A nurse is reviewing the medical history of a client who is to start taking prednisone. Which of the following findings should the nurse identify as a contraindication to prednisone therapy?

Prior episode of kidney stones

Taking levothyroxine orally

Has a systemic fungal infection

History of asthma

Answer and Explanation

The Correct Answer is C

A.   Prior episode of kidney stones: A history of kidney stones is not a contraindication to prednisone therapy. However, it may require monitoring due to potential fluid and electrolyte imbalances associated with corticosteroid use.
B.   Taking levothyroxine orally: Taking levothyroxine orally is not a contraindication to prednisone therapy. However, concurrent use of corticosteroids and levothyroxine may require dosage adjustments of both medications due to potential interactions.
C.   Has a systemic fungal infection: Corticosteroids like prednisone can suppress the immune system, increasing the risk of fungal infections and worsening existing fungal infections.
Therefore, the presence of a systemic fungal infection is a contraindication to corticosteroid therapy.
D.   History of asthma: Asthma is not a contraindication to prednisone therapy. In fact, prednisone is commonly used as a treatment for asthma exacerbations. However, caution may be needed in individuals with asthma to avoid exacerbating symptoms or complications.

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Correct Answer is A

Explanation

A. Filing a report with the facility to document the incident as a near miss medication error is essential for tracking and investigating medication errors to prevent future occurrences.
B. While contacting the prescribing provider may be necessary, the priority is to report the error internally within the facility.
C. While documenting the nurse's actions is important, it is essential to report the error through the appropriate channels within the facility.
D. While informing the client about the error is necessary, the immediate action should be to report the error internally within the facility.

A. Bruxism B. Confusion C. Insomnia D. Weight loss

Correct Answer is B

Explanation

A. Bruxism: Bruxism, or teeth grinding, is a potential adverse effect of citalopram but is generally less severe than confusion. While it should be monitored and reported if severe or persistent, it is not typically considered a priority adverse effect.
B. Confusion: Confusion can indicate a serious adverse reaction or complication, such as serotonin syndrome, which is a potentially life-threatening condition associated with the use of selective serotonin reuptake inhibitors (SSRIs) like citalopram. Therefore, confusion is the priority adverse effect to report to the provider.
C. Insomnia: Insomnia is a common side effect of citalopram and other SSRIs but is generally less severe than confusion. It should be monitored and reported if severe or persistent, but it is not typically considered a priority adverse effect.
D. Weight loss: Weight loss can occur as a side effect of citalopram but is generally less severe than confusion. It should be monitored and reported if excessive or rapid, but it is not typically considered a priority adverse effect.

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A nurse is reviewing the medical history of a client who is to start taking prednisone. Which of the following findings should the nurse identify as a contraindication to prednisone therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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