A nurse is teaching a patient who is to begin long-term therapy with prednisone to treat rheumatoid arthritis.
The nurse should instruct the patient to take which of the following supplements while taking this medication?
Pantothenic acid and vitamin B6.
Biotin and vitamin B2.
Folic acid and vitamin C.
Calcium and vitamin D.
The Correct Answer is D
Choice A rationale
Pantothenic acid (vitamin B5) is involved in fatty acid metabolism and coenzyme A synthesis, while vitamin B6 (pyridoxine) is crucial for amino acid metabolism and neurotransmitter synthesis. Prednisone does not typically lead to deficiencies in these vitamins.
Choice B rationale
Biotin (vitamin B7) plays a role in carbohydrate, fat, and protein metabolism, and vitamin B2 (riboflavin) is essential for cellular respiration and energy production. Prednisone therapy is not directly linked to a need for these supplements.
Choice C rationale
Folic acid (vitamin B9) is necessary for DNA synthesis and cell division, and vitamin C (ascorbic acid) is an antioxidant involved in collagen synthesis and immune function. Prednisone's effects do not primarily target these metabolic pathways to cause deficiencies.
Choice D rationale
Long-term prednisone therapy can lead to bone demineralization by increasing osteoclast activity and decreasing calcium absorption in the gut, thus increasing the risk of osteoporosis. Vitamin D is essential for calcium absorption and bone health. Supplementation with calcium and vitamin D helps to mitigate these adverse effects of prednisone. Normal serum calcium levels range from 8.5 to 10.5 mg/dL, and normal vitamin D levels are generally considered to be between 20 to 50 ng/mL, although optimal levels may vary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Elevating the affected leg promotes venous return and lymphatic drainage, which helps to reduce swelling and inflammation associated with cellulitis. Gravity assists in the removal of excess fluid from the interstitial spaces, thereby alleviating pressure and promoting healing.
Choice B rationale
Applying fresh ice packs every 4 hours can provide some pain relief and vasoconstriction, potentially reducing inflammation in the initial stages of cellulitis. However, heat is generally preferred after the acute inflammatory phase to promote circulation and healing. Frequent, prolonged ice application might impede blood flow.
Choice C rationale
While rest is important for healing, enforcing strict bedrest for 3 days might not be necessary and could increase the risk of complications such as deep vein thrombosis. Moderate activity with elevation is usually recommended to promote circulation without exacerbating the infection.
Choice D rationale
Cellulitis is a deep infection of the skin and subcutaneous tissues, typically caused by bacteria entering through a break in the skin. Applying topical antibiotic ointment is unlikely to reach the deeper infected tissues and is not the primary treatment. Systemic antibiotics are required to treat cellulitis effectively.
Correct Answer is A
Explanation
Choice A rationale
A 24-hour urinary output of 380 mL falls below the generally accepted threshold for oliguria in adults. This reduced output could indicate kidney dysfunction or decreased renal perfusion following surgery.
Choice B rationale
A 24-hour urinary output of 600 mL is within the low end of the normal range for adult urinary output, which is generally considered to be 800 mL to 2000 mL per 24 hours.
Choice C rationale
A 24-hour urinary output of 550 mL is also within the low end of the normal range for adult urinary output. While lower than average, it does not meet the criteria for oliguria.
Choice D rationale
A 24-hour urinary output of 720 mL is within the normal range for adult urinary output and does not indicate oliguria.
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