Which medical condition would warrant a prescription for high-dose corticosteroids?
Uncontrolled diabetes mellitus
A recent diagnosis of lung cancer
Acute exacerbation of COPD
Chronic asthma
The Correct Answer is C
Choice A rationale:
Uncontrolled diabetes mellitus: Corticosteroids can have a hyperglycemic effect, meaning they can raise blood sugar levels. This makes them generally unsuitable for use in patients with uncontrolled diabetes mellitus. In fact, corticosteroids might even worsen glycemic control in these patients. While corticosteroids might be used in some cases of diabetes mellitus, such as to treat diabetic retinopathy or nephropathy, they would be used cautiously and with close monitoring of blood sugar levels.
Choice B rationale:
A recent diagnosis of lung cancer: Corticosteroids are not a primary treatment for lung cancer. They might be used in some cases to help manage symptoms or side effects of other treatments, such as chemotherapy or radiation therapy. However, they would not typically be used as a first-line treatment for lung cancer itself.
Choice C rationale:
Acute exacerbation of COPD: Corticosteroids are a mainstay of treatment for acute exacerbations of COPD. They work by reducing inflammation in the airways, which helps to improve airflow and relieve symptoms such as wheezing, shortness of breath, and chest tightness. Corticosteroids can be given orally, intravenously, or by inhalation. The dose and duration of treatment will depend on the severity of the exacerbation.
Choice D rationale:
Chronic asthma: Corticosteroids are often used as a long-term control medication for chronic asthma. However, they are typically used at lower doses than those used for acute exacerbations of COPD. Inhaled corticosteroids are the preferred form of treatment for chronic asthma, as they deliver the medication directly to the airways and have fewer systemic side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Prednisolone is a corticosteroid that has anti-inflammatory and immunosuppressant effects. It does not have a direct effect on urine output.
While it may be used in some cases of head trauma to reduce inflammation, it would not be the first-line choice to address excessive urine output.
Prolonged use of prednisolone can have adverse effects such as fluid retention, weight gain, hypertension, and hyperglycemia.
Choice B rationale:
Corticotropin (ACTH) is a hormone that stimulates the adrenal glands to produce cortisol. Cortisol has a variety of effects, including increasing blood pressure and blood sugar levels.
It does not have a direct effect on urine output and would not be used to address this issue.
ACTH can have significant side effects, including fluid retention, electrolyte imbalances, and mood changes.
Choice C rationale:
Vasopressin is a hormone that regulates fluid balance in the body. It works by increasing water reabsorption in the kidneys, which can help to reduce urine output.
It is the most appropriate medication to administer to a client with excessive urine output following head trauma.
Vasopressin can be administered intravenously or subcutaneously. It is important to monitor the client's fluid intake and output closely when administering vasopressin, as it can lead to fluid overload if not used carefully.
Choice D rationale:
Calciferol is a form of vitamin D that helps to regulate calcium and phosphorus levels in the body. It does not have a direct effect on urine output.
It would not be used to address excessive urine output in a client with head trauma.
Excessive doses of calciferol can lead to hypercalcemia, which can cause kidney stones, bone pain, and other serious problems.
Correct Answer is D
Explanation
Choice A rationale:
Placing the tablet under the patient's nose is not an effective method of administering aspirin. Aspirin is not absorbed through the nasal mucosa.
This action would not provide any therapeutic benefit to the patient with a suspected myocardial infarction. It could potentially lead to aspiration of the tablet if the patient sneezes or coughs.
Choice B rationale:
Enteric-coated aspirin tablets are designed to dissolve in the intestines, not in the stomach. This delays the absorption of aspirin and its antiplatelet effects.
In a patient with a suspected myocardial infarction, it is crucial to achieve rapid absorption of aspirin to inhibit platelet aggregation and prevent further clot formation.
Therefore, enteric-coated aspirin is not appropriate in this situation.
Choice C rationale:
Chewing the aspirin tablet would indeed speed up its absorption. However, it also increases the risk of gastric irritation and bleeding.
Aspirin can be irritating to the stomach lining, and chewing it can exacerbate this effect.
This is particularly concerning in a patient with a suspected myocardial infarction, who may already be at risk for gastrointestinal bleeding due to decreased blood flow to the stomach.
Choice D rationale:
Giving the aspirin tablet with a small sip of water is the most appropriate action for the nurse to take in this situation. This allows for timely absorption of the aspirin while minimizing the risk of gastric irritation.
The water helps to dissolve the tablet and transport it to the stomach, where it can be absorbed into the bloodstream. It also helps to lubricate the esophagus and reduce the risk of the tablet becoming lodged in the throat.
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