a patient with rheumatoid arthritis is taking prednisone what is an important side effect for the nurse to monitor a patient with rheumatoid arthritis is taking prednisone what is an important side effect for the nurse to monitor
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1. 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 hyperglycemia. Prednisone, a corticosteroid, can lead to elevated blood sugar levels as a side effect, particularly in patients with diabetes or those predisposed to developing diabetes. Monitoring for hyperglycemia is crucial to prevent complications like diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome.

2. Where does gluconeogenesis occur?

Correct answer: C

Rationale: Gluconeogenesis mainly occurs in the liver. It is a process where glucose is synthesized from non-carbohydrate sources such as amino acids and glycerol. The liver is the primary site for gluconeogenesis due to the presence of key enzymes and substrates required for this process. Muscles do not play a significant role in gluconeogenesis, making choice A incorrect. The pancreas is involved in the regulation of blood sugar levels through insulin and glucagon but is not the primary site for gluconeogenesis, so choice B is incorrect. The spleen is not a major organ involved in glucose metabolism, making choice D incorrect.

3. When assessing a client with a small bowel obstruction, what finding should a nurse expect?

Correct answer: C

Rationale: High-pitched bowel sounds are often heard early in a small bowel obstruction due to increased peristalsis as the bowel tries to overcome the blockage. Choices A, B, and D are incorrect. Abdominal distention is more commonly associated with large bowel obstructions, while large bowel movements and copious vomiting are not typical findings in small bowel obstructions.

4. A nurse is planning care for a school-age child who is 4 hr postoperative following perforated appendicitis. Which of the following actions should the nurse include in the plan of care?

Correct answer: D

Rationale: Administering analgesics on a scheduled basis for the first 24 hours is crucial to ensure adequate pain control in the immediate postoperative period. Choice A is incorrect because clear liquids are typically initiated gradually and advanced as tolerated but not specifically at 6 hours post-surgery. Choice B is incorrect as cromolyn nebulizer solution is not indicated for postoperative pain management in this scenario. Choice C is incorrect as applying a warm compress may not be appropriate for the operative site after appendicitis surgery and can potentially increase the risk of infection.

5. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients may sometimes receive false negative results in this exam. This means that the test is not perfect in terms of which characteristic of a diagnostic examination?

Correct answer: D

Rationale: Sensitivity is the ability of a diagnostic test to correctly identify individuals with the disease. A test with high sensitivity will rarely give false negative results, as it will detect almost all positive cases. In the context of the given scenario, false negative results indicate that the test is lacking in sensitivity to pick up all cases of pulmonary tuberculosis, leading to some cases being missed.

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