Which of the following clients is at a higher risk of developing osteoarthritis?

A client who has hypertension and is taking amlodipine

A client who has COPD and has been on frequent courses of prednisone

A client with atrial fibrillation who is taking warfarin

A client who is Caucasian and has had multiple child

Answer and Explanation

The Correct Answer is B

A.   Amlodipine is a calcium channel blocker used to manage hypertension. It is not associated with an increased risk of osteoarthritis. While hypertension itself is a health concern, amlodipine does not directly contribute to the development of OA.
B.   Prednisone is a corticosteroid that can lead to various side effects, including bone loss and osteoporosis with long-term use. Although osteoporosis and OA are different conditions, long-term use of corticosteroids can potentially increase the risk of joint issues and contribute to the development or exacerbation of OA due to the impact on joint cartilage and bone density.
C.   Warfarin is an anticoagulant used to prevent blood clots in atrial fibrillation. It is not directly associated with an increased risk of osteoarthritis. The primary concerns with warfarin involve bleeding risks rather than joint health.
D.   Being Caucasian and having multiple children do not directly contribute to an increased risk of osteoarthritis.

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Correct Answer is C

Explanation

A. Prednisone, a corticosteroid, is more commonly associated with fluid retention rather than fluid volume deficit. Fluid volume deficit would generally be a concern with diuretics or other medications that increase urine output. Prednisone can lead to fluid retention and edema, not a deficit.
B. Prednisone is more likely to cause weight gain rather than weight loss. Corticosteroids can increase appetite and lead to fluid retention, both of which contribute to weight gain. Significant weight loss is not a typical side effect of prednisone.
C. Prednisone and other corticosteroids can cause sodium retention, which can lead to fluid retention and hypertension. Sodium retention is a common side effect of corticosteroids, and it contributes to the fluid retention and potential weight gain associated with these medications.
D. Prednisone can cause thinning of the skin rather than thickening. Long-term use of corticosteroids can lead to skin thinning, increased bruising, and easy tearing of the skin. Thickening of the skin is not a common side effect of prednisone.

A. Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes. B. After administration, the client will experience worsening facial weakness and ptosis. C. After administration of the medication, there will be no change in the status of the ptosis or facial weakness. D. The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Correct Answer is A

Explanation

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

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Which of the following clients is at a higher risk of developing osteoarthritis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who will begin a prolonged course of prednisone to treat a multiple sclerosis flare. What information should the nurse include in the education about this medication?

Correct Answer is C

Explanation

The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Correct Answer is A

Explanation

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