Nokea
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus was previously well controlled with daily glyburide (DiaBeta). However, the fasting blood glucose level has recently been in the range of 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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When is the best time for a client to take a daily dose of prednisone?
- A. At noon
- B. At bedtime
- C. Early morning
- D. Anytime, at the same time each day
Correct Answer: C
Rationale: The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.
A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:
- A. Avoid drinking alcohol.
- B. Report yellow eyes or skin immediately.
- C. Avoid Swiss or aged cheeses.
- D. Avoid vitamin supplements during therapy.
Correct Answer: B
Rationale: When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.
A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?
- A. I should brush and floss my teeth regularly.
- B. I should take the medication with antacids.
- C. I can stop taking the medication once my seizures are controlled.
- D. I should avoid drinking milk while taking this medication.
Correct Answer: A
Rationale: The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).
A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?
- A. Lung sounds
- B. Blood pressure
- C. Blood ammonia level
- D. Serum potassium level
Correct Answer: C
Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.