A client receiving long-term treatment with high-dose corticosteroids is expected to exhibit which of the following?

Pale thick skin

Moon face

Weight loss

Hypotension

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Pale thick skin is not a typical effect of long-term corticosteroid use. Corticosteroids cause skin thinning due to reduced collagen production, leading to fragile, atrophic skin prone to bruising. Thick skin is more associated with conditions like scleroderma, not the catabolic effects of corticosteroids on skin tissue.

Choice B reason: Moon face is a classic sign of long-term corticosteroid use, resulting from fat redistribution to the face due to glucocorticoid-induced lipolysis and lipogenesis. Excess cortisol promotes fat deposition in the face and trunk, creating a rounded facial appearance, a hallmark of Cushing syndrome or iatrogenic corticosteroid effects.

Choice C reason: Weight loss is not expected with long-term corticosteroid use. Corticosteroids increase appetite and promote fat redistribution, leading to weight gain, particularly in the trunk and face. Weight loss may occur in conditions like Addison’s disease, where cortisol is deficient, not in hypercortisolism states.

Choice D reason: Hypotension is not a common effect of corticosteroids. They can cause fluid retention and increased blood volume due to mineralocorticoid activity, potentially leading to hypertension. Hypotension is more associated with adrenal insufficiency, where cortisol and aldosterone deficiencies reduce vascular tone and fluid balance.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Early mobilization post-ischemic stroke is critical during recovery to prevent complications like deep vein thrombosis, pneumonia, and muscle atrophy. It promotes neuroplasticity, improves circulation, and enhances functional recovery, making it a priority intervention in the immediate recovery period to optimize outcomes and reduce disability.

Choice B reason: Maximizing PaCO2 is not appropriate post-ischemic stroke. Elevated CO2 causes cerebral vasodilation, potentially increasing ICP, which is harmful. Maintaining normal CO2 levels supports cerebral perfusion without exacerbating edema, making this intervention irrelevant or potentially dangerous in stroke recovery.

Choice C reason: Positioning to avoid ICP is more relevant for hemorrhagic stroke, where ICP is a concern. In ischemic stroke, ICP is less likely unless severe edema occurs. Early mobilization takes precedence to prevent complications and promote recovery, making ICP positioning a secondary concern.

Choice D reason: Administering hypertonic IV solutions is used in cases of cerebral edema or elevated ICP, more common in hemorrhagic stroke. In ischemic stroke, hydration with isotonic fluids supports perfusion, but early mobilization is the priority to enhance recovery and prevent immobility-related complications.

A. Decreased heart rate B. Alteration in level of consciousness (LOC) C. Slurred speech D. Bradycardia

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Decreased heart rate is a late sign in subdural hematoma, occurring with increased intracranial pressure (ICP) causing Cushing’s triad (bradycardia, hypertension, irregular breathing). Early manifestations like altered LOC appear first due to hematoma compression, making heart rate changes a secondary concern.

Choice B reason: Alteration in level of consciousness is the earliest manifestation of subdural hematoma. As the hematoma expands, it compresses brain tissue, impairing cerebral function, leading to confusion, lethargy, or reduced responsiveness. This precedes other signs like motor deficits or vital sign changes, making it the first to monitor.

Choice C reason: Slurred speech may occur in subdural hematoma if motor or speech areas are affected, but it is not the earliest sign. Altered LOC typically precedes focal neurological deficits, as hematoma compression globally impacts brain function before specific areas, making speech changes secondary.

Choice D reason: Bradycardia, like decreased heart rate, is a late sign in subdural hematoma, part of Cushing’s triad from severe ICP elevation. Early signs like altered LOC occur first due to initial brain compression, making bradycardia a later manifestation requiring urgent intervention.

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A client receiving long-term treatment with high-dose corticosteroids is expected to exhibit which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Nursing care during the immediate recovery period from an ischemic stroke should normally prioritize which intervention?

Correct Answer is A

Explanation

A client suffers a head injury. The nurse implements an assessment plan to monitor for potential subdural hematoma development. Which manifestation does the nurse anticipate seeing first?

Correct Answer is B

Explanation

A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client?

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A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be the best response by the nurse?

The nurse is assessing a new client with reports of acute fatigue and a sore tongue that is visibly smooth and beefy red. This client is demonstrating signs and symptoms associated with what form of hematologic disorder?

A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

A nurse is assisting a client who had a recent stroke with getting dressed for physical therapy. The client looks at each piece of clothing before putting it on the body. The client states, “This is how I know what item I am holding.” What impairment is this client likely experiencing?

The nurse is caring for a 13-year-old diagnosed with sickle cell anemia. The client asks the nurse what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client?

The nurse should advise a client with iron deficiency anemia to take which action to prevent staining of the teeth?