A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which expected effect of this drug therapy would cause a change in the patient’s appearance?

Moon face

Weight loss

Pale skin color

Hair loss

Answer and Explanation

The Correct Answer is A

Choice A reason: Moon face, a hallmark of long-term prednisone use, results from fat redistribution due to corticosteroid-induced metabolic changes. Prednisone promotes lipogenesis in facial and neck areas, causing a rounded, puffy appearance. This Cushingoid feature is a common, visible side effect of prolonged systemic corticosteroid therapy.

Choice B reason: Weight loss is not typical with long-term prednisone therapy. Prednisone increases appetite and promotes fat deposition, leading to weight gain, not loss. Catabolic effects on muscle may occur, but overall weight gain, including fluid retention, is more characteristic, making this incorrect.

Choice C reason: Pale skin color is not a common effect of prednisone. Corticosteroids can cause skin thinning or bruising due to reduced collagen synthesis, but pallor is not typical. Hyperpigmentation may occur in some cases, but moon face is the primary appearance-related side effect of long-term use.

Choice D reason: Hair loss is not a primary side effect of prednisone. Corticosteroids may cause hirsutism or thinning skin, but hair loss is more associated with chemotherapy or other drugs. Prednisone’s metabolic effects lead to fat redistribution, like moon face, rather than alopecia, making this incorrect.

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Correct Answer is A

Explanation

Choice A reason: Nystatin lozenges must dissolve slowly in the mouth to ensure prolonged contact with oral mucosa, effectively treating candidiasis by disrupting fungal cell membranes. Slow dissolution maximizes local antifungal activity, targeting Candida albicans in the oral cavity, a common complication of inhaled corticosteroid use.

Choice B reason: Rinsing the mouth with water before using an inhaler is appropriate for corticosteroids to prevent thrush but is irrelevant for nystatin lozenges. Nystatin treats existing oral candidiasis, and rinsing beforehand may reduce its contact time with affected mucosa, decreasing efficacy.

Choice C reason: Rinsing with mouthwash after an inhaler is not standard for nystatin or corticosteroid use. Mouthwash may contain alcohol, irritating oral mucosa or reducing nystatin’s antifungal effect. Rinsing with water after corticosteroids prevents thrush, but this instruction is misapplied to nystatin lozenges.

Choice D reason: Chewing nystatin lozenges is incorrect, as it reduces contact time with oral mucosa, decreasing antifungal efficacy. Swallowing the drug shifts its action to the gastrointestinal tract, ineffective for oral candidiasis. Slow dissolution ensures targeted treatment of Candida in the mouth, preventing recurrence.

A. Albuterol is considered “long-acting” and salmeterol is considered “short-acting.” B. Albuterol is considered “short-acting” and salmeterol is considered “long-acting.” C. Salmeterol’s effects last for 3 to 4 hours, and albuterol has an extended duration of action up to 12 hours. D. Because of the onset of action, albuterol should not be used during an acute attack of asthma, but instead, salmeterol should be used.

Correct Answer is B

Explanation

Choice A reason: Albuterol is a short-acting beta-2 agonist (SABA), with effects lasting 4-6 hours, while salmeterol is a long-acting beta-2 agonist (LABA), lasting up to 12 hours. This statement reverses their durations, making it incorrect, as albuterol is used for acute relief, not maintenance.

Choice B reason: Albuterol, a SABA, acts within minutes and lasts 4-6 hours, ideal for acute asthma relief. Salmeterol, a LABA, has a slower onset (20-30 minutes) and lasts 12 hours, used for maintenance. This pharmacodynamic difference in duration makes this the correct statement.

Choice C reason: Salmeterol’s effects last up to 12 hours, not 3-4 hours, and albuterol’s duration is 4-6 hours, not 12 hours. This statement inaccurately describes their pharmacodynamic profiles, as salmeterol is long-acting and albuterol is short-acting, making it incorrect.

Choice D reason: Albuterol’s rapid onset (within minutes) makes it ideal for acute asthma attacks, while salmeterol’s slow onset (20-30 minutes) makes it unsuitable for acute relief. This statement is incorrect, as albuterol, not salmeterol, is the first-line rescue medication for asthma exacerbations.

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A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of asthma. Which expected effect of this drug therapy would cause a change in the patient’s appearance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is taking nystatin oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?

Correct Answer is A

Explanation

Which statement describes a pharmacodynamic difference between albuterol and salmeterol?

Correct Answer is B

Explanation

When monitoring a patient who is taking intravenous dexamethasone, the nurse will monitor for signs of which condition?

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If a patient is taking fluconazole with warfarin, the nurse will monitor for which possible interaction?

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A patient has prescriptions for two inhalers. One inhaler is albuterol, and the other is fluticasone. Which instruction regarding these inhalers will the nurse give to the patient?

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A patient with a known heart condition is prescribed an antibiotic before a dental procedure. What type of antibiotic therapy is this considered?

Which of the following is a common side effect of inhaled corticosteroids used in asthma management?