The nurse is providing discharge teaching for a client prescribed prednisone to be taken on alternate days. The client asks why he cannot just take half a pill every day.
What rationale should the nurse describe?
To decrease adrenal suppression.
To eliminate adverse side effects.
To prevent steroid tolerance.
To prolong therapeutic effects.
The Correct Answer is A
Prednisone is a glucocorticoid that suppresses the production of natural cortisol by the adrenal glands. Taking prednisone on alternate days allows the adrenal glands to recover and produce some cortisol on the days without prednisone.
Choice B is wrong because prednisone does not eliminate adverse side effects, but may cause some such as weight gain, fluid retention, increased blood pressure, increased blood glucose, and increased risk of infection.
Choice C is wrong because there is no evidence of steroid tolerance, which means that higher doses are needed to achieve the same effect.
Choice D is wrong because prednisone does not prolong therapeutic effects, but may decrease them over time due to feedback inhibition of cortisol secretion.
Normal ranges for cortisol are 6 to 23 mcg/dL in the morning and 2 to 11 mcg/dL in the afternoon.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The CTZ has to be stimulated in order for vomiting to occur. The CTZ is located in the area postrema of the medulla oblongata and receives input from various sources, such as the blood, the vestibular system, and the gastrointestinal tract.
Choice A is wrong because the limbic system involves emotion, not vomiting or other forms of GI function.
Choice B is wrong because the hypothalamus regulates various functions such as body temperature, hunger, thirst, and circadian rhythms, but not vomiting.
Choice D is wrong because the medulla oblongata is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting, but it is not the site of stimulation for vomiting.
The medulla oblongata contains the vomiting center, which receives signals from the CTZ and other sources and initiates the act of vomiting.
Correct Answer is D
Explanation
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.
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