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 C

Explanation

Choice A reason: Assessing color, warmth, movement, and sensation of extremities is relevant for neurological or vascular conditions, not a fluid deprivation test. This test induces dehydration to evaluate ADH function, which primarily affects fluid status and cardiovascular parameters, not peripheral limb function, making these assessments less critical for monitoring during the test.

Choice B reason: Breath and bowel sounds are not prioritized during a fluid deprivation test. The test assesses the body’s ability to concentrate urine under dehydration stress, primarily impacting fluid and cardiovascular status. Respiratory and gastrointestinal functions are not directly affected by short-term fluid restriction in diagnosing diabetes insipidus.

Choice C reason: Heart rate and blood pressure are critical during a fluid deprivation test, as dehydration from fluid restriction can cause hypovolemia, leading to tachycardia and hypotension. Monitoring these parameters ensures patient safety and detects cardiovascular responses to fluid loss, which are key to evaluating the severity of diabetes insipidus.

Choice D reason: Temperature and oxygen saturation are secondary in a fluid deprivation test. Dehydration may cause slight temperature changes, but these are not primary indicators. Oxygen saturation remains stable unless severe hypovolemia leads to shock, which is rare in a controlled setting, making these assessments less critical than cardiovascular monitoring.

A. Homonymous hemianopsia B. Receptive aphasia C. Hemiplegia D. Agnosia

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Homonymous hemianopsia causes loss of half the visual field, affecting object recognition due to visual impairment, not cognitive processing. The client’s need to inspect clothing to identify it suggests a sensory processing deficit, not a visual field loss, making agnosia more likely.

Choice B reason: Receptive aphasia impairs language comprehension, affecting the ability to understand spoken or written words, not object recognition. The client’s ability to identify clothing by inspection, not language, points to a sensory processing issue, ruling out aphasia as the primary impairment.

Choice C reason: Hemiplegia, or paralysis of one side, affects movement, not object recognition. The client’s difficulty identifying clothing is cognitive, not motor, as they can manipulate items but need visual inspection to understand them, indicating agnosia rather than a physical impairment like hemiplegia.

Choice D reason: Agnosia, a post-stroke impairment, prevents recognition of objects despite intact sensory input. The client’s need to inspect clothing to identify it suggests visual agnosia, where the brain fails to process familiar objects, matching the described behavior and indicating a perceptual deficit from stroke.

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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

The health care provider has ordered a fluid deprivation test for a client suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?

Correct Answer is C

Explanation

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?

Correct Answer is D

Explanation

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