A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?

Correct Answer: A

Rationale: The correct answer is A: Hyperglycemia. Prednisone is a corticosteroid that can cause an increase in blood glucose levels by promoting gluconeogenesis and decreasing insulin sensitivity. Monitoring for hyperglycemia is crucial as it can lead to serious complications such as diabetic ketoacidosis. Bradycardia (B) and hypotension (C) are not typical side effects of prednisone, as it tends to cause fluid retention and hypertension. Hyperkalemia (D) is also unlikely as prednisone can actually cause hypokalemia due to increased renal potassium excretion.

Correct Answer: A

Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of DVT is the absence of regular INR monitoring required with rivaroxaban. This is because rivaroxaban is a direct oral anticoagulant with more predictable pharmacokinetics, eliminating the need for monitoring. Regular INR monitoring is necessary with warfarin to ensure the drug is within the therapeutic range, which can be burdensome for patients and healthcare providers. The other choices are incorrect as they do not directly address the primary advantage of rivaroxaban over warfarin for this specific patient population.

Correct Answer: A

Rationale: The correct answer is A: Reduce intraocular pressure. Timolol is a beta-blocker that works by decreasing the production of aqueous humor in the eye, thereby reducing intraocular pressure. This action helps to prevent damage to the optic nerve in patients with glaucoma. Choices B and C are incorrect because timolol does not affect pupil size. Choice D is incorrect because timolol does not enhance tear production; in fact, it may have a drying effect on the eyes.

Correct Answer: B

Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival overgrowth as a side effect. This is due to its effect on fibroblasts in the gums, leading to increased connective tissue production. Hypotension (A), bradycardia (C), and hyperkalemia (D) are not common side effects of phenytoin. Monitoring for gingival hyperplasia is crucial to prevent complications such as difficulty in eating, speaking, and maintaining oral hygiene.

Correct Answer: C

Rationale: The primary action of digoxin in heart failure is to strengthen cardiac contractions. Digoxin inhibits the sodium-potassium pump, leading to an increase in intracellular calcium levels, which enhances the force of myocardial contractions. This helps improve cardiac output and symptoms of heart failure. Explanation: A: Incorrect - Digoxin does not increase heart rate, it mainly affects the strength of contractions. B: Incorrect - Digoxin does not decrease cardiac output; it actually helps improve it by enhancing contractility. D: Incorrect - Digoxin may have a slight effect on lowering blood pressure, but its primary action in heart failure is to strengthen cardiac contractions, not lower blood pressure.

Correct Answer: C

Rationale: Step-by-step rationale for choice C: 1. Metformin can cause gastrointestinal side effects. 2. Taking it with meals helps reduce stomach upset. 3. It also helps in better absorption and effectiveness. 4. Therefore, the nurse should instruct the patient to take metformin with meals. Summary of other choices: A: Taking on an empty stomach can worsen gastrointestinal side effects. B: Metformin doesn't typically cause hypoglycemia. D: Increasing simple carbohydrates can counteract the effects of metformin.

Correct Answer: B

Rationale: The correct answer is B: Infection. Prednisone is a corticosteroid that suppresses the immune system, increasing the risk of infections in patients. The nurse should monitor for signs of infection such as fever, increased white blood cell count, and localized symptoms. Rationale: A: Hypoglycemia is not a common side effect of prednisone. Prednisone typically causes hyperglycemia. C: Hypotension is not a common side effect of prednisone. Prednisone can actually cause fluid retention and increased blood pressure. D: Weight loss is not a common side effect of prednisone. Prednisone can actually cause weight gain due to fluid retention and increased appetite.

Correct Answer: C

Rationale: The correct answer is C: Take the medication with a full glass of water. Alendronate should be taken with a full glass of water on an empty stomach in the morning to enhance absorption. Option A is incorrect because taking alendronate with milk decreases its absorption. Option B is incorrect as lying down after taking alendronate can lead to esophageal irritation. Option D is incorrect because taking the medication before bedtime can cause esophageal irritation as well due to the risk of reflux when lying down.

Correct Answer: D

Rationale: The correct answer is D: Reduce anxiety. Alprazolam is a benzodiazepine that acts on the central nervous system to enhance the effects of a neurotransmitter called GABA, which helps to calm the brain and reduce anxiety. This medication does not increase energy levels (choice A), induce sedation (choice B), or elevate mood (choice C). Alprazolam's primary action is to target and alleviate the symptoms of anxiety by promoting relaxation and reducing excessive brain activity associated with anxiety disorders.