A client with diabetes mellitus is prescribed prednisone for a rash. Which statement by the client indicates the need for further teaching?

Correct Answer: D

Rationale: In this scenario, option D, "I will gradually stop the prednisone when my rash goes away," indicates a need for further teaching. Prednisone is a corticosteroid medication that should not be stopped abruptly as it can lead to adverse effects due to adrenal suppression. Gradual tapering is required to allow the body to adjust and resume normal cortisol production. Option A, "I might have trouble falling asleep while taking prednisone," is a common side effect of prednisone and does not indicate a need for further teaching. Option B, "I might feel emotional when I am on this medicine," is also a known side effect of prednisone and does not require additional teaching. Option C, "I might need to increase my regular insulin during this time," is incorrect as prednisone can actually increase blood glucose levels by antagonizing the effects of insulin. Therefore, the client may need to adjust their insulin regimen to manage hyperglycemia while on prednisone. Educationally, this question highlights the importance of patient education regarding the proper use of corticosteroids like prednisone to prevent potential complications. It emphasizes the need for healthcare providers to educate clients on the importance of gradual tapering of corticosteroids to ensure their safety and well-being.

Correct Answer: B

Rationale: The correct answer is B because a decrease in blood pressure is an expected outcome when propranolol, a beta-blocker, is effectively managing hyperthyroidism. Propranolol helps control symptoms such as tachycardia and hypertension associated with hyperthyroidism. Choices A, C, and D are incorrect because weight gain, increased energy, and an increased respiratory rate are not direct indicators of propranolol's effectiveness in treating hyperthyroidism.

Correct Answer: D

Rationale: Corrected Question: When a client with heart failure is prescribed enalapril, monitoring for hyperkalemia is essential. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to an increase in potassium levels in the blood. This adverse effect can be serious and potentially life-threatening. Choices A, B, and C are incorrect because enalapril does not typically cause hypertension, hypokalemia, or hyperglycemia as adverse effects. It's essential for healthcare providers to be vigilant in monitoring potassium levels when clients are on ACE inhibitors like enalapril.

Correct Answer: D

Rationale: The correct strategy to include in the teaching after a gastrectomy is to avoid drinking liquids with meals. This helps prevent dumping syndrome, a condition characterized by rapid emptying of undigested food and fluids from the stomach into the small intestine. Choices A, B, and C are incorrect. Drinking fluids between meals is appropriate to maintain hydration, eating three large meals can exacerbate dumping syndrome, and lying down after meals is not recommended as it can increase the risk of reflux.

Correct Answer: C

Rationale: Elevated ammonia levels in a client with liver disease can lead to hepatic encephalopathy, requiring immediate intervention. Ammonia is a neurotoxin that can cause cognitive impairment and altered mental status. Elevated bilirubin levels (Choice A) are common in liver disease but do not require immediate intervention. Low albumin levels (Choice B) and low hemoglobin levels (Choice D) are also common in liver disease but do not pose an immediate threat compared to elevated ammonia levels.