A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

Hyperglycemia

Hyperkalemia

Fluid retention

Gl distress

Hypotension

Answer and Explanation

Correct Answer : A,C,D

A) Hyperglycemia:
Prednisone, a glucocorticoid, can increase blood glucose levels by stimulating the liver to produce more glucose and decreasing the effectiveness of insulin. This can lead to hyperglycemia, particularly in individuals who are predisposed to diabetes or glucose intolerance. Therefore, monitoring blood glucose levels is important during prednisone therapy, especially in clients with a history of diabetes or those at risk for developing it.

B) Hyperkalemia:
Prednisone and other corticosteroids typically decrease potassium levels rather than increase them. This occurs because corticosteroids can promote the excretion of potassium in the kidneys. Hyperkalemia is not a common side effect of prednisone therapy. In fact, hypokalemia (low potassium) is more likely to occur, so this is not a concern for clients receiving prednisone.

C) Fluid retention:
One of the common side effects of prednisone is fluid retention due to its effect on the kidneys and the way it can increase sodium reabsorption. This can lead to edema (swelling), especially in the lower extremities, and could also contribute to an increase in blood pressure. Clients taking prednisone, particularly in higher doses or for extended periods, should be monitored for signs of fluid retention and hypertension.

D) GI distress:
Gastrointestinal distress, including gastritis, ulcers, or nausea, is a common side effect of prednisone and other corticosteroids. The risk is higher if the medication is taken on an empty stomach or at high doses. To minimize this, prednisone is typically taken with food or milk, and clients are monitored for signs of GI irritation.

E) Hypotension:
Prednisone can cause increased blood pressure due to fluid retention and the resulting increased blood volume. It can also affect the balance of sodium and potassium, contributing to hypertension rather than hypotension. Hypotension is not a typical side effect of prednisone therapy, and the nurse should be vigilant for signs of high blood pressure rather than low.

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 A

Explanation

A) Class II:
According to the New York Heart Association (NYHA) classification of heart failure, Class II is characterized by slight limitation in physical activity. Patients in this class are comfortable at rest but experience symptoms (such as fatigue, palpitations, or shortness of breath) during ordinary physical activity. This description fits the client's reported symptoms, which include comfort at rest and the onset of symptoms with routine activity, such as walking or climbing stairs.

B) Class IV:
Class IV is the most severe stage of heart failure. Patients in this class are unable to carry out any physical activity without discomfort and experience symptoms at rest, such as shortness of breath or fatigue. The symptoms do not improve with rest, and even minimal exertion exacerbates the condition.

C) Class I:
Class I heart failure is characterized by no limitation in physical activity. Patients in this class are able to carry out ordinary physical activity without fatigue, palpitations, or dyspnea. Since this client experiences symptoms with ordinary activity, they do not meet this criteria.

D) Class III:
Class III represents patients with marked limitation of physical activity. They are comfortable at rest, but less than ordinary activity causes fatigue, palpitations, or shortness of breath. While this client does report symptoms with ordinary physical activity, Class III patients experience greater limitation in activity than described in this scenario. The client in this case only has slight limitation with ordinary activity, so Class III does not apply.

A. Barrel chest B. Increased fatigue C. Respiratory rate 40bpm D. Thin appearance

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Assessment findings	Expected Findings	Findings to be reported to provider
Barrel chest	✔️
Increased fatigue		✔️
Respiratory rate 40bpm		✔️
Thin appearance	✔️

Barrel chest: Expected Finding

Increased fatigue: Finding to be reported to the provider

Respiratory rate 40 bpm: Finding to be reported to the provider

Thin appearance: Expected Finding

Rationales:

Barrel chest – Expected Finding:

A barrel chest is a common physical finding in clients with chronic obstructive pulmonary disease (COPD), especially emphysema. It results from hyperinflation of the lungs over time, altering the shape of the chest wall.

Increased fatigue – Finding to be reported to the provider:

While COPD clients often experience fatigue, a sudden or unusual increase in fatigue may indicate worsening respiratory function or exacerbation of the disease. This finding requires further assessment and possible intervention to prevent complications.

Respiratory rate 40 bpm – Finding to be reported to the provider:

A respiratory rate of 40 bpm indicates significant tachypnea and respiratory distress. This finding, coupled with accessory muscle use, suggests the client may be experiencing an acute exacerbation of COPD or impending respiratory failure, which requires immediate provider notification.

Thin appearance – Expected Finding:

Clients with COPD often have a thin or cachectic appearance due to increased energy expenditure for breathing and reduced caloric intake. This is a typical finding in advanced COPD and does not require urgent reporting unless accompanied by other concerning symptoms.

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

A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client who is diagnosed with heart failure and reports slight limitation of physical activity, is comfortable at rest but ordinary physical activity causes symptoms. What heart failure classification does this patient fall under?

Correct Answer is A

Explanation

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

A nurse discusses the self-care guidelines to minimize the side effects of radiation on the skin. Which self-care instructions can the nurse provide the client receiving radiation? [Select all that apply.]

A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

A client in the emergency room begins to experience an acute asthma attack. The nurse expects that which medication will be used as initial treatment?

A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see?

A client is admitted into the Cardiac ICU unit with a diagnosis of chronic stable angina. The nurse should teach the client that the most common characteristic of stable angina pain is that?

A client with history of myasthenia gravis is experiencing prolonged periods of weakness and difficulty breathing. The provider orders an edrophonium [Tensilon] test. Once the dose is administered, the client becomes weaker. The nurse interprets this test result as:

A nurse is caring for a client who develops the rhythm below. The client is unresponsive, pulseless, and apneic. Which of the following actions should the nurse expect to do first?