A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?

"I should take my flu vaccine within one week of starting this medication."

"I should eat more bananas while taking this medication."

"I should take aspirin for minor aches and pains while taking this medication."

"I can expect a sore throat for the first week after starting this medication."

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because the client should avoid live vaccines while taking prednisone, as it can suppress the immune system and increase the risk of infection.

Choice B reason: This is correct because prednisone can cause hypokalemia (low potassium levels) and bananas are a good source of potassium. The client should monitor their potassium levels and eat foods rich in potassium while taking prednisone.

Choice C reason: This is incorrect because the client should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin while taking prednisone, as they can increase the risk of gastrointestinal bleeding and ulceration.

Choice D reason: This is incorrect because a sore throat is not a common side effect of prednisone. However, the client should report any signs of infection, such as fever, sore throat, or cough, to the provider, as prednisone can mask the symptoms of infection.

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Correct Answer is B

Explanation

Choice A reason: Hyperkalemia is not the correct answer. Hyperkalemia is a high level of potassium in the blood. Corticosteroids do not cause hyperkalemia, but rather hypokalemia. Hyperkalemia may be caused by other factors such as renal failure, acidosis, or potassium-sparing diuretics.

Choice B reason: Hypokalemia is the correct answer. Hypokalemia is a low level of potassium in the blood. Corticosteroids can cause hypokalemia by increasing the excretion of potassium and sodium in the urine. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.

Choice C reason: Hypermagnesemia is not the correct answer. Hypermagnesemia is a high level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypermagnesemia may be caused by other factors such as renal failure, excessive antacid use, or magnesium-containing laxatives.

Choice D reason: Hypomagnesemia is not the correct answer. Hypomagnesemia is a low level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypomagnesemia may be caused by other factors such as malnutrition, alcoholism, or diuretic use.

A. Administer with short-acting insulin. B. Assess for hypoglycemia 4 hr after the insulin injection. C. Inject the insulin 15 min before a meal. D. Monitor for polyuria.

Correct Answer is C

Explanation

Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.

Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.

Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.

Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.

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A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

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