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The nurse is educating a group of students on the effects of corticosteroids. It would be appropriate for the nurse to identify the following adverse effects associated with corticosteroids.
- A. Mood lability
- B. Immunosuppression
- C. Hypoglycemia
- D. Hyperkalemia
- E. Weight gain
Correct Answer: A, B, E
Rationale: Corticosteroids cause mood changes, suppress immunity, and promote weight gain via fluid retention and fat redistribution. They cause hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia.
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The nurse is teaching a client about diabetes mellitus (type one) and exercise. NWhich statement, if made by the nurse, would be appropriate?
- A. Increasing exercise would increase insulin requirements
- B. Increasing exercise would decrease insulin requirements
- C. Insulin needs do not change with exercise
- D. Decreasing exercise would decrease insulin requirements
Correct Answer: B
Rationale: In type 1 diabetes, exercise increases glucose uptake by muscles, lowering blood sugar and thus decreasing insulin needs. Increased or decreased exercise adjusts insulin in the opposite direction.
The nurse has instructed a client with diabetes mellitus (type 1) about proper exercise. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I should carry a snack rich in protein just in case I feel shaky.
- B. I will not take my prescribed daily glargine insulin if I plan on exercising.
- C. I can initially expect my glucose level to rise with vigorous exercise, but if I continue exercising, my levels may eventually decrease.
- D. I should start my exercise near the time that my insulin peaks.
Correct Answer: C
Rationale: Vigorous exercise can initially raise blood glucose due to stress hormones, but prolonged activity increases glucose uptake by muscles, lowering levels. Carrying a carbohydrate-rich snack, not protein, is best for hypoglycemia. Insulin should never be skipped, and exercising at peak insulin time risks hypoglycemia.
The nurse is caring for a client receiving prescribed dexamethasone. Which of the following adverse reactions may occur?
- A. Infection
- B. Hypotension
- C. Peripheral edema
- D. Hypoglycemia
- E. Weight loss
- F. Insomnia
Correct Answer: A,C,F
Rationale: Dexamethasone, a corticosteroid, increases infection risk, causes fluid retention (peripheral edema), and insomnia. Hypotension, hypoglycemia, and weight loss are not typical; hypertension, hyperglycemia, and weight gain are more common.
The nurse is caring for a client receiving a continuous infusion of regular insulin. The nurse should plan to monitor which clinical data?
- A. Hourly blood glucose
- B. Potassium
- C. BUN and creatinine
- D. Gastric pH
- E. Fasting blood glucose
Correct Answer: A, B
Rationale: Insulin lowers glucose and shifts potassium into cells, risking hypokalemia. Hourly glucose and potassium monitoring are critical to adjust therapy and prevent complications.
The nurse is caring for a client with the syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment finding requires immediate follow-up?
- A. Disorientation
- B. High urine specific gravity
- C. Oliguria
- D. Increased thirst
Correct Answer: A
Rationale: SIADH causes water retention and hyponatremia, which can lead to disorientation—a neurological symptom requiring urgent follow-up to prevent seizures or coma. Other findings are expected.