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
Prednisone is a glucocorticoid that suppresses the production of natural cortisol by the adrenal glands. Taking prednisone on alternate days allows the adrenal glands to recover and produce some cortisol on the days without prednisone.
Choice B is wrong because prednisone does not eliminate adverse side effects, but may cause some such as weight gain, fluid retention, increased blood pressure, increased blood glucose, and increased risk of infection.
Choice C is wrong because there is no evidence of steroid tolerance, which means that higher doses are needed to achieve the same effect.
Choice D is wrong because prednisone does not prolong therapeutic effects, but may decrease them over time due to feedback inhibition of cortisol secretion.
Normal ranges for cortisol are 6 to 23 mcg/dL in the morning and 2 to 11 mcg/dL in the afternoon.
Correct Answer is D
Explanation
Oxygen cannot diffuse rapidly across the membrane to tissues in the eye. Diabetic retinopathy is caused by damage to the blood vessels of the retina, which is the light-sensitive tissue at the back of the eye. This damage can reduce the oxygen supply to the retina and lead to vision problems.
Choice A is wrong because cells in the eye can reproduce normally, but they may not function properly due to high blood sugar levels or lack of oxygen.
Choice B is wrong because diabetic retinopathy does not affect the production of aqueous humor, which is the fluid that fills the front part of the eye.
However, diabetes can cause another eye condition called glaucoma, which is caused by increased pressure from too much aqueous humor.
Choice C is wrong because diabetic retinopathy does not affect the nerve innervations throughout the eye.
However, diabetes can cause another eye condition called diabetic neuropathy, which is caused by damage to the nerves that control eye movement and pupil dilation.
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