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 B
Explanation
Metoclopramide is a medication that increases muscle contractions in the upper digestive tract and speeds up the rate at which the stomach empties into the intestines. It is used to treat gastroparesis (slow stomach emptying) in people with diabetes, which can cause heartburn and stomach discomfort after meals.
Choice A is wrong because impaction is a condition where a large mass of dry, hard stool becomes stuck in the rectum and cannot be passed.
Metoclopramide does not treat impaction, but laxatives or enemas may be used instead.
Choice C is wrong because encopresis is a condition where a child over the age of 4 has involuntary bowel movements, usually due to chronic constipation.
Metoclopramide does not treat encopresis, but behavioral therapy, laxatives, or dietary changes may be used instead.
Choice D is wrong because metoclopramide is not used for clients requiring diagnostic procedures involving the stomach or intestines.
However, it may be used to prevent nausea and vomiting caused by chemotherapy or surgery.
Correct Answer is A
Explanation
800 mg PO at bedtime is an appropriate dosage and frequency of cimetidine for the treatment of gastric ulcer. Cimetidine is a histamine H antagonist that reduces the secretion of gastric acid.
Choice B is wrong because 150 mg PO b.i.d. is too low of a dose for cimetidine. The usual adult dose for duodenal ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
Choice C is wrong because 20 mg PO b.i.d. is not a valid dose for cimetidine.
The lowest available tablet strength is 100 mg.
Choice D is wrong because 300 mg PO at bedtime is also too low of a dose for cimetidine.
The usual adult dose for gastric ulcer is 800 mg PO once a day at bedtime or 300 mg PO four times a day.
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