would worsen hyperkalemia and should be avoided.
D. Kayexalate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the gastrointestinal tract. However, checking the potassium level is the first step in confirming the diagnosis and determining the appropriate treatment.

A. Edrophonium B. Prednisone C. Carbidopa-levodopa D. Riluzole

Correct Answer is C

Explanation

A. Edrophonium is used to diagnose myasthenia gravis, a neuromuscular disorder that causes muscle weakness. It is not used to treat the symptoms described in the question.
B. Prednisone is a corticosteroid used to treat various conditions, including autoimmune diseases and allergies. It is not used to treat Parkinson's disease, which is the most likely diagnosis based on the symptoms described.
C. This medication is the gold standard for treating Parkinson's disease, a neurodegenerative disorder that causes tremors, rigidity, bradykinesia (slowed movements), and postural instability. Carbidopa- levodopa helps to increase dopamine levels in the brain, which can improve motor function and reduce symptoms.
D. Riluzole is used to treat amyotrophic lateral sclerosis (ALS), a neurodegenerative disease that affects motor neurons. It is not used to treat Parkinson's disease.

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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

A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?

Correct Answer is A

Explanation

A client is seen in a primary care provider's office. The client has gradually developed a stooped posture, shuffling gait, and a lack of facial expressions. Which medication should the nurse anticipate will be prescribed to treat these symptoms?

Correct Answer is C

Explanation

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