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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Famotidine is a histamine type 2 receptor antagonist (H blocker) which is commonly used for treatment of acid-peptic disease and heartburn. Famotidine has been linked to rare instances of clinically apparent acute liver injury, but it is less likely to cause hepatotoxicity than cimetidine, another H blocker. Famotidine also has fewer drug interactions than cimetidine.
Choice A is wrong because nizatidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Nizatidine has not been linked to cases of clinically apparent liver injury, but it has not been widely used.
Choice B is wrong because ranitidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Ranitidine has also been associated with rare instances of clinically apparent liver injury, some of which were fatal or required liver transplantation.
Choice C is wrong because cimetidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Cimetidine has also been implicated in several cases of clinically apparent acute liver injury, some of which were severe and led to acute liver failure and death.
Cimetidine also has many drug interactions due to its inhibition of cytochrome P enzymes.
Normal ranges for serum aminotransferases are 7 to 56 U/L for alanine aminotransferase (ALT) and 10 to 40 U/L for as
Correct Answer is C
Explanation
This statement indicates that the patient understands the common side effect of codeine and how to prevent accidents while taking it.
Choice A is wrong because the patient should not take the medication anytime he starts to cough, but only as prescribed by the doctor.
Taking too much codeine can lead to overdose, addiction, or respiratory depression.
Choice B is wrong because this medication may not make the patient anxious and nervous, but rather sedated and relaxed.
Anxiety and nervousness are more likely to occur with decongestants, which are stimulants.
Choice D is wrong because diarrhea is not a common side effect of codeine.
In fact, codeine may cause constipation, so the patient should increase fluid and fiber intake while taking it.
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