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 D
Explanation
Guaifenesin is an expectorant that helps thin and loosen mucus in the lungs, making it easier to cough up the sputum. Some possible explanations for the other choices are:
Choice A. Benzonatate is wrong because benzonatate is an antitussive that suppresses the cough reflex by numbing the throat and lungs.
It does not help with sputum production or clearance.
Choice B. Dextromethorphan is wrong because dextromethorphan is also an antitussive that acts on the brain to reduce the urge to cough.
It does not affect the mucus or bronchial secretions.
Choice C. Hydrocodone is wrong because hydrocodone is a narcotic antitussive that works by binding to opioid receptors in the brain and spinal cord, blocking pain signals and decreasing cough.
It can cause sedation, respiratory depression, and dependence, and is not indicated for bronchitis.
Normal ranges for sputum production vary depending on the individual and the cause of the cough, but generally range from 10 to 100 mL per day.
Excessive or abnormal sputum may indicate an infection, inflammation, or obstruction of the airways.
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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