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
Octreotide is a synthetic analog of somatostatin, a hormone that inhibits the secretion of growth hormone, insulin, glucagon, and other hormones. Octreotide can cause gastrointestinal side effects such as abdominal pain, diarrhea, constipation, nausea, vomiting, and flatulence. These side effects are more common and severe with the oral route than with the injectable route.
Choice B is wrong because tinnitus, or ringing in the ears, is not a common or serious side effect of octreotide.
Choice C is wrong because alteration in consciousness is not a common or serious side effect of octreotide.
However, octreotide can affect blood glucose levels and cause hypoglycemia or hyperglycemia, which can lead to confusion, dizziness, fainting, seizures, or coma in severe cases.
Choice D is wrong because changes in vision are not a common or serious side effect of octreotide.
However, octreotide can cause rare but serious eye problems such as blurred vision, double vision, eye pain, or blindness due to optic nerve damage or retinal detachment.
These eye problems require immediate medical attention.
Normal ranges for blood glucose are 70 to 100 mg/dL (3.9 to 5.6 mmol/L) for fasting and less than 140 mg/dL (7.8 mmol/L) for postprandial.
Correct Answer is C
Explanation
Hypercalcemia is a condition caused by having too much calcium in the blood, which can affect the function of nerves, muscles, kidneys and heart. Hypercalcemia can occur in children due to various causes, both acquired and genetic. One of the most common causes of hypercalcemia in children is cancer, especially cancers that affect the bones or produce substances that mimic parathyroid hormone (PTH), which regulates calcium levels.
Choice A is wrong because liver failure does not directly cause hypercalcemia, although it can affect vitamin D metabolism and calcium absorption.
Choice B is wrong because radiation injury does not cause hypercalcemia, unless it damages the parathyroid glands or causes bone destruction.
Choice D is wrong because hypothyroidism does not cause hypercalcemia, although it can affect bone turnover and calcium excretion.
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