The nurse is caring for a client who is diagnosed with an autoimmune disease that causes significant joint pain. The client reports that they take prednisone daily at home and occasionally take ibuprofen when the pain is extreme. What is the best response by the nurse?

Choice A reason: Negative glucose in urine is normal, as the kidneys reabsorb glucose unless blood levels exceed 180 mg/dL (e.g., in diabetes). In hypertension, this finding does not indicate renal damage or require further assessment, as it aligns with normal renal function and glucose handling.

Choice B reason: Negative white blood cells in urine suggest no urinary tract infection or inflammation, a normal finding. In hypertensive patients, this does not signal kidney damage or other complications, so no additional assessment is needed, as it indicates an absence of acute inflammatory processes.

Choice C reason: Proteinuria (positive protein) indicates potential renal damage, common in hypertension due to glomerular injury from elevated pressure. It suggests impaired filtration, allowing proteins like albumin to leak into urine. This finding warrants further assessment, such as quantifying protein levels or evaluating kidney function, making it the correct choice.

Choice D reason: Creatinine in urine is normal, as it is a waste product excreted by the kidneys. While serum creatinine assesses renal function, urinary creatinine presence is expected and does not indicate pathology in hypertension, so it does not require additional assessment in this context.

Choice A reason: PPIs are used for short-term treatment of ulcers and gastroesophageal reflux disease (GERD), typically 4-8 weeks, not long-term, due to risks like nutrient deficiencies or infections. Long-term use is reserved for specific conditions like Barrett’s esophagus, making this statement inaccurate for general use.

Choice B reason: While PPIs are available orally and intravenously, this is not the primary focus of patient education. Their efficacy in suppressing acid production is more critical than administration routes. This statement is less relevant, as it does not address therapeutic use or safety considerations.

Choice C reason: PPIs cause adverse effects in older adults, including increased risks of fractures, Clostridium difficile infection, and vitamin B12 deficiency due to prolonged acid suppression. This statement is inaccurate, as older clients are particularly susceptible to these risks, requiring careful monitoring during PPI therapy.

Choice D reason: PPI treatment emphasizes the lowest effective dose for the shortest duration to minimize risks like infections, fractures, or nutrient malabsorption. This approach balances acid suppression with safety, especially for ulcers or GERD, making this statement accurate and critical for patient education on safe use.