Nokea
The nurse is caring for a client who is receiving newly prescribed prednisone. Which of the following medications should the client avoid while receiving this medication?
- A. valsartan
- B. naproxen
- C. omeprazole
- D. acetaminophen
Correct Answer: B
Rationale: Naproxen, an NSAID, should be avoided with prednisone due to increased risk of gastrointestinal bleeding and ulceration. Valsartan, omeprazole, and acetaminophen are generally safe with prednisone, though monitoring is needed.
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The nurse is developing a plan of care for a client with hypothyroidism that is not controlled with medication. The nurse should recommend
- A. applying lotion after a warm bath.
- B. high-fiber snacks.
- C. caffeinated beverages to promote energy.
- D. physical activities with frequent rest breaks.
- E. adding fans to the room to keep it cool.
Correct Answer: A, B, D
Rationale: Hypothyroidism causes dry skin, constipation, and fatigue. Lotion hydrates skin, high-fiber snacks aid bowel movements, and rest breaks accommodate low energy. Caffeine may overstimulate, and fans are unhelpful as clients feel cold, not hot.
The nurse has instructed a client scheduled for an injection of dulaglutide for diabetes mellitus (type two). Which of the following statements by the client would require follow-up?
- A. I should tell my doctor if I experience abdominal pain and vomiting.
- B. I should take this medication within one hour of eating a meal.
- C. If this medication works, I should notice a reduction in my hemoglobin A1C (HbA1c).
- D. I will receive this medication once a week.
Correct Answer: B
Rationale: Dulaglutide, a GLP-1 agonist, is taken weekly regardless of meals, not within one hour of eating. Abdominal pain/vomiting should be reported, HbA1c reduction is expected, and weekly dosing is correct.
The nurse is assessing a client with a myxedema coma. Which of the following would be an expected finding?
- A. Glucose 59 mg/dL (3.28 mmol/L) [70-110 mg/d, 4.0-6.0 mmol/L]
- B. Sodium 155 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]
- C. Serum pH 7.49 [7.35-7.45]
Correct Answer: A
Rationale: Myxedema coma, a severe hypothyroid state, can cause hypoglycemia due to reduced metabolism. Hypernatremia and alkalosis are not typical; hyponatremia and acidosis are more common.
The nurse is performing a physical assessment on a client with Cushing's disease. Which assessment findings should the nurse expect?
- A. Hypotension
- B. Acne
- C. Hirsutism
- D. Buffalo hump
- E. Truncal obesity
Correct Answer: B, C, D, E
Rationale: Cushing's disease from excess cortisol causes acne, hirsutism (excess hair), buffalo hump, and truncal obesity due to fat redistribution. Hypertension, not hypotension, is typical.
The nurse is caring for a client who has nephrogenic diabetes insipidus. Which of the following medications should the nurse expect to be prescribed for the client?
- A. prednisone
- B. hydrochlorothiazide
- C. verapamil
- D. lithium
Correct Answer: B
Rationale: Nephrogenic diabetes insipidus reduces kidney response to ADH. Hydrochlorothiazide paradoxically reduces urine output by increasing sodium excretion, concentrating urine. Prednisone, verapamil, and lithium are unrelated or worsen DI.