The home health nurse provides client teaching to a client who is taking oral prednisolone.
The nurse provides what instruction to the client?
“Split the dose into two equal doses.”.
“Take before bedtime.”.
“Take 1 hour before meals.”.
“Take it first thing in the morning.”.
The Correct Answer is D
This is because prednisolone can cause insomnia if taken later in the day, and it mimics the natural secretion of cortisol by the adrenal glands, which peaks in the morning.
Choice A is wrong because splitting the dose into two equal doses can increase the risk of adrenal suppression and reduce the efficacy of alternate-day therapy (ADT), which is used to minimize adverse effects of corticosteroids.
Choice B is wrong because taking prednisolone before bedtime can interfere with sleep and cause nocturnal cortisol secretion, which can lead to Cushing syndrome.
Choice C is wrong because taking prednisolone 1 hour before meals can cause gastric irritation and ulceration, and it is recommended to take it with food or milk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.
Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.
The dose adjustment should be based on serum theophylline levels and clinical response.
Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.
Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.
Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.
The dose of theophylline should be carefully titrated according to serum levels and clinical response.
Correct Answer is A
Explanation
800 mg PO at bedtime is an appropriate dosage and frequency of cimetidine for the treatment of gastric ulcer. Cimetidine is a histamine H antagonist that reduces the secretion of gastric acid.
Choice B is wrong because 150 mg PO b.i.d. is too low of a dose for cimetidine. The usual adult dose for duodenal ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
Choice C is wrong because 20 mg PO b.i.d. is not a valid dose for cimetidine.
The lowest available tablet strength is 100 mg.
Choice D is wrong because 300 mg PO at bedtime is also too low of a dose for cimetidine.
The usual adult dose for gastric ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
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