A patient has been taking oral prednisone for a few weeks after having a severe reaction to poison sumac. What would be an educational point the nurse would want to tell the patient regarding the sudden cessation of the drug?

Adrenal insufficiency

Memory complications

Cardiovascular complications

Psychosis

Answer and Explanation

The Correct Answer is A

Choice A reason : When a patient stops taking oral prednisone abruptly after prolonged use, the body may not immediately resume normal production of cortisol, which is a hormone that prednisone mimics. This can lead to adrenal insufficiency, a condition where the body produces insufficient amounts of cortisol. Symptoms can include fatigue, weakness, weight loss, abdominal pain, and low blood pressure¹². It is crucial for patients to understand the need to taper off the medication gradually under medical supervision to avoid this potentially serious condition.

Choice B reason : Memory complications are not typically associated with the sudden cessation of prednisone. While some patients may experience mood swings or cognitive changes while taking prednisone, these are not the primary concerns when discontinuing the medication.

Choice C reason : Cardiovascular complications are not directly related to the sudden stoppage of prednisone. However, adrenal insufficiency can indirectly affect cardiovascular health due to the role of cortisol in maintaining blood pressure and cardiovascular function.

Choice D reason : Psychosis is a possible side effect of taking prednisone, especially at high doses, but it is not a common withdrawal symptom. Withdrawal symptoms are more likely to include physical signs of cortisol deficiency rather than severe psychiatric symptoms.

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Correct Answer is D

Explanation

Choice A reason : Delegating the NG tube placement to a more experienced nurse does not address the client's refusal of the procedure. The nurse must respect the client's autonomy and decision-making rights.

Choice B reason : While a referral to Social Services may be appropriate in some cases, it does not directly address the immediate concern of the client's refusal of the NG tube placement.

Choice C reason : Seeking consent from the client's spouse is not appropriate as the client is competent and has the right to refuse treatment. The client's autonomy must be respected.

Choice D reason : Documenting the client's wishes and notifying the physician is the correct action. The nurse must respect the client's right to refuse treatment and communicate this decision to the physician so that alternative management can be considered.

A. Abdominal distension B. Jugular venous distention C. Dependent edema D. Hacking cough

Correct Answer is D

Explanation

Choice A reason : Abdominal distension is more commonly associated with right-sided heart failure due to fluid accumulation in the abdominal cavity. Left-sided heart failure primarily affects the lungs, leading to respiratory symptoms¹.

Choice B reason : Jugular venous distention is typically a sign of right-sided heart failure, indicating increased pressure in the right atrium and venous system. It is not a primary symptom of left-sided heart failure¹.

Choice C reason : Dependent edema, or swelling in the lower extremities, is also more indicative of right-sided heart failure, where fluid accumulates due to poor venous return. In left-sided heart failure, fluid backs up into the lungs rather than the extremities¹.

Choice D reason : A hacking cough, especially when lying down, is a symptom of left-sided heart failure, as fluid backs up into the lungs causing pulmonary congestion. This can lead to coughing and shortness of breath, particularly during exertion or when lying flat¹.

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A patient has been taking oral prednisone for a few weeks after having a severe reaction to poison sumac. What would be an educational point the nurse would want to tell the patient regarding the sudden cessation of the drug?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

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