A client who has been taking prednisone to treat lupus erythematosus has discontinued the medication because of lack of funds to buy the drug. When the nurse becomes aware of the situation, which assessment is most important for the nurse to make first?

Correct Answer: B

Rationale: The most important assessment for the nurse to make first in this situation is the client's blood pressure. Abrupt discontinuation of prednisone, especially in a client with lupus erythematosus, can lead to adrenal insufficiency or an Addisonian crisis. Addisonian crisis can present with symptoms such as severe hypotension, fatigue, weakness, and even shock. Therefore, monitoring the client's blood pressure is crucial to assess for signs of adrenal insufficiency and to intervene promptly if needed. Once blood pressure is assessed, the nurse can then proceed to assess other parameters such as breath sounds, capillary refill, and the presence of a butterfly rash.

Correct Answer: B

Rationale: The most important assessment for the nurse to make first in this situation is the client's blood pressure. Abrupt discontinuation of prednisone, especially in a client with lupus erythematosus, can lead to adrenal insufficiency or an Addisonian crisis. Addisonian crisis can present with symptoms such as severe hypotension, fatigue, weakness, and even shock. Therefore, monitoring the client's blood pressure is crucial to assess for signs of adrenal insufficiency and to intervene promptly if needed. Once blood pressure is assessed, the nurse can then proceed to assess other parameters such as breath sounds, capillary refill, and the presence of a butterfly rash.

Correct Answer: D

Rationale: Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The recommended treatment for gonorrhea is a combination of antibiotics. Currently, multidose administration of antibiotics such as ceftriaxone or azithromycin is often used due to increasing antibiotic resistance. Treatment by topical applications to lesions is not effective in treating systemic infections like gonorrhea. Treating all sexual contacts is an essential part of the management of gonorrhea to prevent reinfection and further transmission of the infection.

Correct Answer: A

Rationale: The standard treatment for Wilms tumor is a nephrectomy of the affected kidney while preserving the other kidney.

Correct Answer: D

Rationale: Increased appetite is a common side effect of short-term corticosteroid therapy. Corticosteroids can affect the areas of the brain that control appetite, leading to an increase in hunger and potentially weight gain. While weight loss can occur with long-term corticosteroid use, short-term therapy is more likely to cause increased appetite as a side effect. Fever and hypertension are less commonly associated with short-term corticosteroid therapy.