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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The client should avoid taking aspirin while taking corticosteroids because of the potential drug-drug interaction between them. This interaction may cause a reduction in the blood levels of aspirin and decrease its effectiveness. It may also increase the risk of gastrointestinal side effects such as inflammation, bleeding, ulceration, and perforation.
Choice A is wrong because dimenhydrinate is an antihistamine that is used to prevent and treat nausea, vomiting, and dizziness.
It does not have a significant interaction with corticosteroids.
Choice C is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain, inflammation, and fever.
It has a similar interaction with corticosteroids as aspirin, but it is less potent and less likely to cause bleeding.
Choice D is wrong because famotidine is a histamine-2 receptor antagonist that is used to treat and prevent ulcers, gastroesophageal reflux disease (GERD), and other conditions that cause excess stomach acid.
It does not have a significant interaction with corticosteroids.
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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