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.

Answer and Explanation

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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Correct Answer is B

Explanation

This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.

Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.

The dose adjustment should be based on serum theophylline levels and clinical response.

Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.

Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.

Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.

The dose of theophylline should be carefully titrated according to serum levels and clinical response.

A. A client being treated for a traumatic brain injury. B. A client with a history of ischemic heart disease. C. A pediatric client. D. A client with type 2 diabetes.

Correct Answer is A

Explanation

This is because phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines can cause central nervous system effects such as drowsiness, dizziness, and extrapyramidal symptoms that may worsen the condition of a client with a brain injury.

Choice B is wrong because phenothiazines are not contraindicated in clients with ischemic heart disease.

However, they should be used with caution as they can cause hypotension and cardiac arrhythmias.

Choice C is wrong because phenothiazines are not contraindicated in pediatric clients.

However, they should be used with caution as they can cause sedation, anticholinergic effects, and paradoxical excitement.

Choice D is wrong because phenothiazines are not contraindicated in clients with type 2 diabetes.

However, they should be used with caution as they can cause hyperglycemia and alter the effects of antidiabetic drugs.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms. What change may need to be made to the client’s theophylline dose?

Correct Answer is B

Explanation

For which client would the use of a phenothiazine most likely be contraindicated?

Correct Answer is A

Explanation

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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?