Question

The 2-year-old patient with asthma is placed on a short-term dose of prednisone. What important instruction will the nurse provide the patient about this drug?

Answer 1

Correct Answers:

Do not stop this medication suddenly; you will have to taper dosage gradually.

Rationale :

✏️ Prednisone is a glucocorticoid that can suppress the body's normal hypothalamic-pituitary-adrenal (HPA) axis when systemic therapy is sufficient in dose and duration.

✏️ Abruptly discontinuing glucocorticoid therapy after clinically significant adrenal suppression can result in acute adrenal insufficiency.

✏️ Manifestations of adrenal insufficiency can include weakness, fatigue, hypotension, nausea, vomiting, hypoglycemia, and electrolyte abnormalities.

✏️ Gradually tapering the dose allows endogenous adrenal corticosteroid production to recover when tapering is clinically indicated.

✏️ The parent should administer prednisone exactly as prescribed and should not independently change or discontinue the medication.

✏️ Very brief corticosteroid courses do not always require tapering, so the prescribed regimen and healthcare provider's instructions should be followed.

✏️ Prednisone can also increase susceptibility to infection and may produce metabolic and gastrointestinal adverse effects during treatment.

✏️ Teaching caregivers not to abruptly discontinue systemic corticosteroids when a taper has been prescribed is therefore an important medication-safety instruction.

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Answer 2

Correct Answers:

Risk for infection related to immunosuppression

Rationale :

💜 Glucocorticoids suppress immune and inflammatory responses, increasing susceptibility to infection.

💜 These medications decrease the activity and migration of inflammatory and immune cells involved in defending the body against pathogens.

💜 Infection can also be more difficult to recognize because glucocorticoids can suppress inflammatory manifestations, including fever and localized inflammation.

💜 Patients receiving prolonged or high-dose therapy have a greater risk of developing serious bacterial, viral, or fungal infections.

💜 The nurse should monitor carefully for subtle manifestations of infection, including changes in temperature, respiratory symptoms, wounds, and general condition.

💜 Appropriate infection-prevention measures include good hand hygiene and avoiding unnecessary exposure to individuals with communicable illnesses.

💜 Patients should be taught to promptly report manifestations suggesting infection rather than attempting to manage them independently.

💜 Risk for infection related to immunosuppression is therefore the highest-priority nursing diagnosis among the choices provided.

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Answer 3

Correct Answers:

subcutaneously with the needle at a 45- to 60-degree angle.

Rationale :

🤎 Insulin is administered subcutaneously into the fatty tissue beneath the skin rather than into muscle.

🤎 A thin patient has less subcutaneous adipose tissue, increasing the possibility that a deeply inserted needle could enter muscle.

🤎 Using approximately a 45-degree angle with an appropriate needle can help ensure that insulin reaches subcutaneous tissue in a very lean patient.

🤎 The exact angle can vary according to the patient's adipose tissue, needle length, injection site, and whether a skin fold is used.

🤎 Intramuscular administration can cause insulin to be absorbed more rapidly and unpredictably than intended.

🤎 Consistent subcutaneous administration supports more predictable insulin absorption and glucose control.

🤎 Injection sites should be appropriately rotated within the same anatomical region to decrease the risk of lipohypertrophy and other tissue changes.

🤎 Among the choices provided, subcutaneous injection at a 45- to 60-degree angle is the best technique for this very thin patient.

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Answer 4

Correct Answers:

serum electrolytes.

Rationale :

🖤 Piperacillin and corticotropin therapy can create concern for alterations in electrolyte balance, particularly potassium levels.

🖤 Corticotropin (ACTH) stimulates the adrenal cortex and increases endogenous corticosteroid production.

🖤 Increased corticosteroid activity can promote sodium and water retention while increasing potassium loss.

🖤 Piperacillin therapy can also be associated with electrolyte abnormalities, including hypokalemia, particularly in susceptible patients.

🖤 Concurrent therapy therefore increases the importance of monitoring the patient's serum electrolyte concentrations.

🖤 Significant hypokalemia can produce muscle weakness, fatigue, and potentially serious cardiac dysrhythmias.

🖤 The nurse should monitor laboratory findings and report clinically important abnormalities so that appropriate treatment can be initiated.

🖤 Requesting an order for serum electrolyte monitoring is therefore the most appropriate response among the choices.

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Answer 5

Correct Answers:

Digoxin (Lanoxin)

Rationale :

⏩ Metoclopramide increases upper gastrointestinal motility and accelerates gastric emptying.

⏩ Increased gastrointestinal transit can alter the absorption of medications administered concurrently, including digoxin.

⏩ Metoclopramide can decrease digoxin absorption, potentially reducing its serum concentration and therapeutic effectiveness.

⏩ Digoxin has a narrow therapeutic index, making clinically significant changes in drug exposure particularly important.

⏩ Reduced therapeutic effect can be concerning in patients receiving digoxin for conditions such as heart failure or certain cardiac dysrhythmias.

⏩ The nurse should review the patient's medications carefully and monitor the clinical response to digoxin when potentially interacting medications are used.

⏩ Serum digoxin concentrations may be monitored when clinically indicated, particularly when therapeutic failure or toxicity is suspected.

⏩ Concurrent use of digoxin and metoclopramide therefore represents the most important drug-drug interaction among the choices provided.

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Answer 6

Correct Answers:

I will not be concerned about a raised knot under my skin from injecting insulin.

Rationale :

✅ “I will not be concerned about a raised knot under my skin from injecting insulin.” — Correct

✅ A raised knot at an insulin injection site can indicate lipohypertrophy, which is an abnormal accumulation of fatty tissue beneath the skin.

✅ Lipohypertrophy commonly develops when insulin is repeatedly injected into the same or closely spaced sites.

✅ Injecting insulin into abnormal fatty tissue can result in delayed or unpredictable insulin absorption and contribute to unstable blood glucose levels.

✅ The patient should routinely inspect and palpate injection areas for lumps, thickening, swelling, or other tissue changes.

✅ Insulin should not be injected into areas containing lipohypertrophy, scars, inflammation, bruising, or damaged skin.

✅ Proper site rotation helps prevent repeated tissue trauma and reduces the development of lipohypertrophy.

✅ The patient should report persistent or concerning injection-site abnormalities and receive additional instruction about appropriate rotation technique.

✅ The statement that a raised knot is not concerning therefore indicates a need for further teaching.

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Answer 7

Correct Answers:

Infection

Rationale :

➡️ Long-term corticosteroid therapy suppresses normal immune and inflammatory responses, increasing susceptibility to infection.

➡️ Corticosteroids decrease the activity of immune cells involved in recognizing and responding to infectious organisms.

➡️ Patients receiving prolonged therapy can develop bacterial, viral, or fungal infections more easily than individuals with normal immune function.

➡️ Corticosteroids can also mask manifestations of infection, including fever, inflammation, redness, and swelling.

➡️ The nurse should therefore monitor for subtle findings such as malaise, respiratory symptoms, wound changes, or unexplained deterioration.

➡️ Appropriate hand hygiene and infection-prevention measures should be incorporated into the patient's care.

➡️ Patients should be instructed to avoid unnecessary exposure to individuals with contagious illnesses and promptly report possible infection.

➡️ Preventing and recognizing infection is therefore a major nursing priority during long-term corticosteroid therapy.

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Answer 8

Correct Answers:

Cyclic breast changes and chloasma

Rationale :

↪️ Increasing the estrogenic activity of a combined oral contraceptive can increase estrogen-related adverse effects.

↪️ Estrogen can cause breast tenderness, fullness, or cyclic breast changes because of its effects on breast tissue.

↪️ Chloasma, characterized by patchy facial hyperpigmentation, can also occur with estrogen-containing oral contraceptives.

↪️ Chloasma commonly appears as brownish pigmentation on areas such as the cheeks, forehead, or upper lip.

↪️ Sun exposure can make chloasma more noticeable, so appropriate sun protection can be beneficial.

↪️ Higher estrogen exposure can also contribute to symptoms such as nausea and other estrogen-related effects in susceptible individuals.

↪️ Patients using combined oral contraceptives should also understand warning manifestations of serious complications such as thromboembolism.

↪️ Cyclic breast changes and chloasma therefore best represent effects associated with increased estrogenic activity.

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Answer 9

Correct Answers:

Type 2 diabetes mellitus

Rationale :

*️⃣ Type 2 diabetes mellitus is the most common form of diabetes mellitus.

*️⃣ It is characterized primarily by insulin resistance combined with progressive impairment of pancreatic beta-cell insulin secretion.

*️⃣ In insulin resistance, body tissues become less responsive to insulin, reducing their ability to use glucose effectively.

*️⃣ The pancreas initially compensates by producing additional insulin, but insulin production can become insufficient as the disease progresses.

*️⃣ Risk factors include family history, increasing age, overweight or obesity, physical inactivity, and certain metabolic conditions, although type 2 diabetes can occur without all of these factors.

*️⃣ Management can include nutritional modification, physical activity, weight management when appropriate, glucose-lowering medications, and sometimes insulin.

*️⃣ Regular monitoring and treatment are important for reducing long-term complications involving the cardiovascular system, kidneys, eyes, and nerves.

*️⃣ Type 2 diabetes therefore represents the most common type of diabetes mellitus.

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Answer 10

Correct Answers:

Myxedema

Rationale :

💠 Myxedema refers to severe or advanced hypothyroidism in adults and is associated with markedly reduced thyroid hormone activity.

💠 Decreased thyroid hormone lowers the body's metabolic rate, producing fatigue, lethargy, slowed cognition, and impaired memory.

💠 Dry skin is characteristic because reduced metabolic activity affects normal skin function and sweat-gland activity.

💠 Accumulation of hydrophilic substances within tissues can produce characteristic nonpitting facial edema and a puffy appearance.

💠 Bradycardia can occur because reduced thyroid hormone decreases cardiovascular stimulation and metabolic demand.

💠 Weight gain commonly occurs because of reduced metabolism and fluid accumulation despite no corresponding increase in caloric intake.

💠 Reproductive manifestations of hypothyroidism can include menstrual abnormalities, including amenorrhea in some patients.

💠 The combination of lethargy, impaired memory, facial edema, dry skin, bradycardia, weight gain, and cessation of menses strongly supports myxedema from severe hypothyroidism.

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QLexNursing

1 :
The 2-year-old patient with asthma is placed on a short-term dose of prednisone. What important instruction will the nurse provide the patient about this drug?

2 :
When developing a plan of care for the patient receiving a glucocorticoid, what nursing diagnosis would be of highest priority?

3 :
The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin

4 :
The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas. The nurse learns that the patient receives corticotropin to treat multiple sclerosis. The nurse will request an order for

5 :
A patient who is taking metoclopramide (Reglan) has come to the clinic for a follow-up visit. The nurse will be most concerned about a drug-drug interaction when learning the patient is taking what other medication?

6 :
The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?

7 :
When caring for a patient receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

8 :
A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic activity than her previous COC. When teaching this woman about the new product, the nurse will explain that she may experience which effect(s)?

9 :
The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common?

10 :
A 35-year-old woman reports lethargy, difficulty remembering things, facial edema, dry skin, and cessation of menses. The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit. The nurse will notify the provider of which possible condition?

QLexNursing

1 : The 2-year-old patient with asthma is placed on a short-term dose of prednisone. What important instruction will the nurse provide the patient about this drug?

2 : When developing a plan of care for the patient receiving a glucocorticoid, what nursing diagnosis would be of highest priority?

3 : The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin

4 : The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas. The nurse learns that the patient receives corticotropin to treat multiple sclerosis. The nurse will request an order for

5 : A patient who is taking metoclopramide (Reglan) has come to the clinic for a follow-up visit. The nurse will be most concerned about a drug-drug interaction when learning the patient is taking what other medication?

6 : The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?

7 : When caring for a patient receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

8 : A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic activity than her previous COC. When teaching this woman about the new product, the nurse will explain that she may experience which effect(s)?

9 : The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common?

10 : A 35-year-old woman reports lethargy, difficulty remembering things, facial edema, dry skin, and cessation of menses. The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit. The nurse will notify the provider of which possible condition?

1 :
The 2-year-old patient with asthma is placed on a short-term dose of prednisone. What important instruction will the nurse provide the patient about this drug?

2 :
When developing a plan of care for the patient receiving a glucocorticoid, what nursing diagnosis would be of highest priority?

3 :
The nurse is teaching a patient how to administer insulin. The patient is thin with very little body fat. The nurse will suggest injecting insulin

4 :
The nurse is preparing to administer piperacillin to a patient to treat an infection caused by pseudomonas. The nurse learns that the patient receives corticotropin to treat multiple sclerosis. The nurse will request an order for

5 :
A patient who is taking metoclopramide (Reglan) has come to the clinic for a follow-up visit. The nurse will be most concerned about a drug-drug interaction when learning the patient is taking what other medication?

6 :
The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?

7 :
When caring for a patient receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

8 :
A woman will begin taking a combination oral contraceptive (COC) that has a higher estrogenic activity than her previous COC. When teaching this woman about the new product, the nurse will explain that she may experience which effect(s)?

9 :
The nurse is teaching a group of nursing students about diabetes. The nurse explains that which type of diabetes is the most common?

10 :
A 35-year-old woman reports lethargy, difficulty remembering things, facial edema, dry skin, and cessation of menses. The nurse notes a heart rate of 60 beats per minute and a weight increase of 5 pounds from a previous visit. The nurse will notify the provider of which possible condition?