A client with asthma has been taking prednisone daily for two years and is now in the emergency department complaining of back pain.
An MRI of the spine shows a compression fracture of a vertebra.
Which adverse effect of prednisone is most likely associated with these findings?
Fluid retention
Osteoporosis
Adrenal insufficiency
Gastrointestinal bleeding
The Correct Answer is B
Choice A rationale
Fluid retention is a common side effect of prednisone, but it is not directly associated with compression fractures of the vertebrae.
Choice B rationale
Long-term use of prednisone can lead to osteoporosis, a condition that weakens bones and makes them more likely to break. Osteoporosis can increase the risk of fractures, including compression fractures of the vertebrae. This is likely the adverse effect of prednisone that is most associated with the client’s findings.
Choice C rationale
Adrenal insufficiency is a potential side effect of long-term prednisone use. However, it is not directly linked to compression fractures of the vertebrae.
Choice D rationale
While gastrointestinal bleeding can occur with prednisone use, it is not directly related to compression fractures of the vertebrae.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Digoxin is a cardiac glycoside used to treat heart failure and atrial fibrillation. While it’s important to monitor digoxin levels in patients receiving gentamicin due to the risk of increased digoxin levels, it’s not the most concerning medication.
Choice B rationale
Furosemide is a loop diuretic that can cause ototoxicity, especially when used with aminoglycosides like gentamicin. Therefore, this is the medication the nurse should be most concerned about.
Choice C rationale
Prednisolone is a corticosteroid medication. While it’s important to monitor for potential interactions, it’s not the most concerning medication in this context.
Choice D rationale
Warfarin is an anticoagulant medication. While it’s important to monitor for potential interactions, it’s not the most concerning medication in this context.
Correct Answer is B
Explanation
Choice A rationale
Peripheral edema is not a common side effect of stopping steroids early. Peripheral edema is often associated with conditions such as heart failure, liver disease, or kidney disease.
Choice B rationale
Low blood pressure is a common side effect when a person stops taking steroids like prednisone abruptly. Prednisone is a glucocorticoid, a type of steroid that works to mimic the effects of cortisol, a hormone that the adrenal glands produce. The body uses cortisol to regulate the heart rate and blood pressure. When a person takes prednisone for longer than a few weeks, the body reduces the amount of cortisol it makes. When a person suddenly stops taking prednisone, the body cannot immediately produce enough cortisol to make up for the missing drug. This results in withdrawal symptoms, including low blood pressure.
Choice C rationale
Hyperglycemia, or high blood sugar, is not typically a withdrawal symptom of stopping steroids early. While long-term use of steroids can lead to increased blood sugar levels, stopping the medication does not typically cause hyperglycemia.
Choice D rationale
Weight loss can be a symptom of steroid withdrawal, but it is not the most immediate or common symptom that would be anticipated in a client who stopped taking their prescribed steroids early. More common symptoms include fatigue, joint pain, and low blood pressure.
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