Which type of hemolytic anemia is categorized as an inherited disorder?

Reasoning:

Choice A reason: Pale thick skin is not a typical effect of long-term corticosteroid use. Corticosteroids cause skin thinning due to reduced collagen production, leading to fragile, atrophic skin prone to bruising. Thick skin is more associated with conditions like scleroderma, not the catabolic effects of corticosteroids on skin tissue.

Choice B reason: Moon face is a classic sign of long-term corticosteroid use, resulting from fat redistribution to the face due to glucocorticoid-induced lipolysis and lipogenesis. Excess cortisol promotes fat deposition in the face and trunk, creating a rounded facial appearance, a hallmark of Cushing syndrome or iatrogenic corticosteroid effects.

Choice C reason: Weight loss is not expected with long-term corticosteroid use. Corticosteroids increase appetite and promote fat redistribution, leading to weight gain, particularly in the trunk and face. Weight loss may occur in conditions like Addison’s disease, where cortisol is deficient, not in hypercortisolism states.

Choice D reason: Hypotension is not a common effect of corticosteroids. They can cause fluid retention and increased blood volume due to mineralocorticoid activity, potentially leading to hypertension. Hypotension is more associated with adrenal insufficiency, where cortisol and aldosterone deficiencies reduce vascular tone and fluid balance.

Reasoning:

Choice A reason: Encouraging independence without assistance in an impulsive client post-hemorrhagic stroke increases fall risk. Their lack of insight into limitations heightens injury potential. A bed alarm is safer, as it alerts staff to assist, preventing falls due to unrecognized motor or cognitive deficits.

Choice B reason: Ordering restraints like vests or wrist restraints is not the first choice, as they restrict autonomy and may increase agitation in an impulsive client. Non-invasive measures like bed alarms are preferred to prevent injury while preserving dignity and promoting safe mobility post-stroke.

Choice C reason: Encouraging family to reprimand the client for not seeking help may increase emotional distress and does not prevent injury. It fails to address impulsive behavior directly. A bed alarm proactively alerts staff to assist, reducing fall risk more effectively than behavioral reprimands.

Choice D reason: Installing a bed alarm is the priority to prevent injury in an impulsive client post-hemorrhagic stroke. It alerts staff when the client attempts to move unassisted, compensating for their lack of insight into limitations, reducing fall risk, and ensuring timely assistance for safe mobility.