The nurse is caring for a client who works night shift from 22:00 to 06:00 and normally sleeps from 08:00 (8 AM) until 16:00 (4 PM) each day.
The nurse should teach this client to take the prescribed corticosteroid at what time of the day?
08:00.
22:00.
06:00.
16:00.
The Correct Answer is C
This is because cortisol exhibits a proper 24-h circadian rhythm that affects the cardiovascular system and other organs. Cortisol levels are normally low at the beginning of sleep and high at the moment of awakening. Taking corticosteroids at this time mimics the natural cortisol rhythm and may reduce side effects such as adrenal suppression, sleep disturbances and cardiovascular complications.
Choice A is wrong because taking corticosteroids at 08:00 may not coincide with the client’s natural cortisol peak and may cause insomnia or unpleasant dreams.
Choice B is wrong because taking corticosteroids at 22:00 may disrupt the client’s sleep quality and increase the risk of nocturnal hypertension.
Choice D is wrong because taking corticosteroids at 16:00 may interfere with the client’s natural cortisol decline and cause hyperglycemia or dyslipidemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Diaphoresis means excessive sweating, which is one of the symptoms of hypoglycemia. Hypoglycemia occurs when the blood sugar level is lower than the normal range, which can cause dizziness, confusion, weakness, hunger, and other signs.
Choice B is wrong because flushing of the face is not a symptom of hypoglycemia.
Flushing can be caused by other conditions, such as fever, allergic reactions, or rosacea.
Choice C is wrong because fruity breath is a symptom of hyperglycemia, not hypoglycemia.
Hyperglycemia means high blood sugar level, which can cause the body to produce ketones that give the breath a fruity odor.
Choice D is wrong because unpredictable behaviors are not a specific symptom of hypoglycemia.
However, hypoglycemia can cause confusion, irritability, or anxiety, which may affect the behavior of some people.
The normal range of blood sugar level for most people is between 70 and 130 mg/dL (3.9 and 7.2 mmol/L) before meals and less than 180 mg/dL (10 mmol/L) after meals.
However, this may vary depending on the individual and the type of diabetes.
It is important to monitor the blood sugar level regularly and treat hypoglycemia promptly by eating or drinking a simple sugar source.
Correct Answer is A
Explanation
Phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines are a class of drugs that have antipsychotic, antiemetic, and sedative effects. They act by blocking dopamine receptors in the brain and can cause extrapyramidal symptoms, hypotension, and anticholinergic effects.
Choice B is wrong because phenothiazines are not contraindicated in patients with ischemic heart disease.
However, they can cause orthostatic hypotension and cardiac arrhythmias, so they should be used with caution and monitored closely in these patients.
Choice C is wrong because phenothiazines are not contraindicated in pediatric patients.
However, they can cause sedation, hypotension, and extrapyramidal symptoms, so they should be used with caution and at lower doses in these patients.
Choice D is wrong because phenothiazines are not contraindicated in patients with type 2 diabetes.
However, they can cause hyperglycemia and weight gain, so they should be used with caution and monitored closely in these patients.
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