A client with Type 2 diabetes, controlled with diet and metformin, also has chronic obstructive pulmonary disease (COPD). During an exacerbation of COPD, the client is prescribed prednisone to control inflammation. For which side effect should the nurse monitor the client?

Increased blood glucose levels.

Increased potassium levels.

Increased white blood cell count.

Increased ketones in the urine.

Answer and Explanation

The Correct Answer is A

Choice A reason:
Prednisone is a corticosteroid that can cause hyperglycemia, especially in clients with diabetes. The nurse should monitor blood glucose levels because prednisone can increase insulin resistance and hepatic glucose production, leading to elevated blood glucose levels. Normal fasting blood glucose levels range from 70 to 99 mg/dL, and for individuals with diabetes, maintaining blood glucose levels within the target range set by their healthcare provider is crucial to prevent complications.

Choice B reason:
While corticosteroids can affect electrolyte balance, they typically cause a decrease in potassium levels, not an increase. Therefore, monitoring for hypokalemia, rather than hyperkalemia, would be more appropriate when a patient is on prednisone. The normal range for serum potassium is 3.5 to 5.0 mEq/L.

Choice C reason:
Corticosteroids like prednisone can cause leukocytosis, an increase in white blood cell count, as part of their immunosuppressive action. However, this is generally not a harmful side effect unless accompanied by infection or other complications. The normal range for white blood cell count is approximately 4,500 to 11,000 cells per microliter.

Choice D reason:
Increased ketones in the urine, or ketonuria, is not a typical side effect of prednisone. Ketonuria is more commonly associated with uncontrolled diabetes, particularly Type 1 diabetes, when there is an insulin deficiency and the body resorts to fat breakdown, leading to ketone production.

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","C","D"]

Explanation

Choice a reason:
Avoiding crossing the legs while sitting is crucial after a total hip replacement to prevent dislocation of the new joint. Crossing the legs can put undue pressure on the hip joint and may lead to misalignment or increased strain during the healing process.

Choice b reason:
Eliminating Vitamin K from the diet is not typically recommended after a total hip replacement. Vitamin K is essential for blood clotting, and maintaining a consistent intake is important, especially if the client is on anticoagulant therapy to prevent deep vein thrombosis. Sudden changes in Vitamin K intake can affect the efficacy of anticoagulants like warfarin.

Choice c reason:
Following a home exercise program is an essential part of recovery after a total hip replacement. Exercises help strengthen the muscles around the new joint, improve flexibility, and increase range of motion. It's important that these exercises are done regularly and as instructed by a physical therapist.

Choice d reason:
Using a raised toilet seat after hip replacement surgery helps to prevent excessive flexion at the hip, which can risk dislocating the new joint. It also makes it easier for the client to sit down and stand up with less strain on the hip.

Choice e reason:
Increasing high-impact activities is not recommended after a total hip replacement, especially in the early stages of recovery. High-impact activities can put excessive stress on the new joint and may lead to complications. Low-impact activities such as walking, swimming, or cycling are generally more appropriate.

A. Prevent Wernicke's encephalopathy. B. Prevent alcoholic hepatitis. C. Rehydrate the client. D. Prevent pancreatitis.

Correct Answer is A

Explanation

Choice A Reason
Thiamine, or vitamin B1, is essential for brain function and the metabolism of carbohydrates. In the context of high blood alcohol levels, thiamine is administered to prevent Wernicke's encephalopathy, a serious neurological disorder. This condition is often precipitated by a thiamine deficiency, which can be exacerbated by alcohol abuse. Alcohol consumption can impair thiamine absorption and utilization, leading to depleted stores. Wernicke's encephalopathy is characterized by symptoms such as confusion, ataxia, and ophthalmoplegia, and if left untreated, it can progress to Korsakoff syndrome, a chronic and debilitating condition.

Choice B Reason
While alcoholic hepatitis is a concern in individuals with excessive alcohol intake, thiamine is not specifically used to prevent this condition. Alcoholic hepatitis is inflammation of the liver due to alcohol abuse, and its prevention primarily involves abstinence from alcohol, nutritional support, and medical management of liver inflammation. Thiamine does not play a direct role in preventing liver inflammation but is crucial for overall nutritional replenishment in individuals with alcohol use disorder.

Choice C Reason
Rehydration is indeed important for clients with high blood alcohol levels; however, thiamine does not serve this purpose. Rehydration typically involves the administration of intravenous fluids to restore fluid balance and electrolytes. Thiamine is not a rehydrating agent but is given to prevent neurological complications associated with thiamine deficiency, which can be seen in individuals with chronic alcoholism.

Choice D Reason
Preventing pancreatitis is not the primary reason for administering thiamine in this scenario. Pancreatitis, an inflammation of the pancreas, can be associated with chronic alcohol abuse, but thiamine is not used as a preventative treatment for this condition. The management of pancreatitis involves addressing the underlying causes, supportive care, and sometimes hospitalization for more severe cases.

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 Type 2 diabetes, controlled with diet and metformin, also has chronic obstructive pulmonary disease (COPD). During an exacerbation of COPD, the client is prescribed prednisone to control inflammation. For which side effect should the nurse monitor the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge teaching to a client after a total hip replacement. The teaching should include instructions to:

Correct Answer is ["A","C","D"]

Explanation

A client was admitted to the emergency department with slurred speech and impaired motor coordination. The blood alcohol level is over 300 mg/dL. The physician orders thiamine for the client. The nurse understands that the physician ordered thiamine to:

Correct Answer is A

Explanation

A client is receiving gentamicin and vancomycin IV for urosepsis. Which diagnostic study result should the nurse report to the primary care practitioner?

When teaching a client about cystitis, the nurse explains that women are more prone to the infection than men. Which of the following best explains a woman's increased susceptibility?

The nurse is performing discharge teaching for a Type 2 diabetic client on insulin glargine. The nurse is aware that the teaching has been effective when the client states:

A client who has developed acute compartment syndrome from a compound fracture of the arm asks the nurse to define what this means. Based on an understanding of the condition, the nurse should explain that:

How can the nurse determine that the outcomes of nursing interventions have been successful for the client diagnosed with a sickle cell crisis? (SELECT ALL THAT APPLY)

After examining and treating a client who has been raped, discharge instructions from the emergency department (ED) would include which of the following?